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The woods are lovely, dark, and deep,But I have promises to keep,And miles to go before I sleep,And miles to go before I sleep.
“Stopping by Woods on a Snowy Evening”— Robert Frost
At the onset of this new year, 2008, let metake this opportunity to wish our membership avery special 12 months ahead. I hope all ofyour wishes and aspirations are fulfilled in fullmeasure. This is also a time of reflection for meas I look back on the year gone by. How far wego, and in what direction, is determined bywhere we are and how far we have traveled. Ihope our plans for the future direction of ourSociety are founded on a sense of optimism, yetfirmly grounded in reality. I believe that as wehave accomplished much and grown, that toaim high and far is not an exercise in futility.We can achieve great things because we knowwe have achieved great things in the year goneby.
This is an appropriate time to thank both ourboard members and management company forthe challenging transition of our headquartersfrom Cleveland to Park Ridge, Illinois. Overall,2007 was an incredible year for SOAP. Somuch of the credit for our many successes goesto those who have worked tirelessly and quietlybehind the scenes. Thank you. Yourcontributions will not go unnoticed.
Our financial situation is on firm footing.McCallum R. Hoyt, M.D., M.B.A., has guidedus with invaluable assistance in assetmanagement. We are comfortably situated to
meet our long-term plans and needs. We havean updated online abstract submission optionon ourWeb site that owes much to the efforts ofRichard Smiley, M.D., Ph.D., and RobertD’Angelo, M.D. We also welcome newmanagement Executive Director Chris Dionne,who works out of ASA’s headquarters in ParkRidge. Anne Maggiore, from IARS, previouslyoversaw our office. We thank her for herimmense contributions and wish her well in herfuture pursuits.
The program for the 40th Annual Meetinghas been finalized. Barbara Scavone, M.D., andLinda S. Polley, M.D., have put in a tremendousamount of time and effort to produce anoutstanding program. Please check our Website www.soap.org for program details andregistration information. We hope to see youthere. Please encourage your colleagues toattend this meeting. We promise to make itworth their while.
This past year has been a very active andbusy one. We have had a strong, continualdemand for high quality in our annual meeting,and we need to ask an important question onhow to increase our capacity. How do weimprove our educational opportunities? Thisopens the door to many other very importantquestions that need to be answered to delineatethe road we must follow in 2008. The need fora strategic plan for SOAP is even moreimperative. I have asked Lawrence C. Tsen,M.D., and Dr. D’Angelo to send themembership a series of questions that willultimately determine our future path. It is of thegreatest importance to participate in theirsurveys over the year.
What are other initiatives for 2008? Qualityis always at the essence of what and who weare. That is just what we do. This year, we aregoing to focus strongly on building ourinfrastructure to support scholarly activities,patient safety, educational excellence andmentorship. These are the prerequisites ofquality health care delivery. We start this
process by having motivated people help uswith projects. I would like to draw yourattention to the positions that are availablewithin the structure of SOAP (See page 12). Ifyou are interested in a spot, it is best to contactthe incumbent and ask in-depth questionsregarding the needs of “the job.” As we are anon-profit organization, there are no benefitsfrom SOAP for any of these positions exceptthe satisfaction of service and a job well done.
I invite you to submit ideas for the 2012meeting site to Chris Dionne so she can reviewthe sites to ensure they meet our needs well inadvance of the meeting. Once approved by herand the Board of Directors, you will be invitedto present a short presentation at the businessmeeting.
Winter/Spring 2008
Gurinder Vasdev, M.D.
Year of Transitions —A Message From the President
Samuel C. Hughes, M.D. —1946-2008 . . . . . . . . . . . . . . . . . . . .2
SOAP 40th Annual MeetingReport . . . . . . . . . . . . . . . . . . . . . . .3
40th Annual Meeting Program . . . .4
Spring Treasurer’s Report . . . . . . .8
SOAP Strategic Survey . . . . . . . . .9
Pro/Con . . . . . . . . . . . . . . . . . . . . . .10
Participate in SOAP’s History . . . .14
A&A Is the New OfficialJournal of SOAP! . . . . . . . . . . . . . .15
Inside
www.soap.org
continued on page 2
NewsletterNewsletterSociety for Obstetric Anesthesia and Perinatology
SOAP 41st Annual MeetingWashington, D.C.
Renaissance Washington D.C.Hotel
April 29 - May 3, 2009
SOAP 42nd Annual MeetingMay 12-18, 2010
Grand Hyatt San Antonio
SOAP 43rd Annual MeetingLoews Las Vegas Resort
April 13-16, 2011
SOAP FutureMeetings
SOAP is actively involved in the educationalgoals of ASA. David J. Wlody, M.D., will becoordinating the obstetric track. We have beenasked to participate in the ASA simulationsessions, which resulted from the excellentfeedback we received from the simulation sessionsin Banff. John T. Sullivan, M.D., Chair of theSOAP Education Committee, will oversee thischallenge, and we all look forward to hisproduction.
Residents, fellows and students build theirknowledge on their own unique foundations. Ibelieve that SOAP has vocation to support themwith a venue to present their scholarly activities. Itis a great opportunity to identify their level ofunderstanding so we can supply the appropriatemeans for educational growth. With this, I wouldask each and every member to encourage ourtrainees to come to our meeting and present in thespecial resident session.
I look forward to seeing you all in Chicago!
Best Wishes,
Gurinder Vasdev, M.D.President
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Samuel C. Hughes, M.D., a Professor in the Department of Anesthesia andPerioperative Care at the University of California San Francisco (UCSF), anattending physician at San Francisco General Hospital and a leadinginternational figure in obstetrical anesthesia, died on January 20, 2008, at age61 after a year-long battle with pancreatic cancer. During the course of hiscareer, he provided compassionate care to countless underserved patientsundergoing surgery at SFGH and acted as a voice of reason in the early daysof the AIDS crisis when hysteria threatened the ability of at-risk populationsto receive surgical treatment. He was valued by all who worked with himprofessionally as the true embodiment of a gentleman and a scholar.
Dr. Hughes, born and raised in Wilmington, Delaware, received hisundergraduate education at the University of New Hampshire and served inthe U.S. Army in Belgium. Hewas graduated from JeffersonMedical College in Philadelphiafollowed by clinical training inAnesthesiology at New YorkUniversity Medical Center. Hestudied under the mentorship ofSol Shnider, M.D., a pioneer inObstetrical Anesthesia at UCSF,then joined the UCSF faculty in1980 and remained on staff untilhis death. Hughes studied theclinical use of peridural opioidsfor labor and postoperativeanalgesia, the toxicity of localanesthetics, neurobehavioralchanges of maternal analgesicson the newborn, and placentaltransfer of a variety ofanesthetic and other agents.During his esteemed career, heco-edited a major textbook inhis field, Anesthesia forObstetrics, wrote over twentyinstructive book chapters, fortyoriginal scientific articles and editorials, served as the editor for theInternational Journal of Obstetric Anesthesia, supervised thirty fellows andtrained hundreds of residents in Anesthesia and Obstetrics. He served onnumerous committees for the San Francisco General Hospital, UCSF MedicalCenter, community service organizations and national societies, including thePresidency of the Society for Obstetrical Anesthesia & Perinatology, where hewill be honored posthumously at this yearís annual conference receiving theDistinguished Service Award. Dr. Hughes was a highly sought lecturer; overhis 28-year career, he presented hundreds of lectures nationally andinternationally and was a visiting professor at twenty-five renowned globalmedical institutions.
