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Manu B @nitrousman75.bsky.social · 18/09/2026

So ~ 99% patients on GLP-1’s had no event .Some of that 11-fold increase in aspiration / regurgitation would be the population, not the drug ?

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Manu B @nitrousman75.bsky.social · 14/09/2026

For prevention of delirium. Seems to make a difference.

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Manu B @nitrousman75.bsky.social · 14/09/2026

I suppose the real limitation of this study is the dose of dexmeditomidine . Something that the author argue for revising guidance to recommend judicious perioperative dexmedetomidine in older adults. I regularly use dexmed for all my older pts having surgery.

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Manu B @nitrousman75.bsky.social · 02/09/2026

Why did some of these brilliant academics who did years of training to become anaesthetists think that a few hrs of anesthesia in this case TIVA could have an affect on cancer survival rates ?

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Manu B @nitrousman75.bsky.social · 12/08/2026

Wish that was possible with my model Y juniper . Apparently the YL has an adapter than can do VTL ?

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Manu B @nitrousman75.bsky.social · 04/08/2026

Their procedures should be cancelled as discrimination is unlawful .

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Manu B @nitrousman75.bsky.social · 24/07/2026

Didn't they post their highest revenue ever but their operating costs were up by 47 % cos of the huge amounts of money Tesla is putting into AI & Optimus robots ?

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Manu B @nitrousman75.bsky.social · 27/06/2026

Has any such incident happened before ?

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Manu B @nitrousman75.bsky.social · 27/06/2026

The world seems powerless to stop this crime against humanity .

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Manu B @nitrousman75.bsky.social · 21/06/2026

Yes . end point of RSI is safely getting the tube in asap . That’s achieved by bolus of Thio > propofol > Tiva . Even at aggressive Ce conc one is waiting longer than a bolus .

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Manu B @nitrousman75.bsky.social · 10/06/2026

what was the surprise in this study ? Wasn’t it clinically obvious once sugamadex first came out how superior it was to neo/glyco .

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Manu B @nitrousman75.bsky.social · 05/05/2026

It’ll def be more by the time it’s launched here .

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Manu B @nitrousman75.bsky.social · 18/04/2026

China as well . All the uptake in EV sales .

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Manu B @nitrousman75.bsky.social · 13/04/2026

Politics definitely has . Not sure about religion ? I am with the pope here 👍

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Manu B @nitrousman75.bsky.social · 31/03/2026

These help only the top 8 % in India . India too is governed by a right wing govt headed by a “ strong “ leader like Trump , where the divide between the rich & poor is ever expanding .

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Manu B @nitrousman75.bsky.social · 20/03/2026

Do you not have a duty Anaesthetist or coordinator to give you breaks ?

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Manu B @nitrousman75.bsky.social · 06/02/2026

www.theaustralian.com.au/weekend-aust...

theaustralian.com.au

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Manu B @nitrousman75.bsky.social · 30/01/2026

I understand . Classic LMA is my default in the kind of scenario you mentioned ( difficult airway with failed B&M ) .

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Manu B @nitrousman75.bsky.social · 30/01/2026

Done it but with a smaller size classic LMA .

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Manu B @nitrousman75.bsky.social · 15/01/2026

How did they come to the conclusion it’s safe to continue ACE inhib & ARB’s on the day of surgery ?

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Manu B @nitrousman75.bsky.social · 14/12/2025

Likewise , Awake CEA ‘s & Neck dissection with flap are the MC causes of LA toxicity i’ve seen.

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Manu B @nitrousman75.bsky.social · 20/11/2025

Easy for anyone to pass comments in hindsight .

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Manu B @nitrousman75.bsky.social · 20/11/2025

M&M’s at hospitals I work don’t have the anesthetist directly involved with the incident presenting . Whoever is chairing the meeting usually presents & there’s no mention of the names of the anesthetist , surgeon . Supposed to a safe , blame free environment focused on discussion for learning .

