@@MaxFeinsteinMD would you know if a patient had a seizure on the table if you gave them a paralytic ? Could you tell with those forehead stickers ? lol sorry I have no clue what they are called.
Wow, so much insight I am really interested in anesthesia, as a medical student, and this definitely enlightens the specialty! Thanks for the awesome content!
I just had my robotic hysterectomy last week. Good insight into your field. I remember during one of my OR clinical rotations decades ago, one famous neurosurgeon required that classical music would be playing when he entered the theater. Good experience.
I'm in my fifth year in medical university in Europe. I have been considering anesthesiology for some time, and your videos have additionally pushed my opinion towards the field. Thank you for the fun and informative videos, forever a subscriber!
You nailed it on the segment on neurosurgery! I’m undergoing my second DBS (Right thalamic lead placement) on the 18th of May. My left thalamic was performed on Oct 20, 2020. I have gone from not being able to write and perform everyday functions to having almost no tremor on my right side at all! The ensuite CT scanner will assist them in finding the “sweet spot” place the lead!
What a nice young man! I have been in the operating room many times and did not pay a lot of attention to who does what. I use to get canula oxygen but last time I got some kind of breathing tube. It sparked my interest and I found you on RUclips. I have binge watched all your videos. Your presentation is so interesting to me. I am retired (72). Thanks for your kindness. The knowledge is great!
Hi David, I really appreciate the nice feedback! Glad you enjoyed learning more about anesthesia through these videos, it's something that not many people know much about despite how interesting it is!
I am glad to learn! You always meet the anesthesiologist before the doctor and surgery but I never knew what questions I could ask. One time I did ask what medication I was getting and he said Propofol. I always try to see how long I can stay awake. Lol. I also like to look around the operating room to see if I can see the instruments they will use. Thanks to you, next time I will ask a lot more questions. I always got a cannula for oxygen until last time. They put me to sleep without oxygen. I know I got some type of breathing tube after I was out. I use to pass out if I saw a needle! Haha. I am not afraid anymore. I will be watching your postings. Have a Great day and thanks again.
As a med student, I simply adore your videos! I am studying in Germany and I work as a Student Helper in the OR, assisting in Gynecological Surgeries and listening to you gives me a lot of joy, as I rarely chat with the anesthesiologists. This only makes me more interested in their work, so thank you!
Thanks for watching! Glad you enjoyed the videos. You should chat up the anesthesiologists (when they look relatively unoccupied) and I bet they'd be excited to share some insight into what they do. That's how I got into the field! Best wishes to you.
Interesting topic! I haven’t seen any other RUclips videos on this topic. I was able to learn a few new things! Thank you for taking the time to put out this content! I very much enjoy your videos 😊.
Great, super thorough video. I'm an inpatient pharmacist, and I fell in love with sedation/pain/paralytic management during my ICU rotations. I really appreciate all that you do to help educate the general community, in such a friendly and inviting way. Keep up the amazing work!
Thanks for the nice feedback! I am always very happy to have a pharmacist on rounds with us whenever I do ICU rotations. You all know *so much* and offer a really unique understanding to the team.
Of course!! That's also so kind of you to say. I think anesthesiologists know and respect medications to a similar degree as us pharmacists do, which I've always admired. I love the collaborative aspects of rounds, and love being able to interact with you all as well. Love your videos, I look forward to the future videos to come!
Thanks very much! Yes, I'd like to keep the videos made primarily for medical students, although at some point I may make some intended for patients who are curious about anesthesia. We'll see!
You channel is a lot of help. Because I want to be an anesthesiologist in the future and I’m only in high school. your helping me with an early start thx!!
I'm a final year Anesthesia resident in india. It's really interesting to see how anesthesia is practiced in other countries through your informative channel!
I can see how and why you'd like to have music playing in the background. First of all, there's strength in music. Secondly, certain types of music can help you focus more on the task at hand. When I worked as a nurse, I played smooth jazz on the computer I was using. It gave me greater focus on my documentation and writing new MD orders. Very effective. Another good video Max.
Anesthesiologists are probably very tired at the end of the day. U guys focus on the monitor so much. Like driving for a while u get tired from focusing
Brilliantly explication 🎉💪🏻 I’m a medical student from Ecuador 🇪🇨 I admire you! I really interested in anesthesiology resident all because your videos !!
Glad you enjoyed! Thanks for watching. I actually spent a year in Cali, Colombia, very close to Ecuador but never made it across the border. Hopefully one of these days!
Wow, that’s a whole lot of information you all need to know. But as a patient who has been on the table countless times, I’m sure thankful you all know everything you have to know. Being someone who has had dozens of surgeries on the head alone, man, I’m quite thankful that you all are so thorough and knowledgeable. Who knows what would go wrong if I was in the care of someone who was a quack.
As a prospective MD student!! I just have to say your videos are very very informative! Almost makes us feel as if we’re present there with you!!! Superb!!!!
Hi Alyssa, even I had no idea how much went into anesthesia until I did a rotation in medical school. Glad you're enjoying the videos! Thanks for watching.