Dr. Hughes was an enthusiastic patron and supporter of the arts in SanFrancisco, especially the opera and ballet. He enjoyed the city’s haute cuisineand always appreciated a particularly fine wine. He was a passionate award-winning gardener. He traveled extensively both professionally and for hisenjoyment.
Dr. Hughes is survived by his sisters Lillian Crispin (Ed) and ElaineSingleton (David), brother, George (Judy), nieces, nephews, grandnieces andnephews, and many, many dear friends throughout the world. Donations canbe made to Sam’s Garden, The Wellness Community-Delaware, 4801Lancaster Pike,Wilmington, Delaware 19807 or to a charity of your choice. Acelebration of his life is being planned. For details as they become availableplease visit samhughesmd.blogspot.com.
Samuel C. Hughes, M.D.
Samuel C. Hughes, M.D. – 1946-2008Year of Transitions — A Message Fromthe President … continued from page 1
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April 30 - May 4, 2008Renaissance Chicago Hotel
On behalf of Barbara Scavone, M.D., SOAP 2008 meeting host,and myself, it is our great pleasure to invite you to join us for theSOAP 40th Annual Meeting in Chicago! The meeting will be held atthe Renaissance Chicago Hotel, conveniently located at the gatewayto Chicago’s Magnificent Mile of sophisticated shopping and close tomany of Chicago’s unique attractions. We have assembled anoutstanding faculty of national and international experts in obstetricanesthesia to highlight recent advances and important issues relevantto clinical practice. We have also invited specialists in obstetrics,obstetric medicine and law to offer new information and uniqueperspectives on common and difficult clinical situations. Don’t missthis opportunity to interact with the faculty and meet with yourcolleagues from across the country.
The Scientific ProgramThe meeting begins on Wednesday, April 30 with two optional
sessions. The first is the American Academy of Pediatrics NeonatalResuscitation Certification Program. This popular course willhighlight recent changes in the Neonatal Resuscitation Program(NRP) and review the content required for recertification. Space islimited, so please register early. Satisfactory completion of the coursewill result in a two-year certification from the American Academy ofPediatrics.
The second optional session is the Multidisciplinary Case Forum.The course directors this year are John Sullivan, M.D., and Dr.Scavone, from Northwestern University. SOAP attendees have beenrequesting more opportunities at theAnnual Meeting for discussion ofclinically relevant, complex cases in small groups. Our goal is tominimize didactic material and maximize interactive discussion.Attendees will rotate in groups to each of four rooms for 45-minutepanel sessions.
The meeting officially begins with a wine and cheese welcomereception that will be held on the outdoor high-rise terraceoverlooking the Chicago River and skyline. It should be beautiful atnight! To celebrate our 40th anniversary, Bradley Smith, M.D., and histask force are working on a fascinating historical slide show that willbe projected at the reception. This is a great opportunity to reconnectwith old friends and make new ones. Please join us before you headout to dinner in the city.
Thursday morning, SOAP President Gurinder M. Vasdev, M.D.,will open the meeting, and ASA President Jeffrey Apfelbaum, M.D.,will also extend his welcome to all SOAP participants. The GertieMarx Research Competition follows. Obstetric anesthesia fellows andresidents are eligible to enter and present their work. Other researchcompetitions include the ZuspanAward for work done in collaborationwith an obstetrician or obstetric medicine colleague (Thursdayafternoon) and the Best Paper presentations on Saturday afternoon.
We are honored to present the 2008 Distinguished Service Awardposthumously to Samuel Hughes, M.D., for his outstandingcontributions to SOAP and the subspecialty of obstetricanesthesiology. Later in the morning, pro/con debaters RobertD’Angelo, M.D., and Richard Smiley, M.D., Ph.D., will discuss “Allparturients receiving neuraxial morphine should be monitored withcontinuous pulse oximetry.” This is a topic of current interest giventhe current regulatory pressure to increase postoperative monitoring ofpatients receiving opioid analgesia. Dr. Paul Howell, president-electof the Obstetric Anaesthetists’ Association, will endeavor to keep allon track during this lively session. A second pro/con debate, “Generalanesthesia is acceptable for elective cesarean section,” will bemoderated by Brendan Carvalho, M.B., B.Ch. The very accomplished
Felicity Reynolds, M.D., will take the pro position, and CynthiaWong, M.D., is her worthy opponent. The debates are invariablyinformative and entertaining, and we look forward to this session onSunday!
William Grobman, M.D., will deliver this year’s “What’s New inObstetrics?” lecture. Dr. Grobman is an Associate Professor ofObstetrics and Gynecology and is a member of the Maternal-FetalMedicine division at Northwestern University. Ellen Mason, M.D., isthe internal medicine consultant to the Division of Maternal-FetalMedicine at Stroger Hospital (formerly Cook County Hospital) inChicago, and her “What’s New in Obstetric Medicine?” lecture willfocus on substance abuse and psychiatric disease during pregnancy.Finally, the Gerard W. Ostheimer Lecture, “What’s New in ObstetricAnesthesia?” will be presented by Ruth Landau, M.D., from Geneva,Switzerland. This triad of lectures truly covers the waterfront in termsof emerging information relevant to the care of the pregnant woman.
Panels for the 2008 SOAP meeting focus on the management ofobstetric catastrophes from both the medical and legal points of view.“Advances in the Management of Obstetric Hemorrhage” will bemoderated by William Camann, M.D., of Brigham and Women’sHospital in Boston, and panelists will discuss pharmacologicmanagement, the role of interventional radiology and theobstetrician’s perspective on maternal hemorrhage. The second panel,“Legal Issues in Obstetric Anesthesia,” will be moderated by AndrewHarris, M.D.,Associate Professor ofAnesthesiology at Johns Hopkinsand Maryland state senator. Expert panelists include Karen B.Domino, M.D., M.P.H., who will discussASA closed claims analysis,Patti Kocour, J.D., a Chicago litigation attorney who has devoted hercareer to defending doctors and hospitals, and William Bower, J.D.,Executive Director of Claims and Litigation for NorthwesternMemorial Hospital.
Professor Alan C. Santos, M.D., chair of the Ochsner Clinic inNew Orleans and past-president of SOAP, will deliver the honoraryFred Hehre Lecture.
The second annual Residents’ Forum will be held Thursdayevening with exciting improvements based on feedback from lastyear’s meeting. The session includes a dinner reception for traineesand their faculty mentors followed by small-group oral presentations.We have assembled an impressive group of moderators and judges forthe session, and our goal is to assist residents in developing theirpresentation skills in an informal environment. We fully expect theforum to be the breeding ground for the next generation of leaders inobstetric anesthesiology.
The program also includes the Research Hour, “Making theAlmost Impossible Possible: Overcoming Obstacles to Doing and
Continued on page 9
SOAP 40th Annual Meeting Report
Linda S. Polley, M.D. Barbara Scavone, M.D.
