Chris Prabhakar
@ChrisPrabhakar
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Physician, Husband, Father, Canadian. Interests include regional anesthesia, pain management, patient safety, anatomy, and ultrasound...
Vancouver, Canada
Joined September 2014
RT @RAPMOnline: Comparison of remimazolam and dexmedetomidine for intraoperative sedation in patients undergoing lower extremity surgery un….
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RT @Anaes_Journal: 🔐Local anaesthetic systemic toxicity may occur with any use of local anaesthetics. This new review from @ajrmacfarlane,….
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RT @EMARIANOMD: Thank you @ASRA_Society for this incredible honor and to my friend @nelkassabany for nominating me! . Thanks to @anesthesia….
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RT @Providence_Hlth: ICYMI: Last week, Dr. Keith Walley was recently appointed to the #OrderofCanada for his innovative and translational r….
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RT @amit_pawa: Well- who would have known. Driving home to see my mum, and we stumbled across this little place, in the UK! Thanks to a t….
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RT @mick_kerr: We often only show our "good blocks". Here's a close call with the femoral nerve and some lessons learnt from it. #uglyblock….
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RT @_Anesthesiology: Understanding minimum alveolar concentration and fraction of minimum alveolar concentration helps clinicians titrate v….
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RT @CAS_RegAnes: Excellent #CASAM2023 regional anesthesia and pain mgmt poster session!. Highlights:.- PVB vs ESP RCT for breast ca surgery….
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RT @jon_bailey_anes: Recently I’ve been trying out types of analogue block simulators. Here’s my thoughts on meat vs ballistics gel.#regi….
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RT @antonchau1: Congratulations to @DrTimJen - 2023 recipient of the CAS Dr James Beckstead Award for his work on PIFB RCT! Well deserved!….
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RT @jon_bailey_anes: End #CASAM23 on a high note!. Register for the @CAS_IEF pub night:.🍔 good food.🍻 good beer.🥳 great conversation. Suppo….
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RT @CAS_RegAnes: 💡Another #CASAM2023 Workshop Highlight:."Chest wall blocks" . 🔥Featuring top-notch faculty:.@rljohnsonmd @ChrisPrabhakar @….
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RT @jon_bailey_anes: @DalAnesthesia RA group Hot Ones challenge with .@garrettsbarry @glauncel @szerbj @Ropivacaine @MKwesiKwofie . Best qu….
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The reality of this situation for me is that in a stat case I am not thinking of Mg. I would want to focus on how to get it administered ASAP in Maternity as soon as CS is called. But I am going to think about using it more now, so thanks Ron!.
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if I were to have a conversation with this pt and say I could give her Mg that might reduce risk of a lifelong neurologic condition in her child, but might also cause a bit of temporary hypotension, flushing, bleeding, prolonged ventilation, I think I know what she would pick.
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Other potential benefits?. How about possible less IVH?.How about better pain management (especially in a stat GA CS)?.
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NDMB potentiation? Nothing that a little prolonged ventilation and/or sugammadex. Any other significant harms? Only mild ones reported in the SRMAs of the fetal neuroprotection and pre-eclampsia trials.
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Uterine atony and increased bleeding? Not as per this SRMA of over 40,000 women.
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Of course I don't have clinical data suggesting benefit when given on induction of a stat C/S. Likely will never have it. so next question is what's the harm?.
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So, is there benefit when within minutes of delivery? If the propofol is hitting the brain, then presumably the Mg is hitting the placenta, no? In this cord-gas study Mg levels were not statistically lower in the <20min group compared to other groups.
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