Table Of ContentAnnual Queenstown
Update in Anaesthesia
Programme and Abstracts, 2012
Annual Queenstown Update in Anaesthesia, 2012
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CONTENTS
Welcome ................................................................................................................................................ 3
Social Programme ................................................................................................................................. 4
Scientific Programme ............................................................................................................................ 5
International Faculty .............................................................................................................................. 6
New Zealand Faculty ............................................................................................................................. 8
Abstracts ................................................................................................................................................ 9
An Update in Obstetric Anaesthesia .............................................................................................. 11
Airway Update ................................................................................................................................ 19
Managing the Obese – Lessons from bariatric surgery ................................................................. 23
What’s New in Regional Anaesthesia? .......................................................................................... 29
The New Generation Anaesthetic Machine .................................................................................... 33
Goal Directed Therapy – Experience at a tertiary care centre ....................................................... 45
What’s New in Ventilation? ............................................................................................................. 49
ICU Topics ...................................................................................................................................... 57
Drug Dosage – How many inches should you give? ..................................................................... 61
What’s the Solution? ...................................................................................................................... 67
Enhanced Recovery After Surgery Protocols ................................................................................. 71
Learning From Errors in Obstetric Anaesthesia – Designing systems to improve patient safety .. 77
A Bug’s Life – So simple, and yet so fascinating too ..................................................................... 79
Mercenaries, Misfits and Medics – Helping out overseas .............................................................. 85
Sponsors ............................................................................................................................................. 90
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Annual Queenstown Update in Anaesthesia, 2012
Gold Sponsor
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Silver Sponsors
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Annual Queenstown Update in Anaesthesia, 2012 Welcome
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Welcome to the fourth Annual Queenstown Update in Anaesthesia. AQUA 2012 continues with the
theme of the previous meetings, which is to provide anaesthetists with an annual update on core topics
relevant to current clinical practice. Add in an excellent social programme and the setting of
Queenstown in the ski season, and the ingredients are in place for a great conference. AQUA is run in
partnership with the NZSA and we are grateful for the enthusiasm and support of the NZSA executive.
AQUA 2012 features five international speakers who will add further depth and diversity to this year’s
scientific programme. The international faculty include; AP Nolan McDonnell, Dr Chris Thompson, Dr
Laurence Weinberg, AP Frank van Haren and AP Peter Hebbard. Between them they will cover
everything from obstetrics to the future directions of hardware, regional anaesthesia to goal directed
therapy, patient safety and ICU care.
Once again, we are indebted to our local faculty from around New Zealand for their hard work. Without
their contribution, AQUA would not be possible. The organising committee would like to thank local
speakers for their willingness to be involved.
AQUA 2012 will again capitalise on the attractions Queenstown offers for the social programme.
Although Coronet Peak has had a patchy season this year, we have arranged snow fall especially for
the AQUA meeting. Night skiing will be held in conjunction with the AQUA BBQ on Friday night. The
conference dinner will be held at Skyline Restaurant (not a buffet!). Sipping on a glass of bubbles, you
will be whisked to the Skyline via the gondola enjoying spectacular views of Queenstown. Following a
fantastic dinner accompanied by fine local wines, we will conclude with live test rugby featuring an All
Blacks victory over the Wallabies.*
We trust you will learn during the day, but also enjoy time off as well.
Once again we acknowledge the generous support of our sponsors, in particular GE who are the AQUA
2012 Gold sponsor. We have been well supported by industry this year and we would like to thank them
all for being here. Please visit them in the exhibit area.
Enjoy.
Neil MacLennan
Martin Misur
Kerry Gunn
Karen Patching (KP)
* After last year’s result, the Convening Committee do not guarantee the outcome of the rugby
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Programme Annual Queenstown Update in Anaesthesia, 2012
SOCIAL PROGRAMME
Thursday, 16 August 2012
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AQUA Welcome Drinks 5:00 p.m. – 7:00 p.m.
Friday, 17 August 2012
Ski bus to Coronet Peak departs Millennium Hotel 12:40 p.m.
MedRecruit BBQ at Coronet Peak base building commences 6:00 p.m.
Ski bus to Millennium Hotel departs Coronet Peak 9:00 p.m.