4
SOAP40th Annual Meeting
“No Pain,All Gain”April 30-May 4, 2008
Register online at www.SOAP.orgChicagoWednesday, April 30, 2008
7:45 a.m.-2 p.m. Registration
8 a.m.-noon American Academy of PediatricsNeonatal Resuscitation CertificationProgramCourse Directors: Edwin H. Rho, M.D.;Gurinder M.S. Vasdev, M.D., F.R.C.A.Speakers: Kristi L. Boldt, M.D.; Robert C.Chantigian, M.D.; Paula A. Craigo, M.D.;Robert J. Friedhoff, M.D.; Robert V.Johnson, M.D.; Gerard S. Kamath, M.D.,F.R.C.A.; Matthew M. Kumar, M.D.; EdwardT. McGonigal, M.D., D.D.S.; Dennis C. Shay,M.D.; Peter A. Southorn, M.D.; Ivan A.Velickovic, M.D.; Jack L. Wilson, M.D.
1-5 p.m. Multidisciplinary Case ForumCourse Directors: John T. Sullivan, M.D.;Barbara M. Scavone, M.D.Faculty: Jeanette R. Bauchat, M.D.; YaakovBeilin, M.D.; Patricia Garcia, M.D.; Barry A.Harrison, M.D., M.B., B.S., F.A.N.Z.C.A.;David L. Hepner, M.D.; Marla A.Mendelson, M.D.; Jill M. Mhyre, M.D.;Kenneth E. Nelson, M.D.; Alan M.Peaceman, M.D.; Beth A. Plunkett, M.D.; B.Scott Segal, M.D.; Emily J. Su, M.D., M.S.
6-7:30 p.m. Wine and CheeseWelcome Reception
Thursday, May 1, 2008
7 a.m.-5 p.m. Registration
7-8 a.m. Breakfast with Exhibitors and Posters
8-8:15 a.m. Welcome to the 40th Annual MeetingGurinder M.S. Vasdev, M.D., F.R.C.A.,SOAP President; Linda S. Polley, M.D.,Program Chair, SOAP President-elect;Barbara M. Scavone, M.D., SOAPMeeting Host;Jeffrey L. Apfelbaum, M.D., ASA President
8:15-9:30 a.m. Gertie Marx Research CompetitionModerator: Gerard M. Bassell, M.D.Judges: Brenda A. Bucklin, M.D.; Sheila E.Cohen, M.B., Ch.B., F.R.C.A.;Gordon Lyons, F.R.C.A., M.D.; FelicityReynolds, M.D., M.S., B.S., F.R.C.A.;Lawrence C. Tsen, M.D.
9:30-9:45 a.m. Distinguished Service AwardPresented by: Gurinder M.S. Vasdev, M.D.,F.R.C.A.Recipient: Samuel C. Hughes, M.D.
9:45-10:15 a.m. Coffee with Exhibitors and Posters
10:15-11:30 a.m. Oral Presentations - Session #1Moderator: B. Scott Segal, M.D.
11:30 a.m.-12:30 p.m. Pro/Con Debate #1: All ParturientsReceiving Neuraxial MorphineShould Be MonitoredWith ContinuousPulse OximetryModerator: Paul R. Howell, B.Sc., M.B.,Ch.B., F.R.C.A.
Pro: Robert D’Angelo, M.D.Con: Richard M. Smiley, M.D., Ph.D.
12:30-1:30 p.m. Lunch with Exhibitors
1:30-2:30 p.m. What’s New in Obstetrics?Introduction: Barbara M. Scavone, M.D.Speaker: William A. Grobman, M.D., M.B.A.
2:30-3:30 p.m. Zuspan Research CompetitionModerator: Brenda A. Bucklin, M.D.Judges: William A. Grobman, M.D., M.B.A.;Peter G. Pryde, M.D.; Richard M. Smiley,M.D., Ph.D.; Kathryn J. Zuspan, M.D.
3:30-4 p.m. Coffee with Exhibitors
4-6 p.m. SOAP Business Meeting and AwardsPresentationGurinder M.S. Vasdev, M.D., F.R.C.A.,SOAP President
Friday, May 2, 2008
6-7 a.m. Fun Run/Walk
7 a.m.-5 p.m. Registration
7-8 a.m. Breakfast with Exhibitors and Posters
8-9:15 a.m. Oral Presentations Session #2Moderator: Edward T. Riley, M.D.
9:15-10:15 a.m. What’s New in Obstetric Medicine?Introduction: William R. Camann, M.D.Speaker: Ellen Mason, M.D.
10:15-10:45 a.m. Coffee with Exhibitors and PosterViewing
10:45-11:45 a.m. Poster Review #1Moderator: Jill M. Mhyre, M.D.
11:45 a.m.-12:45 p.m. Panel #1: Advances in the Managementof Obstetric HemorrhageModerator: William R. Camann, M.D.Panelists: David J. Wlody, M.D. -Pharmacologic Management of MaternalHemorrhageWilliam R. Camann, M.D. - The Role ofInterventional Radiology in MaternalHemorrhageSusan E. Gerber, M.D., M.P.H. - TheObstetrician’s Perspective on MaternalHemorrhage
1 p.m. Afternoon and evening on your own
Saturday, May 3, 2008
7-8 a.m. Breakfast with the ExpertsCo-moderators: H. Jane Huffnagle, D.O.;Suzanne L. Huffnagle, D.O.Experts: Pamela Flood, M.D.; Philip E.Hess, M.D.; McCallum R. Hoyt, M.D.,M.B.A.; Robert S. McKay, M.D.; Holly AnnMuir, M.D., F.R.C.P.C.; Peter H. Pan, M.D.;Grace H. Shih, M.D.; Maya S. Suresh, M.D.;Ashutosh Wali, M.D., F.F.A.R.C.S.I.; RichardN. Wissler, M.D., Ph.D.
7-8 a.m. Breakfast and Poster Viewing
8-9 a.m. Panel #2: Legal Issues in ObstetricAnesthesiaModerator: Senator Andrew P. Harris,M.D., M.H.S.Speakers: Karen B. Domino, M.D., M.P.H.,ASA Closed Claim Analysis
William B. Bower, J.D., Executive Director,Claims and Litigation, NorthwesternMemorial Hospital; Patricia Kocour, J.D.,Swanson, Martin, & Bell LLP
9-10 a.m. GerardW. Ostheimer Lecture -What’sNew in Obstetric Anesthesia?Introduction: Alison J. Macarthur, M.D.,M.Sc., F.R.C.P.C.Speaker: Ruth Landau, M.D.
10-10:15 a.m. Coffee Break and Poster Viewing
10:15-11:15 a.m. Poster Review #2Moderator: Kenneth E. Nelson, M.D.
11:15 a.m.-12:15 p.m. Fred Hehre Lecture: See One, Do One,Teach One: Is ThisWhatWomen ReallyWant?Introduction: Gurinder M.S. Vasdev, M.D.,F.R.C.A.Speaker: Alan C. Santos, M.D.
12:15-1:45 p.m. Lunch on your own
1:45-3 p.m. Best Paper PresentationsModerator: Gordon Lyons, F.R.C.A., M.D.Judges: Valerie A. Arkoosh, M.D., M.P.H.,F.R.C.P.C.; Brendan Carvalho, M.B., B.Ch.,F.R.C.A.; M. Joanne Douglas, M.D.,F.R.C.P.C.; Stephen H. Halpern, M.D.,F.R.C.P.C.; Craig M. Palmer, M.D.; CynthiaA. Wong, M.D.
