Anesthesia for Neurosurgery - Interview with Neuroanesthesia Chief Dr. Ben Toure
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- čas přidán 26. 06. 2024
- Anesthesia for neurosurgery requires such a unique skillset that it's a formal subspecialty of anesthesiology. In this video, I interview Dr. Ben Toure, Mt. Sinai Hospital's chief of neuroanesthesia, who talks about the special considerations for anesthesia for neurosurgery.
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0:00 Start
0:44 Dr. Toure's background
2:08 Why neuroanesthesia is a subspecialty
3:05 Unique anesthetic considerations
6:00 Neural monitoring
8:29 Unique equipment
9:32 Neurosurgeons
11:25 Non-neurosurgery anesthesia
12:11 Work/life balance, call
13:38 Anesthesia medications
14:40 Biggest challenges
15:33 Being a minority physician
17:03 Final thoughts
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Find Max Feinstein, MD online:
Instagram: @MaxMFeinstein
Twitter: @MaxMFeinstein
Website: www.MaxFeinsteinMD.com
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Music
Subtle Swagger by Ron Gelinas Chillout Lounge | / atmospheric-music-portal
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Creative Commons Attribution 3.0 Unported License
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The information in this video is not intended nor implied to be a substitute for professional medical advice, diagnosis or treatment. All content, including text, graphics, images, and information, contained in this video is for general information purposes only and does not replace a consultation with your own doctor/health professional.
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#Anesthesiology #Residency #MedicalSchool - Věda a technologie
Thank heavens for specialized neuroanaestesiologist. My brain surgery was absolutely terrifying. I had complication and my anesthesiologist stayed with me through pre-op through surgery to post-op to return to OR back to post-op to Neuro ICU. Him an my surgeon are my life savers.
You were operated under local anesthetic?
I've had 17 neurosurgeries. I had no idea that there is a specific anesthesia for neurosurgery! So cool!
@@qamranxargar3893I would certainly hope they were under general anesthesia. I'd assume the patient needs to be completely paralyzed due to the sensitive nature of the surgical field.
A very interesting and extremely knowledgeable physician who is obviously proud and humbling. Thanks for the interview, Max, and thanks to Dr. Toure tor taking time out of his busy schedule.
Glad you enjoyed the video! Dr. Toure is great to work with, indeed very knowledgable and humble.
2 very, very, VERY smart men right here! You guys are fantastic, and I loved every second of the interview! Dr. Feinstein, thank you for interviewing Dr. Toure and Dr. Toure, thank you for your time to be interviewed!
If I were 20+ years younger, I'd pursue a degree as a nurse anesthetist.
Watching these videos presented by Dr Feinstein has given me an extremely heightened appreciation for Anesthesiologist. Its very rare to meet and greet an anesthesiologist let alone get to know them in the manner we would our surgeons. The last time I had surgery 10 years ago was for a 5.5 hr cochlear implant. Anesthesiologist are frick’n busy busy just prior to being taken in, so if you meet the anesthesiologist for 3 minutes, you’re lucky. I knew then that its pretty much a thankless profession. You never see them afterwards. In fact you never get to meet the surgical teams too. So on that day as the wheeled me into the OR, completely bombed out of my mind (good stuff) barely able to speak coherently, I fought to speak clearly and loud enough “in advance thank you everyone for your help today “. The last thing I remember was a few “you’re welcome(s)”. So when you first meet you anesthesiologist, thank them, its the last chance you’ll get. 👍
I did actually "meet" my anesthesiologist, after my cholecystectomy (gall bladder removal). He was right here at my bedside in the Recovery Room, waiting to tell me when I woke up that I was difficult to intubate and should I need surgery in the future, I should tell the doctor(s) that. My intubation issues caused my surgery to take about a half-hour longer than anticipated. Fortunately. and again due to anesthesia, I was totally unaware of the problems getting that thing down my windpipe. :-D
This was interesting! I've had 10 neurosurgeries myself (1 awake the whole time, 8 general anesthesia, and 1 deep sedation) with more to come.
Great interview with Dr. Toure! I'm an SRNA and just wanted to say that your videos are incredibly well-thought-out and nicely edited too. My RN experience is within the cardiac ICU, so I'll have to mirror some of the votes here for a cardiothoracic attending interview too. Subscribed!