Saturday, 18 August 2012
Ski bus to Coronet Peak departs Millennium Hotel 12:30 p.m.
Ski bus to Millennium Hotel departs Coronet Peak 4:15 p.m.
Dinner
Gondola from 6:00 p.m.
Dinner service from 7:00 p.m.
NB – All transportation will leave promptly at the designated time. If you are late, you will be
responsible for your own transportation.
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Annual Queenstown Update in Anaesthesia, 2012 Programme
SCIENTIFIC PROGRAMME
Day 1 – Friday, 17 August 2012
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0710-0755 Breakfast Exhibitor Area
0755-0800 Welcome and Introduction – Andrew Warmington Galaxy Room
Session 1: SUBSPECIALTY SYNOPSIS
0800-0840 An update in obstetric anaesthesia Nolan McDonnell
0840-0905 Airway update Jeanette Scott
0905-0930 Managing the obese – Lessons from bariatric surgery Craig Birch
0930-0955 What’s new in regional anaesthesia Peter Hebbard
0955-1025 Morning break Exhibitor Area
Session 2: BLACK BOXES Galaxy Room
1025-1105 The new generation anaesthetic machine Chris Thompson
1105-1130 Goal directed therapy – Experience at a tertiary care centre Laurence Weinberg
1130-1155 What’s new in ventilation? Chris Thompson
1155 Close – Lunch packs available for you to pick up Exhibitor Area
1240 Bus to Coronet Peak departs from Main Entrance, Millennium Hotel
Day 2 – Saturday, 18 August 2012
0715-0800 Breakfast Exhibitor Area
Session 3: POTPOURRI Galaxy Room
0800-0830 ICU topics Frank van Haren
0830-0855 Drug dosage – How many inches should you give? Tim Short
0855-0920 What’s the solution? Laurence Weinberg
0920-0945 Enhanced recovery after surgery protocols Matt Taylor
0945-1015 Morning Break Exhibitor Area
Session 4: AND NOW FOR SOMETHING COMPLETELY DIFFERENT Galaxy Room
1015-1040 Learning from errors in obstetric anaesthesia – Designing Nolan McDonnell
systems to improve patient safety
1040-1110 A bug’s life – So simple, and yet so fascinating too Ben Harris
1110-1140 Mercenaries, misfits and medics – Helping out overseas Wayne Morriss
1140 Close – Lunch packs available for you to pick up Exhibitor Area
1230 Bus to Coronet Peak departs from Main Entrance, Millennium Hotel
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Faculty Annual Queenstown Update in Anaesthesia, 2012
INTERNATIONAL FACULTY
Dr Nolan McDonnell
6 Department of Anaesthesia and Pain Medicine,
King Edward Memorial Hospital for Women, Perth
Dr Nolan McDonnell graduated from the University of Auckland in 1998 and
undertook his training in anaesthesia at Palmerston North and Waikato Hospitals. In
2006 he and his family moved to Perth, Western Australia where he undertook a one
year research and obstetric anaesthesia fellowship under the guidance of Prof
Michael Paech. He now works as a Staff Specialist in the Department of
Anaesthesia and Pain Medicine at King Edward Memorial Hospital for Women. This
is Western Australia’s only tertiary referral obstetric, gynaecology and gynae-
oncology hospital and hence caters for a comparatively high risk population. During
his time here he has continued his interest in research, undertaking a Masters of
Clinical Research in post caesarean analgesia.
He is now a Clinical Associate Professor with the School of Women’s and Infants’ Health and the School of
Medicine and Pharmacology, University of Western Australia and is widely published on a number of areas of
relevance to obstetric anaesthesia. In addition to these roles he sits on the executive of both the Obstetric
Anaesthesia and the Welfare of Anaesthetists Special Interest Groups, and he is involved in a number of local
and international research studies as well as having a large clinical education commitment.
