Anesthesia & Analgesia

And, and so the-- it just increases the risk of post-op complication, so don't take that lightly.

Number one, of course, any CRNA, any anesthesiologist, and anybody who works with the Society of Obstetric Anesthesia Providers, um, Perineal, uh, Providers, which is SOAP, will tell you that number one is try to fix what is going on in the regional area.

Try to top that off.

Uh, you know, potentially give some, uh, a per- parenteral, uh, sedation, uh, or m- a mild amnestic.

In other words, the, the big flag there is that if you need to keep dosing the epidural or redosing it, uh, intra o- intrapartum, that, and then she goes to C-section, that's a flag that you may have to convert to general anesthesia.

All right? But isn't that interesting? 6% with spinal, 18% with combined spinal epidural, and 24% with labor epidural that had top-offs intrapartum.

The American Society of Anesthesia also states that the biggest risk of failed epidural with surgical conversion to general anesthesia is exactly that, as we discussed, with an odds ratio of 3.2, meaning the labor epidural top-offs, that chance of conversion, just, just throwing it out there, is 3.2.

So maybe something to prepare the patient for before you actually start the skin incision is like, "Hey, if this thing-- If you're starting to feel something, you gotta let us know, and then we can do things to try to minimize that.

You can see it's called Leading Infinitely.

I, at UAB, have the opportunity of leading a workshop series that I call Lead Infinitely, named after Simon Sinek's The Infinite Game and the article that I wrote in Anesthesia and Analgesia a few years ago.

you would think that it would be pretty easy to advance a curriculum, a workshop series that's built around bringing teams together to create more trusting, more cohesive, more collectively intelligent teams.

You would think that would be an idea that everyone would go, sure, yeah, we're down with that, Matt.