Spoiler Alert! 3 highlights from the World Congress - ESRA

ESRA Updates

May 2023 | Issue 12

Spoiler Alert! 3 highlights from the World Congress

Jeff Gadsden (Duke University Hospital, Durham, NC, USA) @jeffgadsden
Clara Lobo (Editor of ESRA Updates; Cleveland Clinic Abu Dhabi, UAE) @claralexlobo
Ana Patrícia Pereira (ESRA Residents & Trainees Representative, Vila Real, Portugal) @_anapatriciaper

Awake spine surgery – by Jeff Gadsden

Spinal anesthesia for lumbar spine surgery is a technique that provides excellent operating conditions and patient satisfaction. The ability to avoid a general anesthetic and the requisite management of the airway is attractive to many patients. In contrast to the frequently-challenging period after emergence with spine surgery under general anesthesia, spinal anesthetic provides a “soft landing” in the early postoperative period as the block of the lumbar area recedes slowly. In this lecture, I will discuss our experience with awake lumbar spine surgery under spinal anesthesia and provide perspective on several important considerations including:

  • What does “awake spine surgery” really mean? Are all patients wide awake? Is some sedation ok? What sedative agents/plans are appropriate and safe in this setting?
  • Patient selection: Who CAN get awake spine surgery? Who should NOT be considered for awake spine surgery?
  • Communication with patient and surgeon: How to set expectations ahead of time with the patient, the surgeon, and the perioperative team?
  • Technique: The how, where, when and what of our intraoperative regimen with a recipe for success
  • Pitfalls: What can go wrong in awake spine surgery? How to predict and prepare for these
  • Outcomes: Why do we do this? Are we really making a difference? Here we discuss some of the important data that support the use of awake spine surgery in selected patients.

Regional Anaesthesia and Anticoagulation – by Clara Lobo

Regional anesthesia benefits are more than recognized by anaesthesiologists, surgeons and patients. However, whenever anticoagulation therapy is involved, there are significant concerns about the risks of bleeding complications associated with regional anaesthesia. Therefore, many international and national societies developed recommendations to help clinicians manage these patients safely.

In this presentation:

  • I will discuss the latest guidelines for the use of regional anaesthesia in patients receiving anticoagulation therapy, including the different types of blocks that may be used and the specific considerations that must be reflected.
  • I will explore the risks and benefits of both neuraxial and peripheral nerve blocks and provide an overview of the different anticoagulant medications that may be used in these patients.
  • Additionally, I will discuss the importance of risk stratification and careful monitoring during the procedure to ensure that bleeding complications are identified and managed appropriately.

Hopefully, by the end of this presentation, you will have a clear understanding of the guidelines for regional anaesthesia and anticoagulation and will be better equipped to manage these patients in your clinical practice.

À bientôt!
See you in Paris!!

The Trainee Corner – by Ana Patrícia Pereira

The Trainee Corner has been a success since it’s creation in Bilbao back in 2019, bringing trainees together over coffee and an ultrasound machine.
And now, it’s back for the #ESRAWorld2023 with exciting activities, games and surprises!

If you are attending ESRA’s annual meeting in Paris, the Trainee Corner is a must-visit networking spot. Either to find a friendly face to guide you on which lectures to attend, share experiences, catch-up with colleagues from around the world and hear about their projects and realities, or simply just to take a break and escape from the crowd and have a nice chat over coffee while chillin’ at our sofas.

During the event, you will be able to meet and interact closely with some of the best experts in the field, while they perform live ultrasound sessions at our booth during lunch breaks, practice your scanning and needling skills, learn practical tips and tricks, attend our amazing Quiz and win very cool prizes, and stay up-to-date on the latest research projects.

Also, we hope to be even closer to you through daily pop-up notifications advertising the Corner’s activities and/or a WhatsApp group for real-time communication.

The Trainee Corner fosters the opportunity to learn and connect with your peers and experts in a safe and relaxed space, while celebrating regional anaesthesia and friendship. It is definitely a reason why trainees, amongst others, should come to Paris, France in September 2023. Stay tuned for more details!

To learn more and register, please visit esraworld2023.com.

Topics: Regional Anaesthesia , Congress , ESRA Congress , Awake Spine Surgery , Anticoagulation

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