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Manu B @nitrousman75.bsky.social · 22/10/2025

Refusal of an NG by someone who’s about to undergo a laparotomy for SBO is a difficult place to be in ,as an anesthetist ( & /or surgeon ) .

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Manu B @nitrousman75.bsky.social · 27/09/2025

used It when opioid free anesthesia was a fad for a while .Didnt continue with it . Some colleagues continued using it for abdominal surgeries but I don’t think anyone’s doing it any more ? Now use small lignocaine bolus before propofol . Also for minimizing coughing on extubation for c spines .

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Manu B @nitrousman75.bsky.social · 08/09/2025

Do you ever see muscle rigidity with such bolus doses of Remi & if so what do you do then ?

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Manu B @nitrousman75.bsky.social · 06/09/2025

Pete , I don’t do IFT & don’t know anyone that does . Maybe I should .

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Manu B @nitrousman75.bsky.social · 05/09/2025

I would add “ detect / prevent with IFT in paralyzed & look for response to commands in anesthetised patients who are not paralyzed ”.

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Manu B @nitrousman75.bsky.social · 04/09/2025

Infraclavicular Subclavian was my default before USG . I haven’t done any in 20 yrs but I don’t think I’ve lost that skill . IJ is easier with USG so have defaulted to that .

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Manu B @nitrousman75.bsky.social · 04/09/2025

IJ is my go to & USG the basic minimum std for a CVC .The exceptional circumstance you gave the only reason I mentioned landmark SCV as I feel based on my experience & skills ,I’d be losing precious time scouring for great veins with USG . Can’t comment on others opinion on this.

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Manu B @nitrousman75.bsky.social · 03/09/2025

But I wouldn’t advise it to anyone who’s never done a subclavian using landmark technique .

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Manu B @nitrousman75.bsky.social · 03/09/2025

If ever have to put a cvc in a rapidly exsanguinating haemorrhage ( never had to ) I would go for infraclavicular subclavian using landmark technique as it’s probably the only patent , easily accessible central venous access .

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Manu B @nitrousman75.bsky.social · 03/09/2025

Never heard of cvc as an essential resus device .

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Manu B @nitrousman75.bsky.social · 30/08/2025

Can I ask why the VL failed . Was it tube delivery where the problem was?

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Reposted by Manu B

Manu B @nitrousman75.bsky.social · 30/08/2025

I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .

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Manu B @nitrousman75.bsky.social · 30/08/2025

hypothetical situation where I’m unable to intubate , bag & mask to maintain alveolar oxygenation but can achieve the same through a SGA ( reached green zone ) then I would delegate someone to look at ASA or DAS to tell me what to do next .

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Manu B @nitrousman75.bsky.social · 30/08/2025

I still look at the ASA & DAS algorithms . Vortex model is a cognitive aid that tells you what the Goals are . It’s not telling you what to do .

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Manu B @nitrousman75.bsky.social · 30/08/2025

That’s good . For me it was post vortex & what changed ( for me ) was being able to avoid fixation errors ( eg go back to bag & mask / getting to green zone ) and priming for CICO rescue . Avoids the E Bromley type situation outcome .

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Manu B @nitrousman75.bsky.social · 30/08/2025

* Rapidly escalating high pressure situation .

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Manu B @nitrousman75.bsky.social · 30/08/2025

Also Anes nurses find it a lot easier ( to help us ) than DAS algorithms .

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Manu B @nitrousman75.bsky.social · 30/08/2025

Its is a cognitive aid & that’s what’s needed in an airway crises to avoid fixation errors . Don’t ever recollect anyone reading out a DAS algorithm in my 23 yrs in anesthesia during a dynamic , rapidly evolving situation such as an airway crises .

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Manu B @nitrousman75.bsky.social · 23/08/2025

Postop pain is so dynamic . Are there studies looking at acute immediate postop pain , pain after days , weeks , months in patients that had regional Vs those that didn’t? Perhaps that would give better information ?

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