Venous Air Embolism: Pathophysiology, Volumes, and Clinical Effects A venous air embolism (VAE) occurs when air enters the systemic venous circulation and travels to the right heart and pulmonary vasculature. Although uncommon, VAE is a potentially catastrophic perioperative complication that can rapidly lead to cardiovascular collapse if not promptly recognized and treated. Critical Volumes of

Airway Evaluation: Key Concepts for Safe Intubation and Anesthesia By Dr. Paul Mirdamadi A thorough airway evaluation is a critical component of safe anesthesia delivery. Proper positioning, accurate airway classification, and recognition of pediatric anatomic differences allow clinicians to anticipate difficulty, select appropriate equipment, and minimize complications during intubation. This article reviews essential concepts in

Risk Factors for Aspiration: Anesthesia and Surgical Considerations Pulmonary aspiration of gastric contents is a serious perioperative complication that can lead to aspiration pneumonitis, pneumonia, hypoxia, and respiratory failure. Identifying patients at increased risk for aspiration is a critical component of pre-anesthetic evaluation, particularly in office-based anesthesia and maxillofacial surgery. Aspiration risk is influenced by

Bispectral Index (BIS): Interpreting Depth of Anesthesia The Bispectral Index (BIS) is an electroencephalogram (EEG)-derived parameter used to assess the depth of sedation and anesthesia. It provides a numerical value that helps guide anesthetic dosing, minimize awareness, and avoid excessive anesthetic depth. BIS values range from 0 to 100, with higher numbers reflecting greater levels

ASA NPO Guidelines: Preoperative Fasting for Safe Anesthesia Induction Proper preoperative fasting is critical for reducing the risk of pulmonary aspiration during anesthesia. The American Society of Anesthesiologists (ASA) NPO guidelines provide evidence-based recommendations that define safe minimum fasting intervals prior to sedation and general anesthesia. Understanding these guidelines—and the physiologic factors that influence gastric

Pre-Operative Medication Modifications: What to Hold Before Surgery Appropriate management of chronic medications before surgery is critical for maintaining hemodynamic stability, reducing perioperative complications, and ensuring safe anesthesia induction. Certain commonly prescribed medications—particularly antihypertensives and antidiabetic agents—require temporary discontinuation prior to surgery. This article reviews key pre-operative medication modifications, with emphasis on ACE inhibitors, ARBs,