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 OR
Choosing and performing an interscalene block + superficial cervical plexus block
Airway considerations including diabetic stiff joint syndrome and difficult intubation
Why phenylephrine is the pressor of choice
Understanding stroke volume, preload, afterload, and contractility
The role of atrial kick and sinus rhythm in cardiac output
Myocardial ischemia from tachycardia and hypotension
Risks of the beach chair position, including cerebral hypoperfusion
Cerebral autoregulation and why chronic hypertension shifts the curve
Managing Bezold-Jarisch reflex in shoulder surgery
This 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.
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Dr. Blake Forkey. Innehållet i podden är skapat av Dr. Blake Forkey och inte av,
eller tillsammans med, Poddtoppen.