Thanks for the nice feedback! I'll try to get some cardiothoracic-related material up eventually!
3rd year of my med school....I was interested in anesthesia for about 3months...expected to come out of that interst like every other time I got interested in a specialty. But I didn't...and i really hope I get into the anesthesia program.... please don't stop posting regular inspiring uploads like this one, Dr. Feinstein....and keep them coming every week ...
I am about 53 hours post op from an L3-5 interlaminal decompression/partial medial facetectomies/foraminotomies. I had never heard of a neuroanesthesiologist before. Amazing! I had been so afraid of this surgery I had postponed it for 2 years. In preop EVERY member of my surgical team came in and introduced themselves and explained what they were going to be doing for me. By the time I was rolled into the OR I had NO fear. I felt that I was in safe hands. I am so grateful for you doctors and your dedication to doing the best for your patients.
Wow! What a great interview! Please thank Sr. Touray(?) for spending his time with us for this video. He seems like a great guy who really enjoys his work. I really learned a lot from this video. I’m sure this is an intense subspecialty! Thanks for sharing this video!
Really fascinating! You know you’ve been watching and learning from Dr Max’s Videos for multiple years when you can identify the OR anesthesia equipment and know what class the anesthesia medications are in. ❤️👍🏻
Hey loved the video can you please do a video with a Cardiothoracic Anesthesiologist ?
Hey Duquan thanks for watching! Yes once I rotate through cardiac I will hopefully be able to interview one of the attendings. Thanks for the suggestion.
Great interview. Dr. Toure seems like a very approachable teacher. Congrats on finishing your rotation.
Yes he’s a wonderful teacher. Glad you enjoyed the interview. Thanks for watching!
Wow he's so relaxed and u can tell like u he takes it seriously. I think if I was a resident that rotation would scare thhe crap out of me! So glad theirs Doctors that love this type. Your all our heroes ❤
Great interview, we are very proud of you Dr Ben 👍👏 thank you for sharing.
I love this having had neurosurgery myself!
Great interview, thanks Max. I’m in my second year of medschool in Hungary and I’m hoping to be an anesthesiologist one day.
Thanks for watching! Best of luck on your journey.
This is so cool! Thanks so much Dr. Toure for your interview!
Thanks Max and Dr. Toure!
👍Super interview, watching as a 3X brain neurosurgery patient with continued gratitude for my great Anesthesiologists! Due to the nature of my condition(s) and surgeries, extensive nausea and (dangerous) vomiting were my ongoing concerns, and I was SO heard and cared for! 🙏❤️🌈 And it was thoughtful of you to interview Dr. Toure in his natural setting, beeping monitors and all! 😊
Same here with side effects. But my awesome anesthesiologist took care of that.
Thank you to both of you for what you do!
Great video. I had a twelve hour brain surgery last year and have been fascinated with it all since. Wish I could rewind the clock and get into this field.
Thanks for watching! Yes, it's a fascinating field.
Great concept for a video. I’d love to see more! Using mics might help your voices stand out against the background noise of the machines and it might help the echos too.
Thanks for the feedback! You're definitely right, I actually went home and bought a pair of lapel microphones after I recorded this interview.
I’m getting a microvascular decompression in four days! This was definitely interesting to watch as a preoperative neurosurgery patient. I’ll be at NYU Langone, but I’m sure I’ll be surrounded by just as qualified individuals
Neuroanesthesia is awesome and I love doing it on a regular basis. It’s way better to be in a 12h neurosurgery than in several other shorter procedures.
Surely appreciate your videos.
My sister in law had ruptured brain aneurysm, then repair of two more found to be present after the emergency surgery.
Then I have had 6 separate cervical disc surgeries-removal, fusion, and plated. So this particular video was informative.
Enjoyed the part about music. The doctor who did my hysterectomy wore cowboy boots and listened to opera.
Two very humble guys..👍🙏
You gotta love a TIVA! As a neurophysiologist it’s rare that I see an anesthesiologist who is willing to use total intravenous anesthesia to help us make sure that our evoked potentials stay clear and robust. Volatile anesthetics can obliterate our recordings making difficult to differentiate a true change.
