Perioperative Medicine Podcast Series

Blood pressure is one number every anaesthetist watches in every single case but there remains discussion about the 'right' number to defend. Professor Paul Myles joins us to discuss the findings of the PeriOperative Quality Initiative (POQI) international consensus statement on perioperative arterial pressure management.

Chapters
00:00 Introduction: Prof Paul Myles and the POQI consensus
00:59 Why is blood pressure still contested?
03:03 How the POQI consensus process works
04:11 Is there a safe threshold? The autoregulation curve
06:41 Association vs causation in the evidence
08:40 What the randomised trials show
10:44 The new target: MAP 60–65 mmHg
11:45 Which patients need a higher pressure?
13:07 Brief severe vs prolonged moderate hypotension
14:58 The hidden risk: hypotension on the ward
16:13 Continuous monitoring and IV fluids after surgery
18:05 Who owns the first 24 hours after surgery?
20:00 Pre-operative hypertension: cancel or proceed?
23:17 Open questions: which vasopressor is best?
24:21 The case for noradrenaline
26:07 Wrap-up and resources

Every minute lost in an operating theatre is a minute a patient waited for nothing. Dr Sandeep Rakhra joins us to discuss ways in which we can all improve the efficiency of the operating theatres in which we work.

00:00 Welcome and introductions
02:53 Lists, turnover and recovery
08:08 Culture, safety and cost
13:20 On-time starts and add-ons
20:40 Tips and the OTIQ course

How can we design healthcare systems that help people deliver safer care? In this episode of the PeriopMed Podcast, we look ahead to the 2027 Monash University Human Factors and Patient Safety Conference, exploring its theme: 'Adaptive systems by design: humans, technology, safer care.' Bringing together healthcare professionals, researchers and Human Factors practitioners, the conference offers opportunities to connect, exchange ideas and develop practical approaches to improving patient and staff safety. Join the conference on 18–19 March 2027 at Sofitel Melbourne, with separately registered pre-conference workshops on 17 March. Explore the program and register: https://monash-hf2027.com.au

Hypertrophic Cardiomyopathy (HCM) is a condition that often causes concern for anaesthetists and perioperative clinicians. Dr Stuart Hastings joins us to discuss the perioperative management of patients with a history of this complex condition, who require noncardiac surgery.

Special guest Belinda Macleod-Smith joins us to discuss the important role of including patients and their loved ones in the process of designing new policies, processes, and models of care.

Dr Priya Rao is a Specialist Anaesthetist at Western Health, with a special interest in obstetric anaesthesia. She joins us to discuss birth trauma, and the important role of the anaesthetist in mitigating the psychological impact of a negative birthing experience.

Critical incidents can have a significant psychological impact on those involved. Such incidents are rare but it is important to have a process in place to enable those involved in such an event to have the opportunity to debrief in a safe and supportive environment. The 'hot debrief' is one such process.

Dr Katrina Pirie is an anaesthetist who is currently completing a PhD on analgesia for abdominal surgery. She joins us to discuss her research, with a focus on intrathecal opioids for minimally invasive surgery.

In 2024 Alfred Health launched an innovative multidisciplinary Perioperative Medical Service to improve the care of surgical patients. In this podcast we talk to Nadine Laurent and Stephanie Jinks, Clinical Nurse Consultants on the Perioperative Service, about the pivotal role nursing staff play as part of the perioperative team.

Prof Warren Clements and Assoc Prof Jim Koukounaras discuss the rapidly expanding role of interventional radiologists in patient care and expertise they bring to the perioperative team.

Professor Warren Clements is an interventional radiologist and researcher at the Alfred hospital and Monash University. In this podcast, Warren discusses the seven habits that he regards as important in helping to become a highly effective clinician-scientist.

If you have just been told that you need an operation, you're now at the start of a surgical journey. It may be a short journey or it may be a long one, but either way this podcast series is here to help you.

A Just Culture in the workplace means that everyone should feel safe to speak up, and leads to open and honest communication, systems thinking, engagement, and participation, where everyone is involved in making improvements. Professor Janet Anderson and Garry Mann, our Human Factors team, talk to Yooralla’s Director of Just Culture Miranda Cornelissen, about the benefits of implementing a Just Culture in the workplace.

The GLP-1 agonists have been generating much discussion and a degree of consternation in the Perioperative Medicine community. Our panel of experts discusses the mode of action, indications, and perioperative implications of this class of medications.

Thuy Bui is the Lead Pharmacist of the Analgesic Stewardship and Perioperative Medicine Services at the Alfred. She discusses the very important role of the pharmacist in all stages of the Perioperative process.

Any patient undergoing a procedure or intervention should be provided with an explanation of the procedure and the risks involved, and be asked to give their consent. Often this is a process that is poorly done or misunderstood by both of the clinician and the patient. Dr Maryanne Balkin discusses the legal and ethical issues surrounding informed consent and the capacity to provide consent.

Increasing numbers of older people are undergoing surgery and adverse outcomes are common within this patient group. Dr Margot Lodge is a Geriatrician with a special interest in Perioperative Medicine. She discusses the role of the geriatrician in Perioperative Medicine and the use of implementation science in adopting new models of care for the older person undergoing surgery.

Dr Lana Vestarkis is an Anaesthetist at Sunshine Coast University Hospital. For her Master of Perioperative Medicine Capstone Project, Lana worked with her colleague Dr Anna Pietzsch to attempt to rationalise preoperative blood testing in the elective surgical setting. Their project is not only having a major impact in their health network but has gone on to win a national prize. Lana and Anna discuss their project, including the challenges faced and the lessons learned when trying to bring about change.

Dr Sarah Wilmot is a GP Anaesthetist in rural Victoria. For her Master of Perioperative Medicine Capstone Project, Sarah redesigned the pre-anaesthetic process in her practice in an effort to improve patient experience. She discusses her project, including the challenges she faced and the lessons learned when trying to bring about change. Note: this podcast was recorded earlier this year. At the time, Sarah had been recently diagnosed with a terminal illness. Despite feeling unwell she was keen to share her project with a wider audience. Tragically Sarah passed away last month. This conversation is shared in memory of Dr Sarah Wilmott and her dedication to the best care of her patients.

In this episode, Dr Olivia Leahy talks to Dr Harry Sivakumar (Anaesthetist and Pain Specialist) and Dr Martyn Lloyd-Jones (addiction medicine specialist) about buprenorphine, an opioid analgesic used in the management of acute and perioperative pain, and selectively in chronic pain, as well as in opioid replacement therapy.