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Where the Rubber meets the Road. Stroke Ambulance, Stroke Care, and the Anesthesiologist  

September 3, 2025
8 pm ET

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The round focused on both neuroanatomy and physiology of stroke and include the effects of drugs we use everyday in the Operating Room. Attendees learned about the Edmonton Stroke Ambulance Project, a unique prehospital treatment model for stroke which is the first of its kind in Canada and arguably the world.
 

In-Flight Medical Emergencies: Challenges at 40,000 ft. 

April 2, 2025
8 pm ET

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An in-flight medical emergency (IME) refers to any medical incident on board a commercial airline that has exceeded the handling ability of the flight crew. IMEs are more common than we tend to think, occurring roughly every 600 flights, and the incidence is expected to rise considerably due to increases in air traffic, flight times, and the proportion of elderly, co-morbid passengers. Physicians on board are often called upon to assist affected passengers, but most are unaware of the unique aspects of the cabin atmosphere, the resources available to them, and the policies guiding intervention in this complex, resource-limited environment. While anesthesiologists are often viewed through the lens of perioperative care, our expertise with respect to physiology, critical care, and crisis management renders us particularly useful to passengers during an IME.

Anesthesiology, social determinants of health, and perioperative health outcomes

February 5, 2025
8 pm ET

The social determinants of health (SDH) have broad reaching implications throughout all areas of medicine, including perioperative care.  While seemingly far removed from the more social elements of medicine, evidence shows that anesthesiology is not immune to the ways in which bias, at both individual and systemic levels, influence patient outcomes. Reflection on the ways in which the SDH, including provider bias, shape perioperative care allows for the identification of points of intervention to improve health equity, both to improve individual patient outcomes as well as a step towards systemic change.

The Perioperative Breastfeeding Patient

December 4, 2024
8 pm ET

This presentation outlines the anesthetic considerations for the breastfeeding patient coming in for any operative procedure. This is a population that anesthesiologists may not see regularly, but their treatment can have a significant impact on the patient and their infant. The presenters will go through the basics of breastfeeding physiology, perioperative complications, and spend time going through anesthetic medications and their potential infant risks. They will further explain why most patients can continue to breastfeed postoperatively without the need to “pump and dump”. 

The second portion of the presentation will review a local quality improvement project in Edmonton to standardize and improve discharge teaching instructions provided by perioperative practitioners including anesthesiologists, nurses, and surgeons. The presenters will highlight available guidelines and potential opportunities to support this patient population. They will also describe challenges they have faced and lessons learned to inspire similar change in other hospitals in Canada. 
 

Perioperative Frailty

October 2, 2024
8 pm ET

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Understanding perioperative frailty is paramount for Canadian anesthesiologists as it directly impacts patient outcomes. Frailty assessment guides anesthesiologists in tailoring perioperative care to individual patient needs, ensuring optimized preoperative planning, and minimizing postoperative complications. Recognizing frailty enhances risk stratification, enabling more precise interventions and contributing to improved overall patient safety and healthcare quality in the Canadian context. 
 

Secondary Trauma in Operating Room Healthcare Providers

September 4, 2024
8 pm ET

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All health care professionals bear witness to traumatic events at work. Post traumatic stress and vicarious trauma have been extensively studied in military and emergency response personnel. Very little work has occurred on the impact of witnessing and caring for patients undergoing trauma and life altering events on healthcare workers. Post-traumatic stress contributes to physician wellness and burnout. It impacts personal wellness as well as work output and has a significant cost to the individual, the institution, and to the public. This round is an opening to a larger conversation of these issues within anesthesiologists and perioperative teams. 
 

Perioperative care for the transgender patient

May 1, 2024
8 pm ET

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Transgender patients represent approximately 2% of the general population but are some of the most underserved and under-resourced patients in our care. Surgical options for gender affirming care have progressed beyond “top and bottom” surgery and can include facial reconstruction and vocal cord surgeries. Some of these may complicate interpreting our typical airway assessment and scar tissue may interfere with airway interventions. As this is not a topic most physicians have had much training in it is prudent we take time to cover other considerations including chronic pain and restrictive lung physiology from chest binders, relevant comorbidities and approach to gender affirming perioperative care regardless of the planned procedure. 
 

