The development of new guidelines in obstetric anesthesiology and other issues affecting the specialty have raised questions for many anesthesiologists. The questions will be addressed in an education session Monday.

Panelists will tackle 10 hot topics during an interactive session, “You Asked, We Answer: The ASA Committee on Obstetric Anesthesia and SOAP Address Your Top 10 Obstetric Anesthesia Concerns.” The topics were selected by officials of ASA and the Society for Obstetric Anesthesia and Perinatology (SOAP) based on their interactions with members.

“People want to know what is happening in this specialty, what they should be doing and what they should be reading,” said session moderator Heather C. Nixon, M.D. “They have to do it all, so they have to keep current, but they can’t read everything in an area like thrombocytopenia with pregnancy. They want to know what the consensus is. This is a good way to address that by choosing 10 topics and asking ‘What do we need to know?’”

The topics that will be addressed are:

• Non-obstetric surgery
• NPO status
• Thrombocytopenia
• Thomboembolism prophylaxis
• Management of hypertension
• Opioid addiction
• Breastfeeding after anesthesia
• Metrics of quality in obstetric anesthesia
• New terminology and delivery criteria
• Nitrous oxide administration

Each topic will be introduced by Dr. Nixon, Associate Professor of Clinical Anesthesiology at the University of Illinois Hospital and Health Sciences System, Chicago. She will discuss the relevant literature and pose a question, which audience members can respond to using their smartphones. Panelists will use references to summarize the topic and present a summary slide.

“These are things people are confused about or we have new guidelines coming out, so people are trying to figure out how to deal with that,” Dr. Nixon said. “It was hard to whittle it down to just 10 topics.”

Thomboembolism prophylaxis was chosen because obstetric guidelines outlining more aggressive approaches were recently published. Panelist Lisa R. Leffert, M.D., Massachusetts General Hospital, who is leading a national taskforce studying the development of new recommendations for obstetric anesthesiology providers, will present an update.

NPO status is a hot topic because of differing opinions among health care groups.

“There are a lot of questions right now and a lot of tensions among providers, especially midwife groups and some obstetric groups that are pushing toward more liberal NPO guidelines,” Dr. Nixon said.

With changes that link reimbursement to quality metrics, the definition of quality is “a source of angst among providers,” she said.

“Quality is a source of contention that may be linked to reimbursement and other things down the line,” Dr. Nixon said. “Who is working to define this, how will it be used in the future and what are the real problems with some of these metrics? I think that is an area people are very much interested in.”

Other panelists at the session will be:

• Manuel C. Vallejo, D.M.D., M.D., Assistant Dean and DIO, Professor of GME, Anesthesiology, Obstetrics and Gynecology, West Virginia School of Medicine
• Edward A. Yaghmour, M.D., Associate Professor of Anesthesiology, Northwestern University Feinberg School of Medicine
• Mark I. Zakowski, M.D., obstetric anesthesiology at Cedars-Sinai Medical Center, Los Angeles

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