This is one of your older videos but I've been watching a lot of them. I had spine surgery and was intubated and and probably paralyzed and I was given some serious drugs and had a hard time coming down in the recovery room and an outpatient procedure turned into a 3 day hospital stay. I cried for no reason, I couldn't see right, I couldn't think right and I threw up after I'd been taken to my room. In the OR when the Dr. asked "are you ready" I was going to say "good night" but I was out the instant I said "yes, I'm ready."
Thank you again Dr. Feinstein. I knew that you had to know about medications, reactions with other meds, what medications a patient takes and body weight. I did not know the mind blowing amount of all these other factors you have to learn and remember. Holy crap!
My days in the OR mid 1950’s, the anaesthetist had a Boyle’s anaesthetic machine, no electricity required. Other equipment in the OR was a diathermy unit, suction pump, and not much else requiring electricity. Things changed when we started open heart surgery using the Melrose By-Pass Machine-1957. Over the past 12 months I have had several spinal surgeries-so very familiar with the equipment in a neuro theatre as a patient-having a good look round, thanks to my anaesthetist. A huge contrast to my OR days so long ago. Greetings from Tasmania Australia. Very interesting series.
This really helps me when reporting and supporting anesthesia services and the administrative side of medicine. Dr. Feinstein is my friend. We have never met and he doesn't know it yet, but he is, and we will work together soon.
Ive worked in the theatre environment. I’ve had two gynae surgeries, two ankle arthriscopies and an ankle replacement with spinal. Usually with a shot of madaz, after a bit the anaesthetist realises I’m ok and I’ve had my own screen to watch what is happening and discussions with the surgeon! Love spinals!! No post anaesthetic complication!
Wonderful video. You are a gifted educator. Oh and by the way that Bose speaker delivers some terrific tunes. Several people in my family have that one.
@12:00 the last surgery I had, I went in, the surgeon himself was in his early 60s... I get wheeled into the OR and hear rap music being played, I myself like all types of music, but truly I laughed and it helped put me at ease. Laughter is the best medicine and truly it pulled any anxiety off of me, and as you have said that is a big deal.
This is a great video. I am a medical equipment planner. I plan all of the eq in hospitals. OR and anesthesia eq is some of the most critical eq we plan. I talk with anesthesia about what is needed but I don’t often know exactly why it’s needed. This a great info. I laugh about the provider chairs because the chairs are often a very important piece of eq to get correct. Of course for comfort.
Yes I got a donut craving while making this lol. Thanks for the nice feedback. I have a go-to Spotify station called "Operating Room Mix", but I've also been known to put on Bad Bunny radio. Also like to throw in tropical house, especially in ortho rooms because they seem to be particularly down with house music hah.
Hi Dr. Feinstein, I have watched all your videos on here and I’m hooked and find them fascinating. I’m getting ready to have back surgery on 9/7. I’m having a Laminectomy on my L4/L5. I noticed you touched a bit on how the Prone position is a difficult and very intricate situation with watching intubation and leads. I’m a big person, I’m 6’0 and I’m on the overweight side of the scale, but I’m pretty healthy as far as co morbidities go. Anything tips? Also I’m usually a hard stick (for IV’s). So Even though this is my like 16th surgery with general, Im a little nervous with the position and placement of IV. Thank you for all your content! I absolutely love watching it and you have such a great demeanor and knowledge. A very calming sense about all things anesthesia. Sure wish you were gonna be my Anesthesiologist! Stay well, and continue making great content. LeeAnn- Las Vegas,NV
Hi LeeAnn, I totally understand your concerns, and I think these are great questions to discuss with your anesthesiologist prior to surgery. While I can’t provide any specifics, it’s extremely likely that your anesthesiologist is very accustomed to these types of surgeries and how to safely position patients for them.
First it was AM/FM radios, then boomboxes, then really nice stereos with CD players and sound systems with speakers in the walls & ceilings to Bluetooth playlists. A wide variety of musical choices; from surgeons who want absolute quiet to surgeons that play some unique music & played it extra loud. Music played during the day vs. during emergency surgery at 0300. I was amazed how the RN “a.k.a. The DJ” could change the music from classic rock to a mellow jazz and make some surgeons calm down. But alas, I worked in a different time & culture of the OR. Back when different surgeons (& their behaviors) were tolerated. I do miss it all, especially being scrubbed the whole shift & relieving person after person at the end of their shifts. RN (ret), CNOR (E)
I recently had a kidney stone procedure and told my anesthesiologist that he was the most important member in the OR since he was responsible for putting me under but also waking me up.
I think everyone in the OR plays an important role-- without the surgeon, anesthesiologist, or nurses, they surgery couldn't happen, so everyone is essential!
How do you decide what drugs to use and how to set the OR table and other things when the person will get more than one procedure done at the same time? Thank you for the video; it was very interesting!
Not very often would be have 2 different types of surgery at the one time, electively. Setup of the bed etc depends on location of surgical area on body and where the doctors will stand so there is enough room for the trolleys of equipment too
@@MaxFeinsteinMD you all do an amazing job! Thank you. I also think getting thrown in the deep end helped. I tested negative thank god. But when family history comes up, it's always one of those oh god moments.
Max, would you talk about precautions taken to prevent injury, specifically related to POSITIONING? A review of equipment needed would be helpful. Thank you.