3-4 p.m. Research Hour: Making the AlmostImpossible Possible: Overcoming Obstaclesto Doing and Publishing Clinical Researchin Obstetric AnesthesiaIntroduction: Richard M. Smiley, M.D., Ph.D.IRB Issues with Research During PregnancySpeaker: Don E. Workman, Ph.D.Registering Clinical Trials and ObtainingINDs – You Have To Do This To Publish??!Speaker: Cynthia A. Wong, M.D.
6-10 p.m. SOAP’s 40th Anniversary Celebratory DinnerThe meeting's social highlight at theUniversity Club of Chicago, overlookingMillennium Park and Lake Michigan.
Sunday, May 4, 2008
7:30-8 a.m. Continental Breakfast
8-8:15 a.m. Awards CeremonyLinda S. Polley, M.D.
8:15-9:15 a.m. Pro/Con Debate #2: General Anesthesia IsAcceptable for Elective Cesarean SectionModerator: Brendan Carvalho, M.B., B.Ch.,F.R.C.A.Pro: Felicity Reynolds, M.D., M.S., B.S.,F.R.C.A.Con: Cynthia A. Wong, M.D.
9:15-10:15 a.m. Best Case ReportsModerator: David L. Hepner, M.D.
10:15 a.m. Adjournment
Meeting info continued on next page.
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Meeting Highlights
American Academy of Pediatrics: Neonatal ResuscitationCertification Program
Wednesday, April 30, 8 a.m.-noon• Pre-registration is required for this program.• Fee includes book• Enrollment is limited!
American Academy of Pediatrics training video (1.5 hours)new videoLectures:What’s New in Neonatal Resuscitation – Robert C. Chantigian,M.D.Vignettes in Neonatal Resuscitation – Robert V. Johnson, M.D.Megacode TestMCQ Examination
Multidisciplinary Case Forum – NEW THIS YEAR!
Wednesday, April 30, 1-5 p.m.• Pre-registration is required for this program.• Enrollment is limited!
Sessions moderated by Yaakov Beilin, M.D., David L. Hepner,M.D., Kenneth E. Nelson, M.D. and B. Scott Segal, M.D.
Small interactive discussions of clinically complex casesMultidisciplinary panels with representatives from maternal fetalmedicine, cardiology and critical care.
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Hotel InformationThe Renaissance Chicago Hotel is the official headquarters hotel
for all SOAP 40th Annual Meeting activities and related events.
Renaissance Chicago Hotel1 West Wacker DriveChicago, Illinois 60601Phone: (312) 372-7200
ReservationsA special discounted rate of $224 for single/double
occupancy, plus taxes, has been secured for all attendees. Roomreservations can be made by calling (800) 228-9290or online at marriott.com/chisr?groupCode=soasoaa&app=resvlink.Reservations must be made by April 9, 2008.
SOAP Resident ForumCo-chairs: Joanne C. Hudson, M.D., Helene Finegold, M.D.
6-7 p.m.Welcome and Dinner Reception
Introduction: Gurinder M.S. Vasdev, M.D., F.R.C.A.
7-8:30 p.m.Oral Presentations
Moderators:Valerie A. Arkoosh, M.D., M.P.H.William R. Camann, M.D.
Roshan Fernando, M.B., Ch.B., F.R.C.A.; Robert R.Gaiser, M.D.; Alan C. Santos, M.D.; Maya S. Suresh, M.D.
Judges: Helene Finegold, M.D.; Joanne C. Hudson,M.D.; Jill M. Mhyre, M.D.; Edward T. Riley, M.D.;Barbara M. Scavone, M.D.; Monica Servin, M.D.;John T. Sullivan, M.D.; Lawrence C. Tsen, M.D.;Gurinder Vasdev, M.D., F.R.C.A.; Raouf S. Wahba,M.D., F.R.C.P.C.; Richard N. Wissler, M.D., Ph.D.;
Kyle G. Wojciechowski, M.D.
39thAnnual MeetingBanf, Canada
SOAP
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8
SOAP
Spring Treasurer’s Report
2008
It’s official. We are now being managed by the ASA, and likeall new transitions, moving into a new situation brings with it newideas and adjustments. Some of the changes that are occurringwith our financials and this transition are as follows:
Our fiscal year is now the calendar year. Since our time withRuggles, SOAP’s fiscal year has ended on October 31. However,the ASA fiscal year follows the calendar year, and we were askedto change ours to match theirs. Ultimately, this is a veryreasonable thing to do, but during the transition, it means that theaccounting is a bit more complex. We have finished the old fiscalyear well within budget, but because of the two-month lagbetween the old and the new fiscal years, a separate two-monthbudget was created. Preliminary financial reports from that timelook as if most projections were met; however, final reports andthe close of our books with the IARS are still pending as of thetime of this writing. I am working with the ASA personnel to properly transition the reportsthat I see as treasurer and make sure the proper people receive the financial information IARSwas receiving.
SOAP’s banking institution has changed and is now the same as that used by ASA. Theinstitution is called Northern Trust Corporation, and we, as a nonprofit Society, are benefitingfrom interest-bearing accounts similar to those we enjoyed in Cleveland with the IARS and KeyBank.
A fresh eye looking at old accounts is always a good thing, and so upon the suggestion ofGary Hoormann of the ASA, we will be separating the OAPEF financial information from theSOAP operating information. Although this will have no effect on the Society as a whole, thechange will clarify for the BOD and those responsible for suggesting how grants are distributedand for how much (i.e. the Distribution Committee), where the money is, what is restricted, andhow much is available.
Although I have traditionally reported more specifically on our numbers in the SpringReport, a couple more months need to pass to smooth the flow of information from IARS andASA. However, I will have a full report ready for the Annual Meeting and look forward toseeing you there.
Respectfully submitted,
McCallum R. Hoyt, M.D., M.B.A.
McCallum R. Hoyt,M.D., M.B.A.
9
Publishing Clinical Research in Obstetric Anesthesia,” oral andposter presentations of current research, best case reports, andBreakfast With the Experts.
The Social Program2008 meeting host Dr. Barbara Scavone, has an exciting
program planned in a city that is always popular with registrants.Her energy and enthusiasm are remarkable, and she is hard at workto ensure that our 40th anniversary meeting is unforgettable.
All are invited to the meeting’s social highlight — theCelebratory Dinner on Saturday evening at the University Club of
Chicago, a magnificent setting with a breathtaking view ofMillennium Park and beautiful Lake Michigan.
Most importantly, a warm welcome is extended to all, includingthe many practitioners with obstetric anesthesia responsibilities incommunity practice. We seek to enlarge and enrich our societywith all who are interested in the care of women and their babiesin the peripartum period. See you in Chicago this spring!
Linda S. Polley, M.D.SOAP Scientific Program Chair and President-Elect
SOAP 40th Annual Meeting Report continued from page 3
One of the SOAP Board of Directors’responsibilities is strategic planning. Because10 years have passed since the last SOAPLong-Term Planning Committee wasactivated, and the fact that SOAP hasexperienced significant changes the past fewyears, the BOD has asked us to develop along-term strategic plan for the Society.
