Perioperative medicine tutorial of the month [POMTOM]

Tutorial of the month


Perioperative Chronic Pain Management - USA Perspective

Dr Bridger Bach and William Lane

6th Dec 2018

Definitions for chronic pain in published studies include: continuous or recurrent pain persisting beyond expected normal healing time [5], self-reported “chronic pain”, pain lasting greater than 1 month, greater than 3 months, greater than 6 months, greater than 1 year, and pain present on more than 15 days a month [1]. Guidelines from the American Society of Anesthesiologists define chronic pain as pain of any etiology not directly related to neoplastic involvement, associated with a chronic medical condition or extending in duration beyond the expected temporal boundary of tissue injury and normal healing, and adversely affecting the function or well-being of the individual [6].


Non Cardiac Implantable Devices

Dr Manpreet Singh and Dr Arihant Jain

9th Nov 2018

In recent years there has been explosion in the use of noncardiac implantable electronic medical devices with various indications pouring in from the new research. As an anaesthetist, we are very likely to encounter patients with these devices. Not only coming through our theatre doors but also in other areas like radiology, endoscopy suite and intensive care. In the absence of anaesthetic guidelines for non-cardiac electronic medical devices, anaesthetists should ensure risk reduction strategies to enhance patient safety. This article will describe the various non-cardiac devices available and their vulnerability to various environments.


Spinal Opioids

Dr Katyayani Katyayani

12th Oct 2018

Despite the widespread use of intrathecal opioids, there is still neither clear evidence, nor a consensus among anaesthetists, regarding the optimal dose of intrathecal opioids for postoperative pain relief. This review examines some of the key aspects of the use of intrathecal opioids for acute postoperative analgesia.


Perioperative Cardiac Investigations - Indications and Interpretation

Dr Lucy Stacey

5th Sep 2018

An accurate assessment of cardiovascular function is fundamental when assessing fitness for anaesthesia and surgery. Cardiac investigations enable anaesthetists and surgeons to risk stratify patients and plan for post operative care.


Perioperative Care of the Pregnant Patient

Dr Alisha Allana

30 August 2018

A pregnant woman may require surgery at any stage. This patient poses both clinical and ethical challenges for the anaesthetist, not only during the moments of childbirth and labour, but perhaps more importantly when we encounter these individuals during nonobstetric surgery. The immense variations in physiology and anatomy, and therefore pharmacology, need to be taken into account when forming a management plan. This includes staffing, training, equipment, drugs and above all, an insight into the difficulties that may arise when anaesthetising a pregnant patient.

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