Also other neurosurgery suites have intraoperative MRI. You need medical equipment that are MR-compatible or MR-conditional (but it needs to be distanced from the giant magnet).
Hey Max, with the working around the CT scanner do you have to use longer lines or "extensions " perhaps? And are there quick couplers to disconnect those connections? Love your channel, very cool to watch.
Hi Wayne, we do use extensions on our IV tubing, and our ventilator circuit tubing is accordion-like so we can extend it pretty far. Our monitor cables are pretty long by default, so we don't need extensions. Thanks for watching!
Wow you sure make it interesting to become an anesthesiologist!. Thank you for all your information. I feel better about going into sedation from now on.
My husband watched my entire csection. I asked about 20 min after our son was born if they were almost finished.... “your stomach is laying on your chest”. 🤦🏻♀️ I have had an anterior/posterior spine surgery, a lithotripsy, & hysterectomy.... been in all these positions! Geez.
@@MaxFeinsteinMD It's no problem - I enjoy your videos/insights you provide about anesthesiology and appreciate the work you put in. Keep up the great work!
Ty this has helped iam having gallbladder surgery on 26th of August I am complex case with some server health issues plus high chance due to state of gallbladder they hoping key hole but been warned it might be open as I've had a server pneumothorax in the past they are worried about the pressure with me bottom of lung never re inflated
How many slices was the ct scanner u showed in the vid? Very cool. I know a lot about this stuff and very interesting. How many mri scanners do u have at the hospital and what field strength? I know ur an anesthesiologist but I would love to know how many mri scanners this hospital has. Take care bud
Dr Feinstein, you were talking about a partner getting woozy during a C section...have you ever gotten sick during a surgery and had to leave the operating room?
Great question- hasn't happened to me yet, but if it does, my first move would be to call for backup anesthesia help and hand over the reigns to someone else.
Very interesting. I’ve had numerous surgeries and General anesthesia makes me very nauseous. After my hysterectomy, I threw up for hours. What causes that?
Sorry you've had that experience. I'm not sure what mechanisms underlie post-op nausea/vomiting, but I can tell you that some of the top risk factors include the following, which it sounds like you meet at least a few: Young, female, non-smoker, gynecologic surgery.
In my experience, whoever starts playing music first is the one who keeps playing it. It's usually not a contentious issue as long as everyone in the room is okay with music during the case.
When my wife had a C-section it was interesting to watch the anesthesiologist. He just exuded calm and confidence and it was like God up there at the head of the table. I was very impressed.
I like your matter of fact presentations. I have been a patient many times. I was so curious one time that I actually talked the Anesthesiologist into letting me push the Mdazzlem or was it propofol into my I.V. & less than a minute later was Goodnight.
9:51 Partner / Husband passing out during C-Section . Maybe to have a special chair for them that has " safety belts " . To keep them in the chair , not falling into the surgical field or onto the floor , but being fully restrained , but comfortable enough .
Hi. Dr.Max. can you share /video on OR Recovery. Recovery area still under Anes Dr right? Type of recovery? Terms PACU(post Anes) compare to just Recovery(normal). Recovery for surgical/endoscopy etc. Type of monitoring equipment. Medical gasses. Some area in recovery required GA machine? Thanks.
I would like for you to make a video of spinal surgery and anesthesia and all it takes to get the patients ready for surgery I had lower back surgery and I don’t remember to much about the tings they done to me before surgery I recall just same things they were doing to me
One of the big ones I didn’t discuss in this video is significantly increased airway pressures because the abdominal contents are pressing against the diaphragm. This has the same implications as laparoscopic and robotic surgery (decreased venous return to the heart). There may be other implications that I haven’t learned about yet tho!
@@MaxFeinsteinMD Got it. I was pimped by an OB attending regarding the use of NG tubes by anesthesiologists after difficult intubations when trendelenburg would be used in Gyn surgeries. Maybe the same principal of the abdominal organs (air filled stomach) pressing back onto the diaphragm?
Max likes music in the OR. Surgeon: Turn that crap off! Nurse to Surgeon: Don’t make Max angry... You wouldn’t like him when he’s angry. Max’ eyes start to glow green Surgeon: Turn it up! Let’s BOOOOGAY!
Thanks for following along! I'll have to get back to you in a couple years about which one is the hardest. But from talking with my seniors, it seems like they get easier as you move along in residency.
Depends what you mean by memorize- there are so many facts about one single drug (brand name, generic name, mechanism of action, duration of action, alpha half-life, beta half-life, side effects etc etc) but I don’t know all of that information for each drug yet. I know a lot about the drugs I use most commonly, and a reasonable amount about other drugs. Overall, I’d say I’ve studied maybe 150-200 different drugs.
what do you do when people wake up during surgery? does it happen often? I heard once someone felt all the pain during there surgery. how often does that happen?
Hi Charlize, these are great questions. It’s intuitive to think about being anesthetized as a binary thing, where someone is either awake/conscious/remembering or completely under general anesthesia. In reality, anesthesia is more of a continuum, and typically patients are so deeply anesthetized for surgery that there’s no quick way of being fully conscious or making new memories. It’s not unusual for a patient to become “light” during surgery, in which case we simply give a little more of whichever med(s) we’re using for anesthesia. That lightness may manifest as a bit of purposeless muscle movement or increased blood pressure, but it’s extraordinarily rare for anyone to have any subjectively meaningful about of consciousness until we turn off the anesthesia. Hope that helps!