We would like to begin this process bygathering information from you, the membersthat we serve. We believe it is vital tounderstand “where we are” before anydecisions can be made on “where we want togo.” To accomplish this goal, a self-explanatory survey has been designed thatshould take no more than 10-15 minutes tocomplete. Expect to receive the survey by e-mail within the next few weeks. We ask thatyou please take a few minutes to completeand return the survey, since your feedbackwill be the basis for developing our Society’sstrategic plan. To make it as easy as possible,the survey can be returned by mail, e-mail,fax or completed online. Instructions willaccompany the survey.
Thanks in advance for your time andefforts.
Sincerely,
Robert D’Angelo, M.D.Lawrence Tsen, M.D.Val Arkoosh, M.D.
Robert D’Angelo, M.D
Lawrence Tsen, M.D.
Val Arkoosh, M.D.
SOAPStrategicPlanSurvey
PRO
CON
As currently practiced, epidural blood patch (EBP) is an antiquatedtechnique, and its critical re-evaluation is long overdue. For labor analgesia, thelocation of the epidural space is carefully tested using aspiration, test dose andincremental dosing during close observation of the patient. In EBP, blood isinjected directly through the needle. Epidural blood patch has not kept pacewith changes that have improved the safety and efficacy of other epiduralprocedures, and an adequate scientific base for its use has not been developed.Performance of blood patch under fluoroscopic guidance would make it safer,more effective and would help to develop a better scientific foundation for itspractice.
The first experimental dural punctures were quickly followed by the firstpostdural puncture headaches (PDPH), which confined one early researcher tohis bed for nine days.1 Fear of PDPH limited acceptance of central neuraxialtechniques. It was quickly recognized that PDPH resulted from the loss ofspinal fluid, and efforts to treat it focused on replacing the lost fluid or sealingthe dural hole.2 One particularly disconcerting approach placed knotted cat gutinto the epidural space to plug the dural leak.3 A safe and effective treatment forPDPH was needed.
In 1960, Gormley reported complete relief of PDPH after the injection ofblood into the epidural space, and the EBP was born.4 Since that time,anesthetic techniques have changed greatly, as our specialty has led all others inimproving patient safety. In obstetric anesthesia, continuous catheter-basedtechniques with careful identification of the epidural space have revolutionized
The accurate diagnosis, management and treatment of the postdural punctureheadache (PDPH) is an important responsibility as it impacts the post-deliverycourse of affected patients. Although many preventative and conservativemeasures can be employed, the epidural blood patch (EBP) is often the mostdefinitive option. Since its introduction by Gormley1 in 1960, the autologousepidural blood patch has proven to be an effective part of our treatment plan forPDPH. The use of fluoroscopy for other neuraxial procedures performed by ourcolleagues in pain management has become the standard of care, and somewould argue that the routine EBP in the obstetric population should now beperformed under fluoroscopic guidance as it may offer better anatomicalvisualization and the ability for confirmation of needle placement with contrastagents.When considering the merits of this argument for the routine lumbar EBPin the obstetric population, there are several questions one must ask.
1. Will the potential technical advantages of fluoroscopy improve the successrate of the EBP?
Reported success rates for EBP vary anywhere from 902 to 68 percent3 ofpatients having an excellent initial response. These reports are difficult tointerpret as there are differences in study populations, timing of the EBP and inthe amount of blood injected, all which could greatly impact success rates. Somewould argue that fluoroscopy might lead to easier localization of the epiduralspace. Most anesthesiologists use a loss of resistance (LOR) in order to locatethe epidural space for “blind” interlaminar epidural blood patches. Onemanuscript4 reports that the LOR technique was problematic for their painprocedures and associated with a 25 percent false-positive rate. This type offalse positive rate is clearly not an accurate representation of the practice of anexperienced anesthesiologist. There are so many factors that can affectsuccessful placement of an epidural needle; therefore, it is extremely difficult to
10
Should Epidural Blood Patch BePerformed With Fluoroscopic Guidance?
Paula Craigo, M.D.
Ellen Lockhart, M.D.
Pro/Con
“As currently practiced,epidural blood patch (EBP) is anantiquated technique, and itscritical re-evaluation is longoverdue.”
“Although many preventativeand conservative measures can beemployed, the epidural bloodpatch (EBP) is often the mostdefinitive option.”
11
patient care. Changes in practice followed the recognition that,contrary to widespread belief, intravascular toxicity could not bereliably prevented with oxygen and blood pressure support, andaccurate location of the epidural space was of critical importance.5Accumulated data on adverse outcomes from bupivacaine toxicity ledto this recognition, but, because EBP involves injection of blood ratherthan drugs, it escaped the attention of the Food and DrugAdministration, and no central database for recording adverse eventswas developed. EBP is still performed by injecting blood directlythrough a needle placed in the epidural space, without confirmation ofepidural placement beyond loss of resistance and aspiration throughthe needle, an approach essentially unchanged since Gormley’s time.Almost 50 years after its initial description, the EBP stands in markedcontrast to the modern practice of epidural anesthesia for obstetrics.
Is the technique of EBP an unacceptable anachronism or a simpleand effective procedure that has withstood the test of time? The answerdepends on whether there are fundamental differences between EBPand other epidural procedures that would support a difference intechnique. If greater efficacy and a lower risk profile are inherent inEBP, then a less stringent identification of the epidural space might bewarranted. However, a comparison of EBP to labor analgesia fails tosupport this difference in technique.
EBP and labor analgesia differ in their indications, efficacy, thequality of knowledge and scientific foundations supporting thepractice, and risk of adverse outcomes. However, the differencessupport a more stringent approach to EBP rather than the currentapproach.
EBP has less clear indications and is less effective than laboranalgesia. Appropriate indications are particularly important whentherapy entails risk, but require an accurate diagnosis of the conditionto be treated. Though the diagnosis of labor is seldom in question, thediagnosis of PDPH often is, as headache occurs in up to 40 percent of
postpartum patients, though less than 5 percent are thought to bePDPH.6 PDPH frequently resolves spontaneously, but we are unableto identify these patients prospectively. Effective relief of labor pain isreliably provided by epidural analgesia;7 despite early claims, EBPfrequently fails to relieve PDPH.8,9 PDPH not only frequently resolveson its own in a few days, but, if correctly diagnosed, is not associatedwith life- or limb-threatening complications.
