Burnout from Gender Inequity in a Pandemic.

Women represent approximately one-third of all anesthesiologists in the United States. Before the COVID-19 pandemic, research regarding gender bias in anesthesiology defined the scope of the problem. Unfortunately, the pandemic exposed and expanded the imbalances associated with gender, placing women anesthesiologists as both primary caregivers in the home and on the frontlines of health care. These systemic inequities exacerbated burnout in women anesthesiologists. Several initiatives that can improve well-being and the work culture for all anesthesiologists, including women, will also be discussed.

Physician Coaching.

The practice of anesthesiology requires both clinical skills and the ability to navigate complex social situations. Leadership skills such as emotional intelligence, adaptability, conflict management, and negotiation are crucial for success but infrequently taught. Coaching is a thought-provoking process that enhances self-awareness and inspires the maximization of personal and professional potential. It has been used in the business world for personal and professional development for decades, and evidence now exists that coaching also provides benefits for physicians in both professional development and well-being.

Comparison of a lower-lipid propofol emulsion with the standard emulsion for sedation during monitored anesthesia care.

BACKGROUND: The currently used emulsion formulations of 1% propofol contain 10% soybean oil. However, a new emulsion of 1% propofol (Ampofol) containing 50% less lipid has recently become available for clinical investigation. This study was designed to compare the pharmacodynamic properties of Ampofol with those of a standard formulation (Diprivan) when administered for intraoperative sedation. METHODS: Sixty healthy outpatients undergoing minor operations with local anesthesia were randomly assigned to receive either Ampofol (n = 31) or Diprivan (n = 29) for intravenous sedation. The sedation was initiated with an intravenous loading dose of propofol, 0.75 mg/kg, followed by an initial infusion rate of 50 microg x kg(-1) x min(-1) to achieve an Observer's Assessment of Alertness/Sedation score of 3. The targeted level of sedation was maintained with a variable-rate propofol infusion during the operation. The onset times to achieving a sedation score of 3, the severity of pain on injection of the loading dose, intraoperative hemodynamic variables, and electroencephalographic Bispectral Index values were recorded. In addition, recovery times, postoperative pain and nausea, and patient satisfaction with the sedative medication were assessed. RESULTS: There were no significant differences between Ampofol and Diprivan with respect to onset times, dosage requirements, Bispectral Index values, hemodynamic variables, recovery times, or patient satisfaction scores. The incidence of moderate pain on injection was higher in the Ampofol group (26%vs. 7% with Diprivan; P < 0.05). CONCLUSIONS: Ampofol was equipotent to Diprivan with respect to its sedative properties during monitored anesthesia care. Although both groups received pretreatment with intravenous lidocaine, Ampofol was associated with more pain on injection.