Hi I had a PSA procedure on April 5, 2021 and was put under general anesthesia. After the surgery the doctor informed me the an oxygen tube was inserted in my throat and that my throat will feel scratchy and coarse. That did happen and lasted for over a week. My question is could they have used a different type of oxygen tube or a different lubricant to avoid the after effects which occurred to me ?
Great question. There have actually been quite a few studies done looking at whether spraying local anesthetic on the vocal cords and trachea before intubation decrease sore throat after intubation. Results have been mixed (some say it's helpful, others don't) but the major study that combined all of the other ones (aka a "meta analysis") indicates that the local anesthetic doesn't make a difference.
I was placed in a prone position when I had an elbow ORIF to repair my olecranon process. I wondered how they maintain those things when you are face down. They put me out before they moved me to the operating table.
Hi Linn, the type of anesthesia given for dental work is really dependent on what the dentist/surgeon decides is most appropriate. It's not unusual to have general anesthesia for dental procedures. If you do receive general anesthesia, you'll probably receive the same typical medication(s) that are used for inducing general anesthesia for other types of surgery. Best of luck!
@@MaxFeinsteinMD Thank you so much for answering me! :) Had a few surgery's but never for dental work. I have MAJOR dental fear so ill be under while they do a lot of work, like root canal fillings. Again, THANK YOU! :D
Do surgeons ever complain about music playing overhead or usually enjoy it as well? I’ve had many many surgeries and never would have guessed music would be playing in there lol. I always assume it’s quiet with the doctor occasionally giving orders and what not
I’m having robotic surgery later this morning and honestly this helped calm my nerves a bit, thank you! Your videos are great 💗
Best wishes for your surgery!
@@MaxFeinsteinMD Thank you 🙏🏻💗!
@@christinabalbuena458 How did it go?
@@christinabalbuena458 That well? Wow.
As a pediatric neurosurgery patient, this was very interesting and informative! Thank you!
Glad you enjoyed, thanks for watching!
@@MaxFeinsteinMD would you know if a patient had a seizure on the table if you gave them a paralytic ? Could you tell with those forehead stickers ? lol sorry I have no clue what they are called.
@@user-iw1oj6to4r A Bis Monitor and EEG I think
Wow, so much insight I am really interested in anesthesia, as a medical student, and this definitely enlightens the specialty! Thanks for the awesome content!
You're very welcome! Glad this has been a good way of seeing more of the specialty- that's the goal.
I just had my robotic hysterectomy last week. Good insight into your field. I remember during one of my OR clinical rotations decades ago, one famous neurosurgeon required that classical music would be playing when he entered the theater. Good experience.
I'm in my fifth year in medical university in Europe. I have been considering anesthesiology for some time, and your videos have additionally pushed my opinion towards the field. Thank you for the fun and informative videos, forever a subscriber!
Do it do it! Haha thanks for watching, glad you found the videos helpful!
You are so amazing! You need your own tv show. Thank you for making people feel better.
Thanks for the nice feedback!
You nailed it on the segment on neurosurgery! I’m undergoing my second DBS (Right thalamic lead placement) on the 18th of May. My left thalamic was performed on Oct 20, 2020. I have gone from not being able to write and perform everyday functions to having almost no tremor on my right side at all! The ensuite CT scanner will assist them in finding the “sweet spot” place the lead!
What a nice young man! I have been in the operating room many times and did not pay a lot of attention to who does what. I use to get canula oxygen but last time I got some kind of breathing tube. It sparked my interest and I found you on RUclips. I have binge watched all your videos. Your presentation is so interesting to me. I am retired (72). Thanks for your kindness. The knowledge is great!
Hi David, I really appreciate the nice feedback! Glad you enjoyed learning more about anesthesia through these videos, it's something that not many people know much about despite how interesting it is!
I am glad to learn! You always meet the anesthesiologist before the doctor and surgery but I never knew what questions I could ask. One time I did ask what medication I was getting and he said Propofol. I always try to see how long I can stay awake. Lol. I also like to look around the operating room to see if I can see the instruments they will use. Thanks to you, next time I will ask a lot more questions. I always got a cannula for oxygen until last time. They put me to sleep without oxygen. I know I got some type of breathing tube after I was out. I use to pass out if I saw a needle! Haha. I am not afraid anymore. I will be watching your postings. Have a Great day and thanks again.
As a med student, I simply adore your videos! I am studying in Germany and I work as a Student Helper in the OR, assisting in Gynecological Surgeries and listening to you gives me a lot of joy, as I rarely chat with the anesthesiologists. This only makes me more interested in their work, so thank you!
Thanks for watching! Glad you enjoyed the videos. You should chat up the anesthesiologists (when they look relatively unoccupied) and I bet they'd be excited to share some insight into what they do. That's how I got into the field! Best wishes to you.
