The Anesthesia Playbook | TAP

A 31-year-old woman at 24 weeks gestation needs urgent surgery. Now every decision in your anesthetic has another layer.When does aspiration risk become significant? When should you use left uterine displacement? How does fetal viability change your monitoring? Which vasopressor would you reach for when the blood pressure falls? And if your pregnant patient arrests in the OR, when does resuscitative delivery become part of maternal ACLS?In this episode of The Anesthesia Playbook, we work through the case the way you might with a resident in the OR—one decision at a time. Along the way, we break down the physiologic changes of pregnancy that actually matter to your anesthetic, difficult airway considerations, uteroplacental perfusion, laparoscopy, fetal monitoring, medication choices, neuromuscular reversal, and postoperative care.The goal isn't to memorize a separate anesthetic for pregnancy. It's to understand the physiology well enough to defend your decisions when the case changes.Understand more. Memorize less.

A 38-kilogram patient. A recent coronary stent. An ankle fracture that can’t wait much longer.At an outpatient surgery center, the plan seems straightforward: assess the cardiac risk, develop an anesthetic plan, control her postoperative pain, and get her safely home.But a few subtle clues begin to change the case.In this episode of The Anesthesia Playbook, we work through the case in real time—making decisions, challenging assumptions, and adapting as new information emerges.If you’re preparing for oral boards, pause when the questions come up and commit to an answer before listening on.Because the important question isn’t just whether you know the right answer.It’s whether you recognize when the case has changed, and if you're able to explain your clinical reasoning. Understand more. Memorize Less.

What could go wrong during a routine sedation case?A patient presents for a seemingly straightforward procedure. She’s appropriately fasted, has no obvious aspiration risk factors, and the plan is simple: propofol sedation, spontaneous ventilation, and local anesthesia from the surgeon.Then everything changes.In this episode of The Anesthesia Playbook, we work through a case inspired by a real event and put you in the anesthesiologist’s seat as the situation evolves.What would you do next—and more importantly, why?Follow along, commit to your decisions, and see how your approach compares as the case unfolds.Understand more. Memorize less.—Want more TAP?Get the weekly TAP Case of the Week delivered to your inbox and test your clinical decision-making with a new case each week.Follow The Anesthesia Playbook on Instagram, TikTok, YouTube, and Facebook for more anesthesia cases, clinical discussions, and quick teaching.🔗 Newsletter, social channels, and more: [Click TAP link]

A 45-year-old woman with poorly controlled Graves disease presents for thyroidectomy with a massive goiter, positional dyspnea, and subtle stridor. The question isn’t just how you’re going to secure the airway—it’s what could happen if you take away the things currently keeping it open.In this episode of The Anesthesia Playbook, we work through the case from pre-op evaluation to the PACU. We’ll reason through the difficult airway, awake intubation, anesthetic planning, thyroid physiology, and the recognition and treatment of thyroid storm. Then, just when the case seems finished, new postoperative problems force us to rethink the differential: hoarseness, neck swelling, and stridor.Along the way, we’ll tackle the kinds of questions that matter both in the OR and on oral boards:Would you sedate this patient? Would you induce general anesthesia before securing the airway? How would you recognize thyroid storm—and distinguish it from malignant hyperthermia? What would you do if she developed an expanding neck hematoma after surgery?This isn’t about memorizing a list of answers. It’s about understanding the physiology, anticipating what could happen next, and making a defensible clinical decision.Follow The Anesthesia PlaybookInstagram / TikTok / YouTube: @TheAnesthesiaPlaybookWebsite: TheAnesthesiaPlaybook.comUnderstand more. Memorize less.The Anesthesia Playbook is intended for education only and does not replace clinical judgment, institutional protocols, or appropriate supervision.

In this episode of The Anesthesia Playbook, we walk through a real-world case of aortic stenosis anesthesia for a patient undergoing shoulder arthroplasty in the beach chair position.This case highlights the critical importance of hemodynamic management, myocardial oxygen supply and demand, and cerebral perfusion in patients with fixed outflow obstruction.We break down:How to manage aortic stenosis in the ORChoosing and performing an interscalene block + superficial cervical plexus blockAirway considerations including diabetic stiff joint syndrome and difficult intubationWhy phenylephrine is the pressor of choiceUnderstanding stroke volume, preload, afterload, and contractilityThe role of atrial kick and sinus rhythm in cardiac outputMyocardial ischemia from tachycardia and hypotensionRisks of the beach chair position, including cerebral hypoperfusionCerebral autoregulation and why chronic hypertension shifts the curveManaging Bezold-Jarisch reflex in shoulder surgeryThis episode is designed for anesthesia residents, CRNAs, and practicing anesthesiologists who want a clear, case-based understanding of complex physiology without memorizing textbooks.If you want to better understand how physiology applies in real cases and how to stay ahead of complications in the OR this episode is for you.

On this episode of The Anesthesia Playbook, we break down one of the most important and high-yield patients in obstetric anesthesia: the preeclamptic patient.This case-based episode walks through a real-world scenario, from labor epidural placement to urgent Cesarean section, while teaching the physiology, anesthetic decision-making, and complication management you need to understand to take care of these patients safely.We cover:The pathophysiology of preeclampsia (and why it’s more than just hypertension)Key pregnancy physiology that drives anesthetic managementEpidural vs spinal vs CSE in preeclamptic patientsPlatelet thresholds and neuraxial anesthesia considerationsPractical epidural tips in patients with scoliosisBlood pressure goals and vasopressor managementMagnesium sulfate: mechanism, benefits, and anesthetic implicationsFluid management and risk of pulmonary edemaIntraoperative management for Cesarean sectionPostoperative complications including respiratory distress and lower extremity weaknessThis episode is designed for anesthesia residents, CRNAs, and practicing anesthesiologists who want a clear, physiology-based understanding of preeclampsia and how to manage it in real clinical scenarios.If you’ve ever wondered:“Is it safe to place an epidural with low platelets?”“Why can fluids worsen preeclampsia?”“What’s the safest anesthetic for a C-section in these patients?”This episode answers those questions and more.