I’m a veterinarian applying for anesthesia residencies. I find your videos extremely insightful and thought provoking when comparing to my profession!
I would *love* to interview a veterinary anesthesiologist! Sounds so fascinating. I've actually already reached out to one in NYC and am hoping to hear back. Best of luck on your residency applications.
@@MaxFeinsteinMD if you need it I can get you in contact with my mentor. She is head of anesthesia at the Animal Medical Center. She also has a PhD in Pharmacology and is overall a phenomenal human being.
Chances are that your mentor is the person I reached out to! Thanks for offering to say something, but I’ll see if she responds via the media person I spoke with. Sounds like things are very busy now 😅
Yes !! That would be so very fascinating
I love your videos! Always inspires me
Thanks so much! Glad you've been enjoying.
seeing this video made my day, I'm having my 44th brain surgery in March
Very interesting...thanks Max. Good job!
Thanks for the nice feedback, glad you enjoyed!
Great channel and interviews! 👍🏾
Glad you enjoyed it!
He's so chill
Yes and awesome to work with in the OR
Congratulations I appreciate your professional skills and kindness sharing the video with kindness and respect
Love ur videos! Keep up the great work!
Thanks for watching and for the nice feedback!
Great Interview!!! BLESSINGS!!!
Great interview, very informative and interesting x 👍🏼😊
great video. Thanks for sharing
So interesting! Thank you for sharing.
Thanks for watching!
Thanks a lot Dr Max.
Amazing never thought of this speciality
I've had relatives who had aneurysms in their brain and friends, and I never knew that this type of anesthesia so important think about people who have car accidents with brain injuries or other accidents. This is so important to know.
I really like your videos. They’re very helpful for someone who wants to be an anesthesiologist.
So glad to hear your feedback, that's the goal!
@@MaxFeinsteinMD 😁I’ve wanted to go into the medical field since I was 3. I know it’s a lot of hard work, but I’m up for it! The dentist told me all they do is give anesthesia and stand around. That’s a boring job. I was like it’s a little more complicated than that...🙂 It’s actually having someone’s life at hands
Thank you for this interesting interview. I am a final year resident in South Africa and this was sure helpful. I life that the practice is the same.. even people of colour being a minority in Anaesthesia. Funny seeing that we in Africa
Enjoyed the interview :).
I totally get the Neuro specialist having quiet environment. I have a habit of driving long hours without any music, sometimes I even go to the extend of putting ear plugs. Which I also wear to rave parties, always one pair in my bag.
Would be really nice if the patient can wear a set of headphones throughout the surgery. Drifting off into soft piano...
Day in the life of Dr. Ben Toure
I was thinking day in the life of a vascular surgeon.
Day in the life of surgeons from.different specialities would be interesting
Max Feinstein, MD yea that would be dope
Excellent interview! Thank you for uploading this!
Thanks for watching!
What an awesome specialty
This man is a golden retriever
What does it mean??
You have a very endearing and loyal personality. It’s a compliment! Golden retrievers are great.
PS: I binged all of your videos today while quarantined from COVID. Thanks for the positive boost
Oh lol this makes much more sense. Very kind of you!
Don't know how I missed this video, Max. I had surgery for a lemon sized meningioma. Prior to the surgery, I had a chat with the anesthesiologist. I told him that he was the most important member of the surgical team and I expected him to be there the entire surgery holding my hand and closely monitoring my condition. I told him that I wanted to wake up with my mental faculties intact. I told him that I did not want a nurse anesthetist. I was told by various hospital personnel that I probably had a nurse anesthetist regardless of my wishes. Your thoughts on nurse anesthetists?
Thank you
Would be interested in other specialties as well! Cardiac next please if possible!
Hey Alex, I’ll eventually do a cardiac anesthesiologist interview once I rotate thru it, thanks for following along!
Ben I really enjoy the videos! I'm not in the medical field directly but I follow it very closely as I work in IT for a lot of biomed and life sciences companies. I thought that interview was great and I was hanging on every word Dr. Ben had to say. But I have to ask, when you do interviews would it be possible to get mic? It was very hard to make out some of the audio with the booming echo of the room and his accent... I found myself backing up the video several times to catch what was said. Still, an excellent video! Would it ever be possible to make a video live in the OR? I know that's probably a tall order and CZcams might even deem it R rated but for those of us who are so fascinated by the field, it was be great. Even if you could just cover your post without patient coverage would still be great! Keep the the excellent work!!!