@@MaxFeinsteinMD Well now I‘ll have plenty to ask them, because you got me interested in the subject :)
Interesting topic! I haven’t seen any other RUclips videos on this topic. I was able to learn a few new things! Thank you for taking the time to put out this content! I very much enjoy your videos 😊.
Glad you enjoyed them! Thanks for the nice feedback.
Great, super thorough video. I'm an inpatient pharmacist, and I fell in love with sedation/pain/paralytic management during my ICU rotations. I really appreciate all that you do to help educate the general community, in such a friendly and inviting way. Keep up the amazing work!
Thanks for the nice feedback! I am always very happy to have a pharmacist on rounds with us whenever I do ICU rotations. You all know *so much* and offer a really unique understanding to the team.
Of course!! That's also so kind of you to say. I think anesthesiologists know and respect medications to a similar degree as us pharmacists do, which I've always admired. I love the collaborative aspects of rounds, and love being able to interact with you all as well. Love your videos, I look forward to the future videos to come!
Another great video Max! I'm so grateful your videos have stayed educational to the medical school and residency levels :)
Thanks very much! Yes, I'd like to keep the videos made primarily for medical students, although at some point I may make some intended for patients who are curious about anesthesia. We'll see!
You channel is a lot of help. Because I want to be an anesthesiologist in the future and I’m only in high school. your helping me with an early start thx!!
Hi Tibou, that's awesome to hear! Best of luck on your future career in anesthesiology!
I'm a final year Anesthesia resident in india. It's really interesting to see how anesthesia is practiced in other countries through your informative channel!
I can see how and why you'd like to have music playing in the background. First of all, there's strength in music. Secondly, certain types of music can help you focus more on the task at hand. When I worked as a nurse, I played smooth jazz on the computer I was using. It gave me greater focus on my documentation and writing new MD orders. Very effective. Another good video Max.
That donut ct scanner looks delicious 😋
I thought so, too. Might be stale, though.
Haha yes now I really want a donut.
Anesthesiologists are probably very tired at the end of the day. U guys focus on the monitor so much. Like driving for a while u get tired from focusing
As a pediatric brain tumor survivor this was really interesting to watch. I know for me I was laying on my stomach as my tumor was in my cerebellum
Wow I can't even imagine. Glad to know you made it through!
Brilliantly explication 🎉💪🏻 I’m a medical student from Ecuador 🇪🇨 I admire you! I really interested in anesthesiology resident all because your videos !!
Glad you enjoyed! Thanks for watching. I actually spent a year in Cali, Colombia, very close to Ecuador but never made it across the border. Hopefully one of these days!
Wow, that’s a whole lot of information you all need to know. But as a patient who has been on the table countless times, I’m sure thankful you all know everything you have to know. Being someone who has had dozens of surgeries on the head alone, man, I’m quite thankful that you all are so thorough and knowledgeable. Who knows what would go wrong if I was in the care of someone who was a quack.
Glad you've had positive experiences with your surgeries! Thanks for the nice feedback, I appreciate it.
As a prospective MD student!! I just have to say your videos are very very informative! Almost makes us feel as if we’re present there with you!!! Superb!!!!
Glad you're enjoying them! Best wishes on your journey to becoming an MD.
I definitely did not realize how much goes into anesthesia. This was super interesting! I love all of your videos!
Hi Alyssa, even I had no idea how much went into anesthesia until I did a rotation in medical school. Glad you're enjoying the videos! Thanks for watching.
This is one of your older videos but I've been watching a lot of them. I had spine surgery and was intubated and and probably paralyzed and I was given some serious drugs and had a hard time coming down in the recovery room and an outpatient procedure turned into a 3 day hospital stay. I cried for no reason, I couldn't see right, I couldn't think right and I threw up after I'd been taken to my room. In the OR when the Dr. asked "are you ready" I was going to say "good night" but I was out the instant I said "yes, I'm ready."
I'm a teacher, nothing close to what you do everyday.. and yet I can't stop watching your videos. Thanks for being so informative!
As a former pediatric cancer patient I enjoy all of your content
Thank you and best wishes for your treatments, Grant!
Thank you again Dr. Feinstein. I knew that you had to know about medications, reactions with other meds, what medications a patient takes and body weight. I did not know the mind blowing amount of all these other factors you have to learn and remember. Holy crap!
As a PREmed student, I enjoy watching your videos. They are very informative and give me a sense of "I can do this." (:
My days in the OR mid 1950’s, the anaesthetist had a Boyle’s anaesthetic machine, no electricity required. Other equipment in the OR was a diathermy unit, suction pump, and not much else requiring electricity. Things changed when we started open heart surgery using the Melrose By-Pass Machine-1957. Over the past 12 months I have had several spinal surgeries-so very familiar with the equipment in a neuro theatre as a patient-having a good look round, thanks to my anaesthetist. A huge contrast to my OR days so long ago. Greetings from Tasmania Australia. Very interesting series.
This really helps me when reporting and supporting anesthesia services and the administrative side of medicine.
Dr. Feinstein is my friend. We have never met and he doesn't know it yet, but he is, and we will work together soon.
