Perioperative medicine, the challenges, the rewards and the future

In this piece we discuss the latest news in medical publishing with Hugh Hemmings, editor-in-chief of the British Journal of Anaesthesia and Laszlo Vutskits, editor of Anesthesiology. We discuss the increasing volume of manuscripts being received by journals; the challenges of peer review, and initiatives to find and support new reviewers. Then we delve into the use of AI by authors and journals, and how this might influence publishing in the future. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Dr Hugh Hemmings, Joseph F. Artusio Jr. Professor and Chair, Department of Anesthesiology, Weill-Cornell Medicine, New York, USA, and Dr Laszlo Vutskits, Head of Pediatric Anesthesia at the Department of Anesthesiology, Pharmacology and Intensive Care at the University Hospital of Geneva, Switzerland.

In this piece we discuss perioperative medicine with Alana Flexman, an anaesthetist and researcher from Vancouver, Canada, and Maryanne Balkin, an anaesthetist and law graduate from Melbourne, Australia. We explore our guests’ career journeys, and gender and equity issues, including unconscious bias and bullying, harassment, and discrimination, in the workplace. Finally we talk about the craziness and joy of continued learning and enquiry. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Dr Alana Flexman, Clinical Associate Professor, Department of Anesthesiology, Pharmacology and Therapeutics, University of British Columbia, and St. Paul’s Hospital/Providence Health Care, Vancouver, Canada, and Dr Maryanne Balkin, Consultant Anaesthetist, Alfred Health, Melbourne, Australia.

In this piece we discuss risk in medicine with Kevin Fong, a consultant anaesthetist, retrieval medicine specialist, and broadcaster. In a wide-ranging conversation we talk about risk in anaesthesia, the effect of adverse events on individual practitioners and teams, and workforce issues in health. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with Professor Kevin Fong, Consultant Anaesthetist and Anaesthetic Lead for Major Incident Preparedness, University College London Hospitals, and Professor of Engagement and Innovation for Science and Medicine at University College London.

In this piece we discuss all things EEG with Chris Connor, an anesthesiologist and researcher from Boston, USA, and Jamie Sleigh, an anesthesiologist and researcher from Hamilton, New Zealand. We start by discussing the engineering behind the BIS algorithm, then move to interpreting the raw EEG, the spectrogram and burst suppression. Finally we discuss the ‘titration paradox’ and how it might influence research and AI. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Dr Chris Connor, Assistant Professor and Vice Chair ad interim for Research, Brigham and Women’s Hospital, Boston, USA, and Professor Jamie Sleigh, Professor of Anaesthesiology and Intensive Care, Waikato Clinical School, University of Auckland, New Zealand.

In this piece we discuss blood management in emergency and elective surgery with Matthew Wiles, an anaesthetist from Sheffield, UK, and editor of the journal Anaesthesia, and Catherine Downs, an anaesthetist from Sydney, Australia. The episode delves into haemorrhage associated with trauma and major surgery, and the benefits of point of care testing. We also took the opportunity to discuss authorship of scholarly work and the need to support emerging researchers and site collaborators. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Dr Matthew Wiles, Consultant Anaesthetist and Clinical Lead for Major Trauma, Sheffield Hospitals NHS Foundation Trust, and Honorary Senior Clinical Lecturer, Sheffield University, Sheffield, UK, and Dr Catherine Downs, Consultant Anaesthetist, Prince of Wales Hospital, and Senior Lecturer, Randwick Clinical Campus, University of New South Wales, Sydney, Australia

In this piece we discuss sustainability in healthcare with Eugenie Kayak, an anaesthetist from Melbourne, Australia, and Dan Lazzari, an anaesthetist from Cairns, Australia. The episode delves into Eugenie’s journey with Doctors for the Environment Australia and her work as an educator in sustainability. We discuss national and international solutions, and local initiatives by Dan and his colleagues to improve sustainability and reduce operating room waste in Cairns. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor Eugenie Kayak, Enterprise Professor in Sustainable Healthcare, University of Melbourne, and Dr Daniele Lazzari, Consultant Anaesthetist, Cairns Hospital, Australia.

In this piece we discuss perioperative medicine with Ramani Moonesinghe, an anaesthetist and intensive care specialist from London, England, and Phuong Markman, an anaesthetist from Cairns, Australia. We explore access to and outcomes from surgery, particularly in relation to remoteness and socioeconomic deprivation. Then we talk about specific interventions to improve the patient experience, such as Sip til Send, and the challenges of implementing the program and demonstrating that it’s safe with respect to aspiration. Finally we discuss whether AI and robotics can assist patients in the perioperative journey. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor Ramani Moonesinghe, Professor of Perioperative Medicine, University College London, National Director of Patient Safety and National Clinical Director for Critical and Perioperative Care, NHS England, and Dr Phuong Markman, Consultant Anaesthetist, Cairns Hospital, Australia.

In this piece we discuss pain medicine with Nadine Attal, a neurologist and pain medicine specialist from France, and Allen Finley, an anesthesiologist and pain medicine specialist from Canada. The episode delves into neuropathic pain and the need to personalize its management, and efforts to standardize the management of paediatric pain in Canada. We talk about the ICD-11 which recognizes chronic pain as a disease, and ChildKind.org which nurtures holistic and responsive support for children or all ages and abilities. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor Nadine Attal, Director for the Center of Evaluation and Treatment of Pain, Ambroise Paré Hospital, Paris, France, and Professor Allen Finley, Professor of Anesthesia and Psychology at Dalhousie University, and Medical Director of Pediatric Pain Management at IWK Health Centre in Halifax.

In this piece we discuss prevention of intraoperative hypothermia with Holly Tonkin, a trainee anaesthetist from Australia. Holly describes her study, in which she measured the prevalence of hypothermia using routine forced air warming and then the prevalence using the 3M™ Bair Hugger™ Universal Warming Gown. Significant reductions in hypothermia were observed. Holly’s study was supported by Solventum. We then discussed the value of trainee research. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guest, Dr Holly Tonkin, Manning Base Hospital and Royal North Shore Hospital, New South Wales, Australia.

In this piece we discuss hot topics in anaesthesia and pain medicine with David Story, President of the Australian and New Zealand College of Anaesthetists and Dilip Kapur, Dean of the Faculty of Pain Medicine. The episode delves into the exciting presentations and events at the meeting, and discusses ‘Future proofing’ through developing emerging leaders, supporting research and advocating for sustainability in healthcare in Australia and New Zealand. Presented by Andy Cumpstey and Kate Leslie on location at the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine in Cairns, Australia, with their guests, Professor David Story, Chair, Department of Critical Care, University of Melbourne, and Dr Dilip Kapur, a pain medicine from South Australia.