Hi Brian, thanks for watching and for the positive feedback. I actually went home from this interview and purchased two lapel microphones, so next time hopefully the audio quality would be better.
I would love to make a live video in the OR! I've actually spoken with my hospital's media department as well as the anesthesia department, and it would be possible but I'd have quite a few hoops to jump through. I will try to do this one day if I can.
I agree, a vídeo on the life of a neuroanestesiologist. Hi from México city, i AM a first year resident in mexico city. By the way working on applying the usmle. Amy advice for an Internacional medical graduate?
I am a neuroanesthesiologist in india AIIMS DELHI .. and trust me it is so satisfying
For the anesthesiologist in private practice, a typical clinical day is 10 to 12 hours long, plus overnight call 2+ nights each month. The average number of hours per week depends on the group and its call structure, but typically 40-60 hours per week including call.👍
Can you clarify on types of private practice and taking overnight calls? I am interested in anesthesiology but in terms of private practice I have only been exposed to outpatient surgery centers. Do you mean a private anesthesia group that covers hospitals etc? Thank you for your insight.
Thanks for the video. I recently had a neurosurgery procedure so this looked interesting. It was hard to hear clearly what Dr Toure was saying. Is there a transcript available?
it would be interesting if there were videos on anesthesiologists or crnas who contract as independent providers who drive their equipment around to put people to sleep for medical surgical procedures such as pediatric procedures, radiology, dentistry, podiatry, etc...
Thank you for sharing this information. I’m having surgery soon for my Moyamoya disease.
Thanks for watching! Best wishes for your surgery.
I'm scheduled for intracranial bypass to treat moyamoya in a week. Could you please tell me what you're experience and recovery was like? I'm scared.
Dr. Toure might be getting close to being able to buy an effiency apt. in N.Y.C. I was shocked when I had to work there for a few months.real estate prices were incredible.
I had a major back surgery and during the surgery the Neuro monitoring reflected zero on my right arm. I was repositioned but upon waking my right arm was paralyzed. It was determined the placement injured the brachial plexi and took about a month to resolve. Big fan of the monitoring
Wow how was that resolved? Did it involve rehabilitation or did it just correct itself?
It resolved on its own as the nerves healed. I went to neurologist for about six months until it was resolved. Very very scary. I was blessed for sure
Sorry to hear that happened to you, but glad it eventually resolved!
Thanks for sharing this I appreciate it and pretty soon I'm going to have an implant in my brain.
Please do Pain Medicine next
So, there are different anesthesia medications for different types of surgery?
Love
If I was smart enough to become a doctor, anesthesia would be an area I would like to be in. I already had an idea of anesthesiology from my branch of healthcare and of course having my own experiences as a child I can reflect on with surgeries. However, I feel like anesthesiology seems to only be given partial credit only when it comes to giving birth. Most people seem to think that anesthesiology is just to give an epidural, you hear about it more then surgeries in conversation. I appreciate that to an extent, you have more set hours as I prefer jobs with "set" hours and I dont mind working overnight. You also have an opportunity to work in most areas of medicine because you are specialized in the area of anesthesiology but you aren't limited to one type of surgery or one area of the hospital. You can almost work with any surgeon and be sub specialized in your own specialty. I know I would feel so much pressure in terms of medication. Since that is such a vital part of the job and requires such diligence. Not that any other area of medicine doesn't require diligence because it does. You want a good surgeon to do his or her job right of course. However the pressure to make sure you have the right medications is huge. Especially since the case of the nurse who accidentally gave the wrong medication. I understand this is after you filmed this video but I just came across this video. I appreciate the knowledge from your channel and I am not even a doctor. Its educational and gives perspective and understanding to those who simply just want to learn about your field. Education is important at any level.
Please can someone explain to me at 5.01 why is hyperventilation leading to cerebral vasoconstriction?