I had a shunt implanted in 2004, and I remember coming into the operating room to Queen, we will rock you. It was great
Ive worked in the theatre environment. I’ve had two gynae surgeries, two ankle arthriscopies and an ankle replacement with spinal. Usually with a shot of madaz, after a bit the anaesthetist realises I’m ok and I’ve had my own screen to watch what is happening and discussions with the surgeon! Love spinals!! No post anaesthetic complication!
Then you’d know it is Midaz...short for Midazolam. Also many complications from spinal...
Thanks for the explanation.
I’m preparing for a procedure and understanding some nuts and bolts is comforting to me.
Wonderful video. You are a gifted educator. Oh and by the way that Bose speaker delivers some terrific tunes. Several people in my family have that one.
Thanks for the nice feedback! Glad you enjoyed the video. I agree, that Bose speaker is fantastic for how small it is!
@12:00 the last surgery I had, I went in, the surgeon himself was in his early 60s... I get wheeled into the OR and hear rap music being played, I myself like all types of music, but truly I laughed and it helped put me at ease. Laughter is the best medicine and truly it pulled any anxiety off of me, and as you have said that is a big deal.
Awesome video Dr. Max. Really nice insight on some of the things you would never think of outside of that scenario
Thanks for the nice feedback Rory!
Thank you for your efforts trying to teach us! I've learned a lot while I'm still a med student
This is a great video. I am a medical equipment planner. I plan all of the eq in hospitals. OR and anesthesia eq is some of the most critical eq we plan. I talk with anesthesia about what is needed but I don’t often know exactly why it’s needed. This a great info. I laugh about the provider chairs because the chairs are often a very important piece of eq to get correct. Of course for comfort.
Interesting as always! Love your job
Wow! This video was very informative and interesting as well!:)
Glad you enjoyed it
Your videos are extremely well done and fascinating. Your presentation and diction are excellent.
That doughnut made me hungry for sweets! LOL Great vid. Explained very well. Thank you. What kind of music do you listen to while on a case?
Yes I got a donut craving while making this lol. Thanks for the nice feedback.
I have a go-to Spotify station called "Operating Room Mix", but I've also been known to put on Bad Bunny radio. Also like to throw in tropical house, especially in ortho rooms because they seem to be particularly down with house music hah.
Hi Dr. Feinstein,
I have watched all your videos on here and I’m hooked and find them fascinating. I’m getting ready to have back surgery on 9/7. I’m having a Laminectomy on my L4/L5. I noticed you touched a bit on how the Prone position is a difficult and very intricate situation with watching intubation and leads. I’m a big person, I’m 6’0 and I’m on the overweight side of the scale, but I’m pretty healthy as far as co morbidities go. Anything tips? Also I’m usually a hard stick (for IV’s). So Even though this is my like 16th surgery with general, Im a little nervous with the position and placement of IV.
Thank you for all your content! I absolutely love watching it and you have such a great demeanor and knowledge. A very calming sense about all things anesthesia. Sure wish you were gonna be my Anesthesiologist!
Stay well, and continue making great content.
LeeAnn- Las Vegas,NV
Hi LeeAnn, I totally understand your concerns, and I think these are great questions to discuss with your anesthesiologist prior to surgery. While I can’t provide any specifics, it’s extremely likely that your anesthesiologist is very accustomed to these types of surgeries and how to safely position patients for them.
First it was AM/FM radios, then boomboxes, then really nice stereos with CD players and sound systems with speakers in the walls & ceilings to Bluetooth playlists. A wide variety of musical choices; from surgeons who want absolute quiet to surgeons that play some unique music & played it extra loud. Music played during the day vs. during emergency surgery at 0300. I was amazed how the RN “a.k.a. The DJ” could change the music from classic rock to a mellow jazz and make some surgeons calm down. But alas, I worked in a different time & culture of the OR. Back when different surgeons (& their behaviors) were tolerated. I do miss it all, especially being scrubbed the whole shift & relieving person after person at the end of their shifts. RN (ret), CNOR (E)
I recently had a kidney stone procedure and told my anesthesiologist that he was the most important member in the OR since he was responsible for putting me under but also waking me up.
I think everyone in the OR plays an important role-- without the surgeon, anesthesiologist, or nurses, they surgery couldn't happen, so everyone is essential!
I love these in detail videos!
Glad you enjoyed! Thanks for watching.
How do you decide what drugs to use and how to set the OR table and other things when the person will get more than one procedure done at the same time? Thank you for the video; it was very interesting!
Not very often would be have 2 different types of surgery at the one time, electively. Setup of the bed etc depends on location of surgical area on body and where the doctors will stand so there is enough room for the trolleys of equipment too
As someone who's first surgery was awake at 14. I soon learned to get over that fear of surgery ever again.
It was the malignant hyperthermia biopsy.
Even many adults who undergo multiple surgeries don't get over their fear!
@@MaxFeinsteinMD you all do an amazing job! Thank you.
I also think getting thrown in the deep end helped.
I tested negative thank god. But when family history comes up, it's always one of those oh god moments.
Max, would you talk about precautions taken to prevent injury, specifically related to POSITIONING?
A review of equipment needed would be helpful.
Thank you.
Also other neurosurgery suites have intraoperative MRI. You need medical equipment that are MR-compatible or MR-conditional (but it needs to be distanced from the giant magnet).
