In this episode of the Atomic Anesthesia Podcast, nurse anesthesia residents are guided through the pivotal moments of emergence and extubation—recognized as one of the riskiest steps in the operating room. Listeners will gain practical strategies for timing and executing a safe, efficient wake-up following general anesthesia, including the choice between restoring spontaneous breathing early for extremity and head or neck surgeries, or precisely titrating off anesthetics and using nitrous oxide during abdominal and thoracic procedures. The episode breaks down emergence criteria, ventilatory and hemodynamic parameters, medication effects, and the consequences of mixing techniques, all illustrated with clear, experience-based teaching points drawn from years of practice. CRNAs at all levels are invited to reflect, share their own perspectives, and incorporate these actionable insights to optimize patient safety, comfort, and workflow in the perioperative environment.

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This is a joint episode recorded with Dr. Chloe Gomez of the My Favorite Learner podcast. This episode explores the foundational concepts of pharmacogenetics and its impact on drug responses during anesthesia, highlighting how genetic, genomic, and epigenetic variations shape individual reactions to commonly used medications in perioperative care. Designed for nurse anesthesia residents, the show walks through the scenarios of variable drug response, the roles of metabolizing enzymes, transport molecules, and molecular targets, as well as the influence of environmental factors and polymorphisms such as single-nucleotide variants and ethnic differences in metabolism. Key topics include disease-specific considerations like G6PD deficiency, acute intermittent porphyria, long QT syndrome, Brugada syndrome, atypical pseudocholinesterase, and malignant hyperthermia, with a focus on clinical implications for personalized medicine, precision dosing, and ethical issues surrounding genetic testing, privacy, and patient equity. Practical advice covers vigilant monitoring, individualized dosing, preoperative assessment for genetic risk, and strategies for documenting and communicating findings for safer anesthesia practice.

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This episode of the Atomic Anesthesia Podcast explores the emerging role of Suzetrigine, a novel non-opioid NaV1.8 channel inhibitor, in multimodal surgical pain management. Host Rhea and guest JR Phillips, a DNAP student, discuss the science, efficacy, and safety profile of Suzetrigine, its potential for opioid-sparing strategies, and its unique advantages over traditional opioids and sodium channel blockers. Listen in for an evidence-based look at how this new FDA-approved analgesic could reshape perioperative care, improve patient outcomes, and what its current limitations and future possibilities might be for anesthesia professionals and learners.

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