The Curbsiders Internal Medicine Podcast

#135 Perioperative Medicine

January 14, 2019
85 min

Optimize perioperative risk and dominate perioperative medicine. Topics include surgical risk calculators, preoperative labs, stress testing, use of BNP and troponins, postoperative MI, cardiac and pulmonary risk stratification, and more! We’re joined by perioperative medicine expert, Avital O’Glasser MD, Associate Professor of Medicine at Oregon Health & Science University and Assistant Program Director for Scholarship and Social Media. ACP members can visit to claim free CME-MOC credit for this episode and show notes (goes live 0900 EST).

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Written and produced by: Matthew Watto MD

CME questions by: Matthew Watto MD

Hosts: Matthew Watto MD, Stuart Brigham MD

Edited by: Matthew Watto MD

Guest: Avital O’Glasser MD

Time Stamps

  • 00:00 Disclaimer, intro and guest bio
  • 04:20 Guest one-liner, book and movie recommendations, career advice
  • 11:20 ACP Internal Medicine Meeting 2019 details
  • 14:02 Patient with coronary artery calcifications going for elective hip surgery and wants "clearance"
  • 20:50 Functional capacity
  • 25:00 Preoperative stress testing and coronary revascularization
  • 31:55 Canadian guidelines, BNP and troponin testing
  • 36:30 The METS trial and predicting perioperative cardiac events and mortality
  • 40:44 Preoperative testing (labs, imaging, urine studies)
  • 50:24 Choosing your perioperative cardiac and surgical risk calculator (RCRI, MICA, ACS-NSQIP)
  • 59:50 Communicating risk to patient and their surgeon
  • 61:30 Pulmonary risk assessment and complications
  • 70:35 Perioperative use of opioids
  • 75:30 Who needs an echocardiogram prior to surgery?
  • 79:00 Canceling a patient's surgery
  • 82:55 Take home points
  • 83:45 Outro

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