Cool! I've given anesthesia during MRI but not for neurosurgery.
Hey Max, with the working around the CT scanner do you have to use longer lines or "extensions " perhaps? And are there quick couplers to disconnect those connections?
Love your channel, very cool to watch.
Hi Wayne, we do use extensions on our IV tubing, and our ventilator circuit tubing is accordion-like so we can extend it pretty far. Our monitor cables are pretty long by default, so we don't need extensions. Thanks for watching!
I had no idea there was so much involved in being an anesthesiologist
Your content and presentation is exceptionall! What a great service younprovude⭐🏆
Wow you sure make it interesting to become an anesthesiologist!. Thank you for all your information. I feel better about going into sedation from now on.
My husband watched my entire csection. I asked about 20 min after our son was born if they were almost finished.... “your stomach is laying on your chest”. 🤦🏻♀️
I have had an anterior/posterior spine surgery, a lithotripsy, & hysterectomy.... been in all these positions! Geez.
Max: *Spends hours filming and editing video*
Me after watching it in 13 minutes: MOAR!
Haha my rate limiting step is the editing which takes much longer than it probably should
@@MaxFeinsteinMD It's no problem - I enjoy your videos/insights you provide about anesthesiology and appreciate the work you put in. Keep up the great work!
Very interesting I never have thought about this extremely important part of surgery
Very well explained.thank you so much 😘
Glad it was helpful!
Ty this has helped iam having gallbladder surgery on 26th of August I am complex case with some server health issues plus high chance due to state of gallbladder they hoping key hole but been warned it might be open as I've had a server pneumothorax in the past they are worried about the pressure with me bottom of lung never re inflated
How many slices was the ct scanner u showed in the vid? Very cool. I know a lot about this stuff and very interesting. How many mri scanners do u have at the hospital and what field strength? I know ur an anesthesiologist but I would love to know how many mri scanners this hospital has. Take care bud
You're a book of knowledge
I wish! I'm just trying to absorb actual books of knowledge haha.
Dr Feinstein, you were talking about a partner getting woozy during a C section...have you ever gotten sick during a surgery and had to leave the operating room?
Great question- hasn't happened to me yet, but if it does, my first move would be to call for backup anesthesia help and hand over the reigns to someone else.
Thank you so much ! You are a great teacher!
Thanks for watching, Sharon!
Very interesting. I’ve had numerous surgeries and General anesthesia makes me very nauseous. After my hysterectomy, I threw up for hours. What causes that?
Sorry you've had that experience. I'm not sure what mechanisms underlie post-op nausea/vomiting, but I can tell you that some of the top risk factors include the following, which it sounds like you meet at least a few: Young, female, non-smoker, gynecologic surgery.
I once had surgery and it took alot to wake me up. Long time in recovery. Any sudjestions????
In another instance of surgery, they said I talked alot at least tried to.
Doctor, Who decides what/who's music is played in the OR? Especially if you are using the overhead vs tableside speakers.
In my experience, whoever starts playing music first is the one who keeps playing it. It's usually not a contentious issue as long as everyone in the room is okay with music during the case.
When my wife had a C-section it was interesting to watch the anesthesiologist. He just exuded calm and confidence and it was like God up there at the head of the table. I was very impressed.
You should do a video on CRNA or interview a CRNA.
That's a great idea, I'd like to one of these days.
I like your matter of fact presentations. I have been a patient many times. I was so curious one time
that I actually talked the Anesthesiologist into letting me push the Mdazzlem or was it propofol into my I.V. & less than a minute later was Goodnight.
9:51 Partner / Husband passing out during C-Section . Maybe to have a special chair for them that has " safety belts " . To keep them in the chair , not falling into the surgical field or onto the floor , but being fully restrained , but comfortable enough .
Excellent video.
Thanks David, appreciate you following along since the beginning!
Thanks! This is amazing!!!! All types of cool careers.
Can you make a video about anesthesia assistants , about they do and how a day looks for them and you
Hi. Dr.Max. can you share /video on OR Recovery. Recovery area still under Anes Dr right? Type of recovery? Terms PACU(post Anes) compare to just Recovery(normal). Recovery for surgical/endoscopy etc. Type of monitoring equipment. Medical gasses. Some area in recovery required GA machine? Thanks.
This is a great idea, thank you Yusl! I will eventually make a video about PACU and the role and anesthesiologists have.
I would like for you to make a video of spinal surgery and anesthesia and all it takes to get the patients ready for surgery I had lower back surgery and I don’t remember to much about the tings they done to me before surgery I recall just same things they were doing to me
Max, are there additional hemodynamic implications of steep trendelenburg for prolonged periods of time?
One of the big ones I didn’t discuss in this video is significantly increased airway pressures because the abdominal contents are pressing against the diaphragm. This has the same implications as laparoscopic and robotic surgery (decreased venous return to the heart). There may be other implications that I haven’t learned about yet tho!
@@MaxFeinsteinMD Got it. I was pimped by an OB attending regarding the use of NG tubes by anesthesiologists after difficult intubations when trendelenburg would be used in Gyn surgeries. Maybe the same principal of the abdominal organs (air filled stomach) pressing back onto the diaphragm?
So very interesting. Thank you
Are patients always intubated?