He is so cool I'm jealous, I wish I was this smart and interesting
To become a Neuromonitorist you actually just need a bachelors degree and a contract company or hospital can hire you and train you on the job to prepare you for the CNIM certification exam
Oh interesting, thanks for the info.
Can you make a video about your work time. Shifts . Etc. And Number of cases you do in a single shift . average?
This is a great idea, thanks for the suggestion.
this was very interesting, am curious tho as I've had brain surgery, car accident, brain got shoved up into sinus cavity, was anesthesia different for my type of surgery OR was it the same, but with more monitoring? car accident almost killed me but thanks to all the Dr's, Nurses, Medics, I'm still here, although I have a huge list of problems due to TBI, I'm thankful I'm still here, my other half also thanks everybody..
Sorry to hear you had a bad accident, but glad you made it through alright. It's likely that the anesthesia you received was similar to what Dr. Toure describes using often. Thanks for watching!
@@MaxFeinsteinMD 8 months later and this video was in my recommended lol here I am again rewatching it and being amazed again....still very interesting...last thing I remember was him telling me to say goodnight...woke up 6 hours later
Interesting. I had brain surgery so anything about it is neat to me. Thank you
can I get some thesis topics in neuroanesthesia?
He looks so nice 🤩
He is very nice!
Would you please go over the Anesthesia used during Deep Brain Stimulation?
If you picked a sub-specialty would that be something you do a fellowship in after you complete your residency?
Pediatric anesthesia!
Is that a Jackson bed behind Dr. Ben Toure?
Yes it is!
Do the chief anestesiologist ever allow the resident to do it totally by themselves without supervision?
It all depends on the attending physician. Generally speaking, the attending physician is present during the most critical times of the case, which means intubation and may or may not include extubation.
I had a brain tumor removed the size of a tennis ball. They expected surgery to last 6 hours but it was completed in 3. I had 2 more surgeries 1 and 5 months later due to infection and cranioplasty. Propofol is amazing. No wonder Michael Jackson was hooked on it.
Yes, too bad his doctor was inadequately trained to administer Propofol and was using it inappropriately.
I just had my third colonoscopy because I'm a cancer magnet and the anesthesiologist said he was using propanolol. He said it's an easy on off type of medication. I said I don't like Michael Jackson. I said I don't want that type of Michael Jackson medication I said I just wanna not feel or remember it and not wake up sick.
Sir how much do you earn as an anesthesiologist? Nice video.
As an anesthesiology *resident* I make $73,000/yr, which is a pretty standard salary for residents from any specialty in the NYC area. Anesthesiology attending salary varies widely but is typically between $250,000 - $450,000.
On the long surgery- bathroom breaks?
Anesthesiologists in large hospitals typically have a system in place to give each other periodic breaks during the day, fortunately 😅
I. Ever knew it was a ting wow
Neither did I until I was a 4th year medical student!
How do medical professionals deal with all the beeping and chiming? That would drive me crazy
Music wars: neuroanasthesiologist plays Mozart while neurosurgeon blasts some Avenged Sevenfold
lol would love to see that
I really like hearing tis stuff, however this one was very hard to follow with the eco sounds ----
Yes, sorry about that! I actually just upgraded microphones so this shouldn't be an issue in the future.
It's a bit surprising that this version Highly Educated man would feel that affirmative action is an automatic thing that everyone should believe should happen in the Supreme Court disagrees
We need these videos. However i did not know you quit breathing on Propofol. That really scares me. What if they cant get you intubated in that short window.....now im more scared
It really depends on the dose and how quickly it's administered, but it's not uncommon for propofol to decrease respiratory rate or stop breathing altogether. But anesthesiologists spend a long time training to become experts at keeping people breathing no matter what happens, so that's something you can take comfort in if you ever need anesthesia. If someone stops breathing on propofol, there are a number of things we can try before resorting to intubation. And if intubation is problematic, there are a number of different things we can try to help someone breathe. You can search for "ASA Practice Guidelines for Management of the Difficult Airway" to see the complete details of how that's handled. Hope that helps and gives you some comfort!
The background noise killed this video for me
The amount of stuff obs and gyne/gen surg need to learn, there is NO WAY neuro anaesthesia is a speciality. Sorry
Is Anesthesiologist doctors 🥼???
Yes