Studies showing benefit of using "individualized PEEP" which is often higher than convention. Another study showing benefit of individualized PEEP in abdominal surgeries.In this episode, we walk through a real-world case of an obese patient undergoing a robotic hysterectomy, and why these cases can quickly become a ventilation challenge.Obesity, pneumoperitoneum, and steep Trendelenburg create a perfect storm for decreased functional residual capacity (FRC), increased closing capacity, and worsening lung compliance. If you don’t anticipate these changes early, you’ll spend the entire case trying to catch up.We break this case down step by step, just like you should in the OR:• Identifying your biggest concerns in an obese patient undergoing robotic surgery• Defining your anesthetic goals for ventilation and oxygenation• Understanding how obesity and positioning affect FRC and closing capacity• How pneumoperitoneum and Trendelenburg worsen compliance• Using PEEP effectively to prevent atelectasis and improve oxygenation• Interpreting airway pressures, including plateau pressure and driving pressure• Recognizing and managing hypoxia in the PACUYou’ll be challenged with questions throughout the episode, forcing you to pause, think, and apply what you know in real time.Because that’s how you train your mind to respond under pressure.We also highlight key patterns you’ll see again and again:Obesity + anesthesia → decreased FRC and rapid atelectasisClosing capacity exceeding FRC → airway closure and hypoxiaLaparoscopy + Trendelenburg → decreased compliance and increased airway pressuresPoor ventilatory strategy → postoperative hypoxiaBy the end of this episode, you’ll have a clear framework for managing ventilation in obese patients undergoing robotic surgery—and a better understanding of how to stay ahead of the physiology.This episode is especially relevant for anesthesia residents and is commonly tested on written and oral board exams.The goal isn’t to give you more to memorize.It’s to change how you think.Understand more. Hesitate less.

How should you actually use The Anesthesia Playbook?In this episode, we break down the method behind the podcast, and how to use it to improve your clinical thinking in the OR.Because the problem isn’t effort.It’s the system.Most anesthesia learning is built around textbooks and isolated topics.But real anesthesia doesn’t happen one chapter at a time.It happens in patients with multiple comorbidities, evolving physiology, and real-time decision making.The Anesthesia Playbook is built differently.Each episode is structured around a real clinical case, guiding you through the same thought process you should be using every day in the operating room:• Identifying your biggest concerns• Defining your anesthetic goals• Understanding key physiology and pathology• Anticipating complications before they happen• Applying that knowledge directly back to the patientYou won’t just listen—you’ll be challenged with questions throughout each episode, forcing you to pause and think.Because that’s how you train your mind to respond under pressure.We also focus on pattern recognition and spaced repetition, so the same high-yield concepts like hemodynamics, ventilation, and pharmacology start to stick and become second nature.These episodes are designed to fit into your day:On your commuteBetween casesAt the gymOr whenever you have 20–30 minutes to learn something that actually matters.Alongside the podcast, we’ll also provide high-yield study guides and quick-reference materials to help you go deeper when you need to without wasting time.Whether you’re:• A CA-1 building your foundation• A CA-2 or CA-3 preparing for oral boards• Or an attending looking to stay sharpThis podcast is designed to help you show up prepared, think ahead, and manage cases with confidence.The goal isn’t to give you more to memorize.It’s to change how you think.Welcome to The Anesthesia Playbook.Where anesthesia stops being memorized and starts being understood.

Welcome to The Anesthesia Playbook—a modern, case-based approach to learning anesthesia.If you’ve ever struggled to get through long textbook chapters… felt unprepared walking into the OR… or found yourself memorizing facts without truly understanding how to apply them...then this is for you.Because the truth is, anesthesia isn’t learned one chapter at a time.It’s learned in real patients. Real decisions. Real moments where you have to think quickly and act with confidence.This podcast is built to help you think like an anesthesiologist.Not just pass exams.Not just memorize information.But actually understand what’s happening in front of you and what to do next.Each episode of The Anesthesia Playbook is designed around real clinical scenarios, guiding you through:• Key concerns for the patient• Goals of the anesthetic• High-yield physiology and pathology• Common and high-risk complications• Practical, real-world decision makingYou’ll be challenged with questions throughout each episode so you’re not just listening, you’re actively thinking.Because that’s how you train your mind to respond under pressure.Whether you’re:• A CA-1 trying to build a strong foundation• A CA-2 or CA-3 preparing for oral boards• Or an attending looking to stay sharpThis podcast is designed to fit into your day and improve your clinical thinking. One case at a time.With spaced repetition, high-yield concepts, and real-world application, you’ll start to recognize patterns faster, build stronger differentials, and approach cases with confidence.This is your go-to resource for:anesthesia residents, anesthesia boards, oral boards prep, physiology, pharmacology, airway management, regional anesthesia, pediatric anesthesia, critical care, and real-world OR decision making.Welcome to The Anesthesia Playbook.Where anesthesia stops being memorized… and starts being understood.