Perioperative mental health: the elephant in the (operating) room

March 6, 2024
8 pm ET

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1 in 5 Canadians have a diagnosable mental disorder within any given year, and surgical patients are at even higher risk. Surgery is a highly stressful experience for many patients and at least half experience significant levels of acute preoperative anxiety and distress. Psychological factors have deleterious effects on critical surgical patient outcomes, such as pain, complications, functional recovery, length of stay, readmission, dissatisfaction with surgery, and mortality. These mental health impacts also extend to the healthcare system as a whole. Mental health disorders incur excess costs upwards of $600 US and $3400 US per patient following oncological and arthroplasty surgeries, respectively. Patients also identify anxiety as the worst component of their surgery experience. Despite the importance of mental health for patients undergoing surgery, perioperative mental health research is in its infancy and there are limited targeted interventions to manage mental health prior to surgery. This round will aim to review extant literature on perioperative mental health, and introduce approaches to optimize mental health prior to surgery.
 

Canadian Airway Training: Guideline-based or choose your own adventure?

February 15, 2024
8 pm ET

Excellence in airway management is a cornerstone in anesthesia education and becomes part of one’s identity in anesthesia practice for many. Airway education is highly variable between Canadian universities and within programs, and the focus on individual skills and decision-making does not reflect the teamwork expected in both standard and emergency airway management. Recognition and predictable team response during airway emergencies lags other emergencies such as trauma and cardiac arrest. This round will address these challenges and help you in assessing airway guidelines. 
 

Diabetic Management in Ambulatory Surgical Patients 

March 12, 2025
8 pm ET

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The second round in the CAS SAMBA Ambulatory Anesthesia Collaborative Rounds Series will focus on the updated North American guidelines for perioperative blood glucose management in ambulatory surgery patients with diabetes.

The Society for Ambulatory Anesthesia has recently updated its consensus statement regarding the management of blood glucose in patients with diabetes mellitus undergoing ambulatory surgery; this 2024 update replaces the 2010 guidelines.  Similarly, the Canadian Standards for Perioperative/ Periprocedure Glycemic Management Expert Consensus Panel has recently updated its consensus guidelines regarding the perioperative management of patients with Type I and Type II Diabetes; the 2025 update replaces the Canadian 2021 recommendations.   

Recent advancements in diabetes management, particularly the introduction of new hypoglycemic agents, insulin pumps, and continuous glucose monitors are reflected in the updates to both the Canadian and American guidelines. These updates are critical for optimizing the perioperative care of the increasing number of diabetic patients. Join the authors of both the new American and Canadian guidelines as we review, compare and contrast the Canadian and American evidence-based recommendations.  

After attending this round, the participants will be able to: 

1. Discuss the newly recommended BG targets in ambulatory surgery (versus inpatient goals) 
2. Assess current literature outlining risks and benefits of oral hypoglycemic use in the perioperative period. 
3. Describe safe and effective practices to dose home insulin prior to ambulatory surgery. 
4. Outline current data examining pre-operative carbohydrates in DM2
5. Identify relevant consideration for the use of GLP-1RAs and diabetes devices 

Moderator: Dr Ronald Goldenberg

Moderator: Dr David Mazer

Presenter: Dr Elizabeth Duggan

SAMBA Pediatric tonsillectomy and adenoidectomy (T&A) guidelines

January 29, 2025
8 pm ET

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Tonsillectomy, with or without adenoidectomy, is one of the most commonly performed pediatric ambulatory surgical procedures. The two most common indications for tonsillectomy are recurrent throat infections and obstructive sleep-disordered breathing. The most frequent early complications after tonsillectomy are ventilatory compromise and hemorrhage. It is important to acknowledge that many pediatric tonsillectomy patients may not be cared for by fellowship-trained pediatric anesthesiologists or those with extensive pediatric experience. 