Dr Chris Thompson
Department of Anaesthesia
Royal Prince Alfred Hospital, Sydney
Dr Chris Thompson graduated from the University of Sydney in 1979. He was
trained at Prince Henry / Prince of Wales Hospitals before becoming a Staff
Specialist at RPAH. During his training he was fascinated by ventilation, and was
with John Lawrence and others at Prince of Wales when they developed Australia’s
first CPAP / SIMV ICU ventilators from Bird machines. At the same time, his interest
in electronics led to a high frequency ventilator driver, a simple ventilator alarm and a
number of peripheral nerve stimulators. A lifelong interest in anaesthetic equipment
ensued.
Chris currently represents the College on international standards committees and has been a design consultant to
several international equipment manufacturers. For the last 15 years he has worked with Dräger in Germany on
the development of their latest anaesthetic machines. His primary clinical interests are neurosurgery, cerebral
protection, ventilation optimisation with modern machines and monitoring.
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Annual Queenstown Update in Anaesthesia, 2012 Faculty
Dr Laurence Weinberg
Department of Anaesthesia,
Austin Hospital, Melbourne
Dr Laurence Weinberg graduated from The University of Witwatersrand, South
Africa in 1997. He worked in teaching hospitals in the United Kingdom for the
following six years being awarded his membership of the Royal College of
Physicians of London in 2002. He completed his anaesthesia training at the Austin 7
Hospital in Melbourne with clinical fellowships in cardiac anaesthesia and liver
transplantation. In 2007, he was appointed as a staff specialist, and continues to
serve the Department of Anaesthesia at Austin Hospital. He is also a Senior Fellow
in the Department of Surgery, University of Melbourne, where he is completing a
Doctorate of Medicine degree.
His primary clinical and academic interests are in the areas of liver transplantation, major hepatobiliary and
cardiothoracic surgery. He has been the recipient of numerous research grants and has lectured both nationally
and internationally. Currently he is the principle investigator for seven randomised clinical trials, three of which are
multicentre studies.
A/Prof Frank van Haren
Intensive Care Unit, The Canberra Hospital, Canberra,
Australian National University Medical School
Dr Frank van Haren completed his dual specialist training as Physician and Intensive
Care Specialist in Nijmegen, The Netherlands in 2000. He has worked as an
Intensive Care Specialist in large teaching hospitals in the Netherlands and lectured
for the Dutch National Intensive Care training programme on topics such as sepsis,
nutritional therapy, and ethics.
From 2005 he worked in the Waikato Hospital, Hamilton, New Zealand, before
moving to Canberra, Australia in 2011, where he has been appointed Associate
Professor with the ANU Medical School, Senior Staff Specialist in the ICU of the
Canberra Hospital, and Director of the ICU research programme.
In 2010 he was awarded a PhD in Medical Sciences by the University of Nijmegen for his work on gastrointestinal
perfusion and microcirculation in sepsis. Other research interests include the effects of hypertonic fluid
resuscitation in sepsis, immunomodulation in sepsis, nutritional therapy, and non-conventional inotropes and
vasopressors. He has published and presented on a wide range of topics, and is reviewer for several international
medical journals.
A/Prof Peter Hebbard
Clinical A/Prof University of Melbourne
Peter Hebbard is Clinical Associate Professor and member of the steering
committee of the Diploma of Clinical Ultrasound at the University of Melbourne. He
was the convener of the ASURA 2012 meeting in Sydney and has been an invited
speaker on regional anaesthesia in the USA, Europe and Asia over the last two
years. In 2008 he won the award for Innovation in Ultrasound guided regional
anaesthesia at the ISURA meeting in Toronto for innovations in abdominal wall
blockade. Current interests include novel regional anaesthesia, pain medicine and
other techniques relating to ultrasound guidance.
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Faculty Annual Queenstown Update in Anaesthesia, 2012
NEW ZEALAND FACULTY
Dr Jeanette Scott
Middlemore Hospital
Auckland
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Dr Craig Birch
Middlemore Hospital
Auckland
Dr Tim Short
Auckland City Hospital
Auckland
Dr Matt Taylor
Middlemore Hospital
Auckland
Dr Ben Harris
Southern Community Laboratories
Christchurch
Dr Wayne Morriss
Christchurch Hospital
Christchurch
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Description:Aug 16, 2012 Welcome to the fourth Annual Queenstown Update in Anaesthesia. AQUA 2012
continues with the theme of the previous meetings, which is to