Safety and best practices are less well established for EBP than forlabor analgesia. Extensive study of labor analgesia has established itsdosage, timing, safety and effects on the mother, fetus and the progressof delivery. Adverse outcomes of epidural analgesia in thousands oflaboring patients have been closely studied in both the obstetrical andanesthesia literatures. In addition, labor analgesia involves drugadministration, and complications are reported to the FDA database. Incontrast, the study of EBP is primarily observational and frequentlyretrospective.10 There is no national database monitoring adverseoutcomes of EBP. Sporadic reports of its complications dot the
assess the success rates of a particular technique. Concern has alsobeen expressed about the accuracy of needle tip position for lumbarepidural procedures.5 It is true that much of the time the epiduralneedle is placed at a level other than the one anticipated.6 This mayindeed be unacceptable for procedures such as epidural steroidinjections where small volumes must be placed at the exact site ofinflammation. In contrast, epidural blood patches work initially byincreasing lumbar CSF pressure7,8 and secondarily by forming clotsthat adhere to the dura,9,10 potentially triggering fibrotic reactions.11MRI studies after EBP using 18-20 ml of blood demonstrate a 3-59 andmean of 4.612 level segmental spread of injected blood. Technetium-labeled RBCs were observed to have a mean spread of 9±2 spinalsegments.13 Given the mechanism of action of the epidural bloodpatch, and with this kind of spread of injected blood, the issue ofentering the epidural space at a level other than the anticipated one isinsignificant. It is not essential to introduce the blood into the exactlevel at which the dural puncture occurred. Failure of an EBP couldindeed mean improper placement; however, there are myriad otherpossibilities, including inadequate amount of injected blood, timing ofthe EBP, puncture of both the anterior and posterior aspects of the dura— especially during spinal anesthesia — or headache due to anetiology other than PDPH.
2. Are there complications or risks of EBP attributable to the“blind” approach?
Complications of EBP include backache, lower extremity radicularpain and neck pain.14 Many of these are related to the process by which
an epidural blood patch is believed to work, and it is therefore not clearthat the use of fluoroscopy would in any way improve upon this. Inaddition, there is always the risk of repeat dural puncture. The risk ofrepeat dural puncture cannot be eliminated with fluoroscopy; in fact,there are reports in the literature of intracord15 and inadvertent lumbardiscogram16 occurring during fluoroscopically guided epiduralprocedures. Some have expressed concern that fluoroscopic guidance“may lend a false sense of security and, without proper training of theoperator, may lead to worse patient safety outcomes.”15-17
3. Is it practical?The use of fluoroscopy requires specialized pain or radiology
Continued on page 12
Continued on page 12
Is the technique of EBP an unacceptableanachronism or a simple and effectiveprocedure that has withstood the test oftime? The answer depends on whetherthere are fundamental differences betweenEBP and other epidural procedures thatwould support a difference in technique.
“In addition to the significant additionalcosts of the fluoroscopic procedure, the costof keeping a postpartum patient with asevere PDPH in the hospital for additionaltime before she can have an EBP would beunacceptable to many, including the patientherself.”
12
PRO
CON
medical literature, though most are likely never published due toeditorial disinterest in the weak science of the case report as well asmedicolegal concerns. Because a vigorous literature is not available,specifics of the performance of EBP are based on convention andpractitioner experience.
Potential complications of EBP include failure, infection, repeatdural puncture and nerve injury. The most common complicationassociated with EBP is failure to relieve the headache in about half ofpatients.9 Reports of infection after EBP are rare. A search of themedical literature suggests that the majority of reported adverseeffects may be temporally but not causally related to EBP and mayhave resulted from inappropriate diagnosis of PDPH. EBP isinappropriate treatment for headaches due to postpartumpreeclampsia, brain tumors11 or cerebral venous thrombosis, and itsadditional contribution to pre-existing intracranial hypertension mayprecipitate side effects later blamed on the EBP.
Injection of blood into a blood vessel, unlike injection of localanesthetics, merely leads to a failed EBP. However, injection into thesubarachnoid or subdural space could result in arachnoiditis orcompression of neural structures.12,13 In addition, unintended andunrecognized dural puncture may be more likely in the patient withPDPH than in the laboring patient due to lower pressure in theepidural space. Just as in labor analgesia, the key to safe performanceof epidural blood patch is accurate location of the epidural space and
a needle that does not move into the subdural or subarachnoid space.Subdural injection in labor analgesia is an unusual cause of
adverse outcomes in labor analgesia, though the radiology literatureindicates that subdural placement may be quite common.14 Subduralinjection of blood may be as damaging to neural structure asintrathecal injection. While injection of an EBP through a catheterthat has been tested with a dose of local anesthetic may avoidsubarachnoid injection, detection of subdural placement requiresimaging or administration of larger doses of local anesthetics.Fluoroscopy would identify subdural placement of catheters orneedles.
Arguments against fluoroscopy include its expense and thenecessity for imaging equipment and specially trained personnel.The added expense is undeniable; scheduling of the procedure maydelay treatment of PDPH. However, the diagnosis of PDPH is notstraightforward, and the procedure not without risk; a 24- to 48-hourdelay is justifiable. Serendipitously, the maturation of the specialty ofpain management has led to proliferation of the equipment andexpertise required to perform procedures with radiologic guidance.As ultrasound technology develops, it may offer a more readilyavailable, convenient and cost-effective substitute for fluoroscopy
Why add fluoroscopic guidance to the practice of EBP? CurrentlyEBP is performed by the standards of the 1960s, identifying theepidural space by loss of resistance and negative aspiration. When
facilities and personnel, is not available at all in some hospitals and,if present, will not be available at all times. Therefore, the use offluoroscopic guidance for these procedures would limit theperformance of this procedure predominantly to anesthesiologistswho have received additional training in pain management or tointerventional radiologists. This change would eliminate the ability ofmost anesthesiologists who deliver anesthesia for obstetrics toperform an EBP on her/his own unit. In addition to the significantadditional costs of the fluoroscopic procedure, the cost of keeping apostpartum patient with a severe PDPH in the hospital for additionaltime before she can have an EBP would be unacceptable to many,including the patient herself.
4. Is there literature to support the practice of EBP withfluoroscopy?
There are numerous reports in the literature of spontaneous ventralor dorsal cervico-thoracic CSF leaks,18,19 which were patched witheither fluoroscopically or CT-guided EBPs. There are also reports oftransforaminal EBPs after unintended dural puncture that occurredduring epidural injection under fluoroscopy.20 If one is performing anEBP using a transforaminal approach in the cervical region in apatient with previous back surgery, or after an intrathecal pumpplacement, the use of fluoroscopy may be indicated. These situations
are rare in the obstetrical population. More commonly encountered isthe patient in whom the initial epidural was exceedingly difficultsecondary to extreme obesity or scoliosis. These may also representindications for fluoroscopy.
In summary, the use of fluoroscopic guidance for placement of theroutine epidural blood patch in the parturient after dural puncture isimpractical, expensive and not available to many practitioners. It isunclear that fluoroscopy could either raise the success rate or lowerthe complication rate. In addition, there are no data to support thispractice. After reviewing the literature and attempting to answer theabove questions, I must conclude that it is appropriate for anexperienced anesthesiologist to perform an epidural blood patchwithout the use of fluoroscopy.
References:1. Gormley J.Treatment of postspinal headache. Anesthesiology. 1960; 21:565-566.2. TaivainenT, Pitkanen M,Tuominen M, Rosenberg PH. Efficacy of epidural blood patch
for postdural puncture headache. Acta Anaesthesiol Scand. 1993; 37:702-705.3. Stride PC, Cooper GM. Dural taps revisited. A 20-year survey from Birmingham
Maternity Hospital. Anaesthesia. 1993; 48:247-255.4. White A. Injection techniques for the diagnosis and treatment of low back pain. Spine.