In response to requests from its members, the Society for Ambulatory Anesthesia (SAMBA) developed a position statement concerning the safe perioperative care of pediatric patients undergoing tonsillectomy with and without adenoidectomy in free-standing ambulatory surgical facilities. Join this collaborative round to learn about the position statement and tonsillectomy patient care.   

Moderator: Dr Kimmo Murto
Presenter: Dr Marjorie Brennan

CAS Neuroanesthesia National Virtual Round # 3 

Thursday, November 28, 2024
8 PM ET

Certificate of Attendance

The Canadian Anesthesiologists' Society Neuroanesthesia Section National Virtual Round is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. 

The CAS Neuroanesthesia Section will host its third National Virtual Round of the year on November 28, at 8:00 p.m. ET. The Section hosts regular rounds on a variety of topics in neuroanesthesia, allowing the sharing of experiences across the country while building a more collegial neuroanesthesia community in Canada.  

This Round is a key part of CAS' mandate to provide education to members to help them reach their professional goals. The event is complimentary for CAS members, but registration is required.  

This Round is moderated by CAS Neuroanesthesia Section Chair Dr Melinda Davis (bio). 

Title: Post-craniotomy Pain - Evidence-based Management 
Speaker: Dr Kan Ma (bio)

Learning objectives: 

After participating in this round, participants will be able to:

1. Describe the origin and pathophysiology of post-craniotomy pain
2. Integrate regional anesthetic techniques in the management of post-craniotomy pain 
3. Formulate an evidence-based approach to managing post-craniotomy pain 

Title: Blood Transfusion and Related Practices in Traumatic Brain Injury
Speaker: Dr Sweatha Balakrishnan (bio)  

After participating in this round, participants will be able to: 

1. Apply latest evidence to their clinical practice in management of patients with traumatic brain injury. 
2. Discuss the challenges with the use of Albumin in traumatic brain injury. 
3. Describe the rationale for the appropriate timing and benefits of administering tranexamic acid in traumatic brain injury. 
4. Review the literature on the haemoglobin threshold for trigger transfusion in traumatic brain injury. 

Moderator: Dr Melinda Davis
Calgary, AB

Dr. Melinda Davis is a neuroanesthesiologist at the University of Calgary. She obtained her medical degree at the University of Newcastle, Australia, and stayed on to complete training in anesthesiology there. Following fellowship to the Australia and New Zealand College of Anaesthetists, Dr. Davis went on to a fellowship in Neuroanesthesiology at the University of Calgary in 2004. Dr. Davis balances her clinical work with a career in medical education where she has taught at all levels from Undergraduate Medical Education through to Faculty Development. She has served as the Program Director for the Anesthesiology Residency program and is currently the Associate Dean for Postgraduate Medical Education at the University of Calgary.



Speaker: Dr Kan Ma
University of Toronto

Dr Ma completed his anesthesia residency program at McMaster University in 2017, his Trauma-Neuroanesthesia and Critical Care Fellowship at University of Toronto in 2018, and the Neurosurgical Anesthesiology Fellowship at Northwestern University in 2019. He is the current Associate Program Director of the Trauma-Neuroanesthesia and Critical Care Fellowship at St. Michael’s Hospital, University of Toronto. His academic interest revolves around intraoperative neuromonitoring with evoked potentials and perioperative pain management for neurosurgical patients. 


Speaker: Dr Sweatha Balakrishnan
University of Ottawa   

Dr Balakrishnan is a board-certified anesthesiologist trained at Narayana Health, one of the largest multi-specialty hospitals in Bangalore, India. She also specializes in neurocritical care and completed her postdoctoral fellowship at NIMHANS, Bangalore, India. Since moving to Canada in 2020, she has completed her 2-year critical care fellowship at St. Michael's Hospital, Toronto, and is currently doing a neuroanesthesia fellowship in Ottawa. Dr Balakrishnan’s areas of interest are intraoperative and bedside neuro monitoring in the ICU, neuro simulation and perioperative patient management. She has publications related to Optic nerve sheath diameter and Regional cerebral oxygen saturation in acute traumatic brain injury. 

