Happy New Year! I’m joined today with a very special guest and current primary exam examiner Dr Anthony. In this episode we take a in depth look at the Pharmacokinetics of Propofol TCI. Anthony has curated this talk over multiple years and starts of by explaining the main equations you should know (05:35). We then integrate these equations into the classic Propofol Cp vs Time graph (11:52). This leads us on to talking about the compartment model (20:11) and how this applies to the ‘Marsh’ TCI model (23:25). To help understand the concepts of rate constants (k) Anthony uses his bucket analogy (27:27). Then we apply this knowledge to understand effect site targeting (Ce) and run through some examples of differences in age (41:30) and weight (66:05). Finally, we finish with a brief look at the ‘Eleveld’ Model and the concept of Keo (72:40). A huge thank you to Anthony and as always if you have any feedback let me know.

Sources/Credit:

All equations/graphs/diagrams/tables – Miller’s Anesthesia 10th Edition 2025

All TCI calculations – simtiva.app

End Episode Song – “The Volatiles”

I’m joined today by a special guest Justin and we go through an overlooked topic of ‘Immunology & Hypersensitivity.’ The first learning objective is to review how the body defends against infection (05:46) and then look how this is effects under anaesthesia (14:06). Finally, we have a long conversation about the pathophysiology of hypersensitivity (16:22) and the clinical context of the treatment of anaphylaxis (24:18). I want to thank Justin again for joining me today and as always if you have any feedback let me know.

Today is the last topic of our cardiac physiology series “Measurement.” I start of by looking at different techniques to measure non-invasive BP from auscultation (01:31) to oscillometry (07:03). Then I look at an invasive method being arterial lines and this is divided into how it works (11:15) and sources of error (17:54). The last LO for today covers different techniques to measure cardiac output (27:41). To finish as always, we look at the past SAQs (33:35). Thanks for listening! As always if you have any feedback let me know

In today’s episode I cover the ‘Past Saqs’ from ‘Applied Cardiac Physiology.” The first SAQ looks at the consequence of tourniquet release after two hours (01:23) followed by the process’s that cause oliguria in hypovolemic shock (09:45). Then I go through the model answers for CVS responses in severe blood loss (14:39), the effects of infusing Hartmann’s solution (16:51) and briefly the impact of IPPV (21:52). Finally, the remaining SAQs look at the effects of a central neuraxial blockade (22:44), the effects of a pneumoperitoneum (27:01) and the effects of ageing and obesity (30:57). Good luck to all the viva sitters this week and thanks for listening! As always if you have any feedback let me know

Today I'm doing a 'Live Practice Viva'. Thanks to Celia for doing this!! I hope you get some technical and non-technical skills from the video. The two topics were: Immune System and Neurophysiology. Topic 1 starts (02:32) with 1 minute thinking time and Topic 2 starts (07:33). We then go through some feedback. Thanks for watching! As always if you have any feedback let me know at anirudh@sweetdreamsanaesthesia.com

Today I cover the topic ‘Applied Cardiac Physiology.” This is the biggest topic so far in our cardiology series and I had to divide it into 2 parts. Today I look at the LO’s starting first with the CVS effects of pneumoperitoneum (01:19) and the effects that occur with changes in patient position (06:13). Then I discuss the cardiovascular responses to exercise (12:45), Valsalva (16:58) and positive pressure ventilation (22:30). Then we go into depth examining the changes that occur with ageing (28:42) and obesity (32:35). The final LO for today is multiple LO’s in one and a very deep dive looking into all aspects of shock (37:13). In Part 2 of this topic, I will go through the SAQs. Thanks for listening! As always if you have any feedback let me know

Today I cover the topic ‘Regional Circulation.” This has one very big learning objective that looks at the factors that govern blood pressure. To understand this, we have to first understand how the systemic circulation works (02:29) and second the physics which control blood flow (08:42), together this helps us to understand the factors that make blood pressure (18:07). I then take a deeper look at total peripheral vascular resistance (19:55) and microcirculation (24:49). The BIG topic for today is understanding the control arc of blood pressure (32:04) and this includes talking about the baroreceptor reflex. Finally, we look at some past SAQs (42:06). Next episode I will go through ‘Applied Cardiac Physiology.’ Thanks for listening! As always if you have any feedback let me know

Today I cover a huge topic ‘Control of Cardiac Output & Pressure.” This used to be one big learning objective with 4 subsections that I will go through today. Frist I define and describe the classic terms of preload, afterload and contractility (01:19). Then I delve into the frank starling mechanism (12:34). Followed by a long look at the Guyton Curves (16:02) and the LV Pressure-Volume Loop (28:38). At the end I have some time to look at the past SAQs (34:04). This is a very diagram heavy topic and I highly recommend reviewing these diagrams in detail in preparation for the exam. Next episode I will go through ‘Regional Circulation.’ Thanks for listening! As always if you have any feedback let me know