1983; 5:78-86.5. Bartynski WS, Grahovac SZ, Rothfus WE. Incorrect needle position during lumbar
epidural steroid administration: inaccuracy of loss of air pressure resistance andrequirement of fluoroscopy and epidurography during needle insertion. AJNR Am J
13
complications are of little severity and the efficacy of the procedure isbeyond question, this approach might be acceptable. EBP meetsneither criterion. Fluoroscopy would help avoid subarachnoid andsubdural injections of blood, decreasing risk, improving efficacy andaiding in the scientific evaluation of the procedure. Admittedly, useof fluoroscopy will not improve the diagnosis of PDPH or avoidinfectious complications. More importantly, it promises to decrease,though not eliminate, unintended subdural and subarachnoidinjections of blood and to ensure that more of the blood is actuallyplaced in the epidural space. Beyond enhanced safety and efficacy,an improved understanding of how EBP works and how it should beperformed could result.
References:1. Harrington BE. Postdural puncture headache and the development of the epidural
blood patch. Reg Anesth Pain Med. 2004; 29:136-163.2. Kunkle E, Ray B,Wolff H. Experimental studies on headache:Analysis of the headache
associated with changes in intracranial pressure. Arch Neurol Psych. 1943a; 49:323-358.
3. Nelson M. Postpuncture headaches: A clinical and experimental study of the causeand prevention. Arch Derm Syph. 1930; 21:615-627.
4. Gormley J.Treatment of postspinal headache. Anesthesiology. 1960; 21:565-566.5. Albright GA. Cardiac arrest following regional anesthesia with etidocaine or
bupivacaine. Anesthesiology. 1979; 51:285-287.6. Goldszmidt E, Kern R, Chaput A, Macarthur A. The incidence and etiology of
postpartum headaches: A prospective cohort study: [L’incidence et la cause des
cephalees du postpartum : une etude prospective]. Can J Anesth. 2005; 52:971-977.7. Anim-Somuah M, Smyth R, Howell C. Epidural versus non-epidural or no analgesia in
labour. Cochrane database of systematic reviews. (online) 2005.8. Safa-Tisseront V,Thormann F, Malassine P, et al. Effectiveness of epidural blood patch
in the management of postdural puncture headache. Anesthesiology. 2001; 95:334-339.
9. Banks S, Paech M, Gurrin L. An audit of epidural blood patch after accidental duralpuncture with aTuohy needle in obstetric patients. Int J Obstet Anesth. 2001; 10:172-176.
10. Sudlow C,Warlow C. Epidural blood patching for preventing and treating post-duralpuncture headache. Cochrane database of systematic reviews (online) 2002.
11. Eede HV, HoffmannVL,Vercauteren MP. Post-delivery postural headache: Not alwaysa classical post-dural puncture headache. Acta Anaesthesiol Scand. 2007; 51:763-765.
12. Diaz JH. Permanent paraparesis and cauda equina syndrome after epidural bloodpatch for postdural puncture headache. Anesthesiology. 2002; 96:1515-1517.
13. Kalina P, Craigo P,Weingarten T. Intrathecal injection of epidural blood patch: A casereport and review of the literature. Emerg Radiol. 2004; 11:56-59.
14. LubenowT, Keh-Wong E, Kristof K, Ivankovich O, Ivankovich AD. Inadvertent subduralinjection:A complication of an epidural block. Anesth Analg. 1988; 67:175-179.
Neuroradiol. 2005; 26:502-505.6. Chakraverty R, Pynsent P, Isaacs K.Which spinal levels are identified by palpation of
the iliac crests and the posterior superior iliac spines? J Anat. 2007; 210:232-236.7. Carrie LE. Postdural puncture headache and extradural blood patch. Br J Anaesth.
1993; 71:179-181.8. Coombs D, Hooper D. Subarachnoid pressure with epidural blood patch. Reg Anesth.
1979; 4:3-6.9. Beards SC, Jackson A, Griffiths AG, Horsman EL. Magnetic resonance imaging of
extradural blood patches: Appearances from 30 min to 18 h. Br J Anaesth. 1993;71:182-188.
10. Edelman JD, Wingard DW. Subdural hematomas after lumbar dural puncture.Anesthesiology. 1980; 52:166-167.
11. DiGiovanni AJ, Galbert MW,Wahle WM. Epidural injection of autologous blood forpostlumbar-puncture headache. II. Additional clinical experiences and laboratoryinvestigation. Anesth Analg. 1972; 51:226-232.
12. Vakharia SB,Thomas PS, RosenbaumAE,Wasenko JJ, Fellows DG.Magnetic resonanceimaging of cerebrospinal fluid leak and tamponade effect of blood patch in postduralpuncture headache. Anesth Analg. 1997; 84:585-590.
13. Szeinfeld M, Ihmeidan IH, Moser MM, et al. Epidural blood patch: Evaluation of thevolume and spread of blood injected into the epidural space. Anesthesiology. 1986;64:820-822.
14. Abouleish E, De la Vega S, Blendinger I,Tio T. Long term follow-up of epidural bloodpatch. Anesth Analg. 1975; 54:459-463.
15. Tripathi M, Nath SS, Gupta RK. Paraplegia after intracord injection during attemptedepidural steroid injection in an awake-patient. Anesth Analg. 2005; 101:1209-1211,table of contents.
16. Huang J, Kwa A. Lumbar discogram resulting from lumbar interlaminar epiduralinjection. J Clin Anesth. 2004; 16:296-298.
17. Munir MA, Rastogi R, Nedeljkovic S. Fluoroscopy and safety of spinal interventionalprocedures. Anesth Analg. 2006; 102:1586; author reply 1587.
18. Karst M, Hollenhorst J, Fink M, Conrad I. Computerized tomography-guided epidural blood patch in the treatment of spontaneous low cerebrospinal fluidpressure headache. Acta Anaesthesiol Scand. 2001; 45:649-651.
19. Hayek SM, Fattouh M, Dews T, et al. Successful treatment of spontaneouscerebrospinal fluid leak headache with fluoroscopically guided epidural blood patch:A report of four cases. Pain Med. 2003; 4:373-378.
20. Weil L, Gracer RI, Frauwirth N. Transforaminal epidural blood patch. Pain Physician.2007; 10:579-582.
Participate in SOAP’s History — With Help Fromthe
On October 13, 2007, SOAP President Gurinder Vasdev, M.D, andthe Board of Directors established a task force on the history of SOAP.Dr. Vasdev pointed out that although the future of SOAP is pleasantlytied to its past, much of our history is at present not accessible.
The charge of the new task force is twofold: the first charge is torender immediate assistance to Program Director Linda Polley, M.D.,in organizing a “Celebration of the History of SOAP” at the 40thAnnual Meeting, which will take place at the Renaissance ChicagoHotel in Chicago, April 30 to May 4, 2008. The second charge is toretrieve, reconstitute, organize, and make available for reference thedocumentary and visual history of the society. Several steps havealready been made toward accomplishing both goals.
Bradley Smith, M.D., has accepted the position of chair of the taskforce, and Alex Pue, M.D., has accepted the position of vice chair.Those who have already accepted positions on the task force includeDouglas R. Bacon, M.D., Donald Caton, M.D., Richard Clark, M.D.,Sheila Cohen, M.D., Joanne Douglas, M.D., Miechyslaw Finster,M.D., Brett Gutsche, M.D., Robert Hustead, M.D., Divina Santos,M.D., Michael Smith, M.D., and Kathy Zuspan, M.D., but others arealso expected.