CAS Neuroanesthesia National Virtual Round  

The Canadian Anesthesiologists' Society Neuroanesthesia Section National Virtual Round is a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada. 

The CAS Neuroanesthesia Section will host its second National Virtual Round of the year on April 17, 2024, at 8:00 p.m. ET. The Section hosts regular rounds on a variety of topics in neuroanesthesia, allowing the sharing of experiences across the country while building a more collegial neuroanesthesia community in Canada.  

This Round is a key part of CAS' mandate to provide education to members to help them reach their professional goals. The event is complimentary for CAS members, but registration is required.  

This Round is moderated by CAS Neuroanesthesia Section Chair Dr Tumul Chowdhury. (bio)  

Title: Postoperative Delirium: Where Are We At?
Speaker: Dr Peter Hedlin (bio)

Learning objectives: 

After participating in this round, participants will be able to:

1. Describe the prevalence, nomenclature and clinical impact of postoperative neurocognitive disorders

3. Evaluate the current perioperative recommendations

4. Discuss the current theories of POD pathophysiology 

Title: Neuromonitoring in Spine Surgery 
Speaker: Dr Sudhakar Subramaniam (bio)  

After participating in this round, participants will be able to: 

1. Describe the fundamentals of spinal neuromonitoring and its associated pathologies 

2. Combine clinical, anatomical, and neurophysiological data to derive a treatment plan for specific case-based scenarios in spinal neuro anesthesia 

3. Make evidence-based recommendations for the management of pathophysiological neuromonitoring changes and outcome predictions

Moderator: Dr Tumul Chowdhury 
Toronto, ON

Dr Chowdhury is an Associate Professor in Anesthesiology at Toronto Western Hospital, University of Toronto. He is the program director of the neuroanesthesia fellowship at Toronto Western Hospital. Nationally, he is the Chair of the Neuroanesthesia Section of the Canadian Anesthesiologists' Society. He is an active researcher, clinician, educator, and mentor. Internationally, he is an active member of various committees Society for Neuroscience in Anesthesiology and Critical Care (SNACC), International Council on Perioperative Neuroscience Training (ICPNT), WFSA (World Federation of Societies of Anesthesiologists) (constitution committee), and Brain-Heart Interactions Society (Secretary). 
 
Dr Chowdhury is the Editor-in-Chief of the SNACC newsletter. He is the board member of SNACC and the director of the membership committee and global outreach committee. He is also an executive board member of ICPNT and serves as the new chair of the Fellowship Accreditation Committee. He has published more than 100 articles and received several research grants. He is an active reviewer for more than 20 journals. He has edited two books and authored more than ten book chapters. His main research areas are brain-heart interactions, trigeminocardiac reflex, stroke, anesthesia, and brain cancer survival.


Speaker: Dr Peter Hedlin
University of Saskatchewan

Dr Hedlin is a clinician scientist who joined the Anesthesia Department at the University of Saskatchewan in 2018 following the completion of his residency training. Prior to medicine, he completed a PhD at the Vaccine and Infectious Disease Organization where he was part of a team investigating vaccine design in relation to prion diseases. This sparked an interest in cognitive dysfunction that has stuck with him since. Currently, he has a mixed practice of clinical anesthesiology, simulation related medical education, and research with a special focus on postoperative cognitive dysfunction.    


Speaker: Dr Sudhakar Subramaniam
Northern Ontario School of Medicine  

Dr Sudhakar completed his residency in India followed by neuroanesthesia and perioperative anesthesia fellowships from Toronto Western Hospital, Toronto. He currently works as a staff member at the Thunder Bay Regional Health Sciences Centre, Thunder Bay, Ontario and is an Assistant Professor at the Northern Ontario School of Medicine.  