Throat or neck surgery?
Max likes music in the OR.
Surgeon: Turn that crap off!
Nurse to Surgeon: Don’t make Max angry... You wouldn’t like him when he’s angry.
Max’ eyes start to glow green
Surgeon: Turn it up! Let’s BOOOOGAY!
LOL thanks for writing my next video script
Love your spirit bro!
Hello. If a patient needed to be defribulated who would do this? You or the surgeon? And would you be tag teaming interventions? Thank you.
That would be the anesthesiologist, contrary to what Grey’s Anatomy would have most people believe haha.
Thanks. Your videos are amazing.
Can you make a video of your life outside work?
That's a good idea, it's definitely something I'll think about in the future!
Do you plan on making a video about the mid-level encroachment debate or anything related? I’d love to hear your thoughts!
Hi big fan!
ALSO, What is the hardest year on the Anesthesiologist career? I feel like Its the 4-year Studying.
Thanks for following along! I'll have to get back to you in a couple years about which one is the hardest. But from talking with my seniors, it seems like they get easier as you move along in residency.
The robotics chair is a rebranded "gaming chair" (really a racing seat), that's hilarious
I have a question. When a cardiac bypass machine ia used, why are the lungs not ventilated allowing collapsed lungs?
How many drugs did you need to memorize and how hard was it to remember all of them when practicing?
Depends what you mean by memorize- there are so many facts about one single drug (brand name, generic name, mechanism of action, duration of action, alpha half-life, beta half-life, side effects etc etc) but I don’t know all of that information for each drug yet. I know a lot about the drugs I use most commonly, and a reasonable amount about other drugs. Overall, I’d say I’ve studied maybe 150-200 different drugs.
Omg this is very informative!
Glad you enjoyed!
Didn't expect surgeons to have a gamer chair at the robot controls lol
what do you do when people wake up during surgery? does it happen often? I heard once someone felt all the pain during there surgery. how often does that happen?
Hi Charlize, these are great questions. It’s intuitive to think about being anesthetized as a binary thing, where someone is either awake/conscious/remembering or completely under general anesthesia. In reality, anesthesia is more of a continuum, and typically patients are so deeply anesthetized for surgery that there’s no quick way of being fully conscious or making new memories. It’s not unusual for a patient to become “light” during surgery, in which case we simply give a little more of whichever med(s) we’re using for anesthesia. That lightness may manifest as a bit of purposeless muscle movement or increased blood pressure, but it’s extraordinarily rare for anyone to have any subjectively meaningful about of consciousness until we turn off the anesthesia. Hope that helps!
Are there any considerations if the patient is sitting? I have had 2 cervical laminectomies sitting both times
Hi
I had a PSA procedure on April 5, 2021 and was put under general anesthesia. After the surgery the doctor informed me the an oxygen tube was inserted in my throat and that my throat will feel scratchy and coarse. That did happen and lasted for over a week. My question is could they have used a different type of oxygen tube or a different lubricant to avoid the after effects which occurred to me ?
Great question. There have actually been quite a few studies done looking at whether spraying local anesthetic on the vocal cords and trachea before intubation decrease sore throat after intubation. Results have been mixed (some say it's helpful, others don't) but the major study that combined all of the other ones (aka a "meta analysis") indicates that the local anesthetic doesn't make a difference.
@@MaxFeinsteinMD
What about the size and shape or rather the top and end of the oxygen tube, would that have any effect ?
The size definitely would. Shape may although I think that’s less likely.
You are the business
Awesome dr
I was placed in a prone position when I had an elbow ORIF to repair my olecranon process. I wondered how they maintain those things when you are face down. They put me out before they moved me to the operating table.
I am going under for dental work (Not normal in Norway) to do multiple things. Is that usually the same way of going under as general?
Hi Linn, the type of anesthesia given for dental work is really dependent on what the dentist/surgeon decides is most appropriate. It's not unusual to have general anesthesia for dental procedures. If you do receive general anesthesia, you'll probably receive the same typical medication(s) that are used for inducing general anesthesia for other types of surgery. Best of luck!
@@MaxFeinsteinMD Thank you so much for answering me! :) Had a few surgery's but never for dental work. I have MAJOR dental fear so ill be under while they do a lot of work, like root canal fillings. Again, THANK YOU! :D
Can you do a vidoe for Anesthesia used for sedated MRI
What is cell saver and when/why do we see it?
Another great video.
Have you done and Hydrocephalus surgeries and is it harder to do things when several different surgeons are all in there?
Do you have to account for baby/babies during a c-section, with regards to anaesthesia?
Seems like just the tip of the iceberg. Really hope this is the beginning of a series. #SimTribe
Thanks! I'd love to do more videos like this as I make my way through residency.
@@MaxFeinsteinMD Awesome!
I would put some Funeral Doom Metal through that speakers during a surgery, if I would be an aenesteziologist. Best to have a propper atmosphere.
Do surgeons ever complain about music playing overhead or usually enjoy it as well? I’ve had many many surgeries and never would have guessed music would be playing in there lol. I always assume it’s quiet with the doctor occasionally giving orders and what not
Very informative
Do u always place an orogastric tube when head down for robotics