Projects already under way for the “celebration” include at leasttwo slide shows of past events, plans for acknowledgement andhonoring or founders and our charter members, and an exhibit ofmemorabilia and pictures documenting our heritage, possibly mannedby pioneer members. Solicitation of industry contributors for funds toproduce a keepsake booklet or CD for distribution to each of theregistrants has begun. The project will be titled “A Celebration ofFortyYears of the Society for Obstetric Anesthesia and Perinatology.”
This production will include a history of the founding and growthof SOAP; a description of the impact SOAP has made in stimulatingand facilitating the improvement in the availability and safety ofclinical obstetric anesthesia in these 40 years; and a section describingcontributions of SOAP members through 40 years of investigation,publishing and teaching obstetric anesthesia.
In addition, there will be a list of all the annual meeting sites, pastpresidents and a section honoring the founders, many of the chartermembers and several subsequent pioneering SOAP members. Therewill be descriptions of the Nils Lofgren Award and the DistinguishedService Award, along with lists of the recipients and theiraccomplishments.
Beginning January 1, 2008, the WoodLibrary-Museum of Anesthesiology(WLM) has agreed to become the officialrepository of SOAP documents andvisual materials and to aid us inestablishing access mechanisms forresearch and retrieval from thesearchives. The board and PresidentVasdevhave arranged that our task force will bethe initial interactive group with WLMfor this activity. Help has been graciouslyoffered by the WLM’s DistinguishedLibrarian Patrick Sim, Librarian KarenBieterman and Archivist Felicia Reilly.These professionals will guide the taskforce members in:
1. Reviewing articles/documents thatwill be transferred from IARS to ASA.New material will be cataloged, indexedand scanned for names and discussionsubjects so that they will be usefulreferences.
2. Soliciting and collecting archivalmaterials of interest to SOAP membersfor posting on the Web site, and or forretention by WLM.
3. Finding and obtaining physicalmemorabilia connected to SOAP history.
4. Identifying historical landmarkpublications to create a bibliography of important milestone papers foraccess through the Internet.
In summary, SOAP NEEDS YOUR HELP! SOAP members whocan contribute documents or memorabilia or who wish to be helpfuleither in preparation of the celebration or in the longer-term archivingefforts should contact Dr. Smith or Dr. Pue at their e-mail addressesbelow.
[email protected]@sharp.com
Bradley Smith, M.D.
Alex F. Pue, M.D.
W L M
14
isThe New Official Journal of
“No other organization can match the Society for ObstetricAnesthesiology and Perinatology’s ability to take medical discoveriesand present new findings for the benefit of the parturient.”
– Bradley Smith, M.D.,founding father of SOAP
We are pleased to announce that as of January 1, 2008, Anesthesia& Analgesia will become the official journal of SOAP. We have hada longstanding and productive affiliation with Anesthesiology foralmost a decade. However, last year, as part of a move to redirect theirmission, Anesthesiology chose to sever ties with its affiliate societies.After much consideration among the SOAP Board of Directors, weselected Anesthesia & Analgesia as our official journal. We believethat this affiliation offers many opportunities for broadening andenhancing the mission of SOAP. A&A has a dedicated subspecialtysection for obstetric anesthesiology, led by section editor CynthiaWong, M.D. Dr. Wong recently assumed this position after manyyears of superb leadership by David Birnbach, M.D. Under theleadership of Steven Shafer, M.D. (no stranger himself to the SOAPfamily), the recently installed new editor-in-chief of A&A, an excitingsynergy is on the horizon. Plans are under way for a “journal-within-a-journal” concept wherein the obstetric anesthesiology section willassume a distinct look and feel and contain innovative and relevantcontent that we hope will entice obstetric anesthesiologists to lookforward to the arrival of A&A each month. The content will includethe finest examples of original research as well as reviews,commentary and other features of interest to obstetricanesthesiologists. The first new feature will be a series of mini-reviews that address narrow topics that are of interest toanesthesiologists practicing obstetric anesthesiology. These reviews,written by experts in the field, will be short and easy to digest and willhelp anesthesiologists to practice state-of-the art obstetricanesthesiology. A circulation of nearly 24,000 per month will help usin our mission to share our knowledge and cause with manyanesthesiologists the world over.
No one organization is large enough to be independent of others,and synergy in the anesthesiology world is paramount to the successof all of us. Ultimately, this synergy translates to better anesthesia careand improved lives of our patients and their families.
The development of new knowledge and its application to themedical care of humans is known by many names, including“translational research” and “bench to bedside.” This process hasalways been an important part of SOAP. Members participate in thisprocess daily, and the research is presented yearly at the annual SOAPmeeting. Publication of this research in A&A will further thiscollaboration with other anesthesiology subspecialties ― again, to thebenefit of our patients. The collaboration inherent in the process helpsexplain SOAP’s world leadership in education, research and patientcare for pregnant women. This is especially important today as wecontinue to work toward improving maternal safety, not only in theUnited States, but in all nations.
The evolution of SOAP has paralleled the growth ofanesthesiology in general. SOAP has created a uniquely scholarlyenvironment necessary to the further development of our field. Thestandards set by Anesthesia & Analgesia fit well within our own goalsof upholding the virtues of sharing and combining talents, fostering aloyal family working together and encouraging our trainees, all inorder to further improve patient care.
Cynthia A. Wong, M.D., Northwestern UniversityObstetric Anesthesia Section Editor
William R. Camann, M.D., Brigham and Women’s Hospital,Harvard Medical School
SOAP Journal Liaison
Cynthia A. Wong, M.D. William R. Camann, M.D.
!
15
Society for Obstetric Anesthesia and Perinatology2007-2008 Board of Directors
520 N. Northwest HighwayPark Ridge, IL 60068-2573
Immediate Past PresidentDavid J. Wlody, M.D.New York, NY
PresidentGurinder M.S. Vasdev, M.D.Rochester, MN
President-ElectLinda S. Polley, M.D.Ann Arbor, MI
First Vice PresidentLawrence C. Tsen, M.D.Boston, MA
Second Vice PresidentRobert D’Angelo, M.D.Clemmons, NC
TreasurerMcCallum R. Hoyt, M.D., M.B.A.Greene, ME
SecretaryBrenda Bucklin, M.D.Denver, CO
Journal LiaisonWilliam R. Camann, M.D.Boston, MA
Chair, ASA Committee onObstetric AnesthesiaCraig Palmer, M.D.Tucson, AZ
Newsletter & Website EditorMichael P. Smith, M.D., M.S.Ed.Akron, OH
Meeting Host 2007Raouf Wahba, M.D., F.R.C.P.C.Calgary, AB, Canada
Meeting Host 2008Barbara Scavone, M.D.Chicago, IL
Meeting Host 2009Robert R. Gaiser, M.D.Mount Laurel, NJ
Director at LargeRakesh B. Vadhera, M.D.,F.R.C.A., F.F.A.R.C.S.I.Galveston, TX
Representative: ASA House ofDelegatesAndrew P. Harris, M.D., M.H.S.Baltimore, MD
ASAAlternate DelegateRichard N. Wissler, M.D., Ph.D.Rochester, NY