CAS Neuroanesthesia National Virtual Round  

Wednesday, February 7, 2024
8 PM ET

Certificate of Attendance

This Round was moderated by CAS Neuroanesthesia Section Chair Dr Tumul Chowdhury. (bio)  

Title: Role of Point-of-Care Ultrasound (POCUS) in Neuroanesthesia and Neurocritical Care
Speaker: Dr Anuja Rathore (bio)

Learning objectives: 

After participating in this round, participants will be able to:

1. Describe the different techniques and the potential clinical applications of brain ultrasonography

2. Discuss the use of POCUS as a tool in assessment of cerebral hemodynamics

3. Evaluate its utility from the neurocritical care standpoint  

Title: Neuroanesthesiology Training, a Global Perspective 
Speaker: Dr Wesley Rajaleelan (bio)  

After participating in this round, participants will be able to: 

1. Review subspeciality training in Neuroanesthesiology in high-income countries (HICs) and lower middle-income countries (LMICs) 

2. Evaluate factors that promote quality and standards in performance in Neuroanesthesiology  

3. Analyse barriers in training in HICs and LMICs 

4. Review standards in curriculum development and evaluation of core competencies in training  

Moderator: Dr Tumul Chowdhury 
Toronto, ON

Dr Chowdhury is an Associate Professor in Anesthesiology at Toronto Western Hospital, University of Toronto. He is the program director of the neuroanesthesia fellowship at Toronto Western Hospital. Nationally, he is the Chair of the Neuroanesthesia Section of the Canadian Anesthesiologists' Society. He is an active researcher, clinician, educator, and mentor. Internationally, he is an active member of various committees SNACC, ICPNT, WFSA (constitution committee) and Brain-Heart Interactions Society (Secretary). 
 
Dr Chowdhury is the editor-in-chief of the SNACC newsletter. He is the board member of SNACC and the director of the membership committee and global outreach committee. He is also the executive board member of ICPNT and serves as the new chair of Fellowship Accreditation Committee. He has published more than 100 articles and received several research grants. He is an active reviewer for more than 20 journals. He has edited two books and authored more than ten book chapters. His main research areas are brain-heart interactions, trigeminocardiac reflex, stroke, anesthesia, and brain cancer survival.



Speaker: Dr Anuja Rathore
Toronto Western Hospital

Dr Rathore is currently a second year fellow in Point of Care Ultrasound at Toronto Western Hospital, having completed a previous neuroanesthesia fellowship at the same hospital.  

Her MD Anesthesia training is from India and her overall experience in Anesthetic practice spans across Canada, Singapore, and India. Dr Rathore’s focus has primarily centered around obstetric, neuro, and cardiothoracic, in addition to her newly acquired passion in perioperative point-of-care ultrasound. She has also been conferred membership by the Royal College of Ireland.  


Speaker: Dr Wesley Rajaleelan 
University of Ottawa, The Ottawa Hospital 

Dr Wesley Rajaleelan is currently a staff anesthesiologist at The Ottawa Hospital (TOH) with a faculty appointment as an Assistant Professor at the University of Ottawa, Faculty of Medicine. He sits on the ACUDA board as the global and rural health representative from the University of Ottawa and is a member-at-large of the Global Surgery OBGYN, Anesthesiology Committee of the Ottawa Hospital (GSOGAC).

He also serves as the interim director and fellowship lead for Global Health at the uOttawa – Department of Anesthesia and Pain Management (DAPM). On the national front, he serves as a member at large of the Annual Meeting Scientific Program Committee, the Abstracts Subcommittee, and the Archives & Artifacts Committee of the Canadian Anesthesiologists’ Society. He was recently inducted into the Scientific Affairs Committee of the World Federation Societies of Anesthesiologists (WFSA) and also serves as the subsection editor for the WFSA.