Anesthesia Patient Safety Podcast

#308 We Break Down The Latest Evidence On Safer Anesthesia Care

Delirium, pain, and prolonged ventilation can feel like “expected” bumps in perioperative care until you look closely at the data. We walk through four recent APSF In the Literature reviews and pull out what’s actually actionable for anesthesia patient safety right now, with clear numbers and real-world implications. First, we dig into a randomized controlled trial of S-ketamine for elderly patients undergoing total hip or total knee arthroplasty under neuraxial anesthesia. With general anesthesia out of the equation, the study reports a notable drop in postoperative delirium, raising practical questions about when S-ketamine belongs in your plan and how you weigh neuroprotection alongside analgesia. Next, we shift to the ICU after cardiac surgery and examine evidence on dexmedetomidine sedation and duration of invasive mechanical ventilation. We talk through the key nuance: dexmedetomidine is associated with longer ventilation overall, yet may shorten ventilation time in patients with a high “sedation burden,” highlighting how stacking sedatives can change the outcome you’re trying to optimize. We then move to labor and delivery with a large prospective cohort on pain during cesarean delivery with neuraxial anesthesia, including higher risk with urgent cases and epidural top-ups, plus an important signal on language and the need for interpreters. We close with a pediatric trial where EEG-guided sevoflurane titration reduces emergence delirium and speeds recovery in the PACU. Subscribe for weekly, evidence-focused anesthesia insights, share this with a colleague, and leave a review so more clinicians can find the latest perioperative patient safety updates. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/308-we-break-down-the-latest-evidence-on-safer-anesthesia-care/ [https://www.apsf.org/podcast/308-we-break-down-the-latest-evidence-on-safer-anesthesia-care/] © 2026, The Anesthesia Patient Safety Foundation

#307 Perioperative Safety In Low And Middle-Income Countries

The world has the knowledge to make anesthesia safer, but too often it’s the basics that are missing where the need is greatest. We’re talking about perioperative patient safety in low- and middle-income countries (LMICs), where a smaller share of surgical volume can still carry a massive share of perioperative death and disability. That imbalance isn’t inevitable, and it isn’t solved by one tool or one training course. It changes when systems change.  We walk through the biggest systemic barriers starting with anesthesia workforce shortages and the downstream effects on access, delays, and confidence in care. We also dig into national surgical, obstetric, and anesthesia plans (NSOAPs) and how partnerships with organizations like the World Health Organization and the World Federation of Societies of Anesthesiologists can help countries set targets, build capacity, and track progress.  From there, we get painfully practical: monitors, oxygen, essential medicines, and rescue drugs. We discuss the WHO Surgical Safety Checklist, what makes implementation succeed, and why the WFSA International Standards for a Safe Practice of Anesthesia matter as both a minimum safety floor and a roadmap for improvement. We close on a critical question for quality improvement everywhere: how do you build accountability when risk-adjusted outcomes data is hard to collect, and what solutions are most realistic?  Subscribe for more anesthesia patient safety conversations, share this episode with a colleague, and leave a review so more clinicians can find the show. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/307-perioperative-safety-in-low-and-middle-income-countries/ [https://www.apsf.org/podcast/307-perioperative-safety-in-low-and-middle-income-countries/] © 2026, The Anesthesia Patient Safety Foundation

#306 Venezuelan Ancestry Anesthesia Alert

Catastrophic neurologic injury after a routine anesthetic is the kind of signal that stops you in your tracks, and that’s exactly why we’re talking about new perioperative recommendations for patients with maternal Venezuelan ancestry. We’ve seen reports of otherwise healthy adults and children who deteriorated after general anesthesia, with sevoflurane appearing repeatedly in the documented events. That pattern has led the American Society of Anesthesiologists and the Society for Pediatric Anesthesia to issue updated guidance aimed at preventing harm while the science catches up.  We walk through what clinicians need to know about the suspected mitochondrial link and why maternal lineage matters for risk assessment. We also discuss why a negative family history does not reliably protect a patient and why laboratories must be explicitly alerted to the mutation of interest because it has been historically labeled a normal variant.  Then, we get practical: how to screen for maternal Venezuelan heritage with care and sensitivity, how to explain the question without implying anything about immigration status, and how to approach anesthetic planning when definitive genetic testing is unavailable. We cover current thinking on avoiding volatile anesthetics, when regional anesthesia may help, considerations around propofol infusions, processed EEG monitoring, and postoperative observation for return to neurocognitive baseline. If this is helpful, please subscribe, share the episode with your team, and leave a review so more clinicians can find these patient safety updates. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/306-venezuelan-ancestry-anesthesia-alert/ [https://www.apsf.org/podcast/306-venezuelan-ancestry-anesthesia-alert/] © 2026, The Anesthesia Patient Safety Foundation

#305 Lead Infinitely

The fastest way to weaken patient safety isn’t a missing checklist, it’s a team that stops trusting each other. We dig into “infinite anesthesia” and the next step, “leading infinitely,” a practical relational leadership approach designed to build psychological safety, empathy, humility, and civility in perioperative care. We share why anesthesia professionals are uniquely positioned to lead across the full health system: we work at the intersection of surgeons, proceduralists, nurses, and hospital leaders, and we see how small culture signals impact big operational and safety outcomes. You’ll hear how trust-based teamwork can improve clinician well-being, strengthen system resilience, and support measurable gains in patient outcomes and retention. We also break down the Lead Infinitely workshop series and what makes it different: teams learn together, practice concrete behaviors, and graduate with a strategic plan instead of a solo certificate. The conversation moves from training to scale, including why research, early wins, and credible champions matter if this work is going to spread beyond the OR and into onboarding, governance, and daily clinical practice. If you want your workplace to feel safer, calmer, and more effective, listen now, share with a colleague, and subscribe so you don’t miss what’s next. After you listen, leave a review and tell us what leadership behavior you want to see more of on your team. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/305-lead-infinitely/ [https://www.apsf.org/podcast/305-lead-infinitely/] © 2026, The Anesthesia Patient Safety Foundation

#304 Infinite Anesthesia Is Not Unlimited Propofol

Workforce shortages and rising demand are squeezing perioperative teams from every side and that pressure can turn colleagues into rivals. We push back on that mindset and explore a different way to think about the future: “infinite anesthesia,” a long-term approach to anesthesia patient care and anesthesia patient safety that prizes trust, teamwork, and a workplace where every clinician is valued.   We share highlights from the APSF Newsletter article “Leading Infinitely in Perioperative Care” and hear directly from author, Dr. Matt Sherrer, on why relational leadership has to extend beyond anesthesia, nursing, and the operating room. When surgeons, proceduralists, and hospital leaders join the same conversation, improvement scales faster and sticks longer. We also break down the “finite vs infinite game” idea and translate it into concrete behaviors: building trusting teams, learning from worthy rivals instead of fighting them, staying flexible with systems thinking and human factors, and having the courage to name tension while still celebrating progress.   Then we get tactical with “crossing the chasm,” a model from the technology adoption lifecycle that explains why great ideas stall without early adopters and strong relationships. If poor communication drives preventable harm, civility and clear dialogue are not soft skills, they are core safety tools. We close with a candid reflection from Dr. Richard Dutton on how scope battles and politics can impair access and quality when there is already more than enough work for everyone.   Subscribe for the next conversation, share this with a colleague, and leave a review so more perioperative teams can build safer systems together. For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/304-infinite-anesthesia-is-not-unlimited-propofol/ [https://www.apsf.org/podcast/304-infinite-anesthesia-is-not-unlimited-propofol/] © 2026, The Anesthesia Patient Safety Foundation