The Anesthesia Playbook | TAP

A 31-year-old woman at 24 weeks gestation needs urgent surgery. Now every decision in your anesthetic has another layer.
When does aspiration risk become significant? When should you use left uterine displacement? How does fetal viability change your monitoring? Which vasopressor would you reach for when the blood pressure falls? And if your pregnant patient arrests in the OR, when does resuscitative delivery become part of maternal ACLS?
In this episode of The Anesthesia Playbook, we work through the case the way you might with a resident in the OR—one decision at a time. Along the way, we break down the physiologic changes of pregnancy that actually matter to your anesthetic, difficult airway considerations, uteroplacental perfusion, laparoscopy, fetal monitoring, medication choices, neuromuscular reversal, and postoperative care.
The goal isn't to memorize a separate anesthetic for pregnancy. It's to understand the physiology well enough to defend your decisions when the case changes.
Understand more. Memorize less.

A 38-kilogram patient. A recent coronary stent. An ankle fracture that can’t wait much longer.
At an outpatient surgery center, the plan seems straightforward: assess the cardiac risk, develop an anesthetic plan, control her postoperative pain, and get her safely home.
But a few subtle clues begin to change the case.
In this episode of The Anesthesia Playbook, we work through the case in real time—making decisions, challenging assumptions, and adapting as new information emerges.
If you’re preparing for oral boards, pause when the questions come up and commit to an answer before listening on.
Because the important question isn’t just whether you know the right answer.
It’s whether you recognize when the case has changed, and if you're able to explain your clinical reasoning.
Understand more. Memorize Less.

What could go wrong during a routine sedation case?
A patient presents for a seemingly straightforward procedure. She’s appropriately fasted, has no obvious aspiration risk factors, and the plan is simple: propofol sedation, spontaneous ventilation, and local anesthesia from the surgeon.
Then everything changes.
In this episode of The Anesthesia Playbook, we work through a case inspired by a real event and put you in the anesthesiologist’s seat as the situation evolves.
What would you do next—and more importantly, why?
Follow along, commit to your decisions, and see how your approach compares as the case unfolds.
Understand more. Memorize less.
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What could go wrong during a routine sedation case?
A patient presents for a seemingly straightforward procedure. She’s appropriately fasted, has no obvious aspiration risk factors, and the plan is simple: propofol sedation, spontaneous ventilation, and local anesthesia from the surgeon.
Then everything changes.
In this episode of The Anesthesia Playbook, we work through a case inspired by a real event and put you in the anesthesiologist’s seat as the situation evolves.
What would you do next—and more importantly, why?
Follow along, commit to your decisions, and see how your approach compares as the case unfolds.
Understand more. Memorize less.
Want more TAP?
Get the weekly TAP Case of the Week delivered to your inbox and test your clinical decision-making with a new case each week.
Follow The Anesthesia Playbook on Instagram, TikTok, YouTube, and Facebook for more anesthesia cases, clinical discussions, and quick teaching.
🔗 Newsletter, social channels, and more: [Click Here]

A 45-year-old woman with poorly controlled Graves disease presents for thyroidectomy with a massive goiter, positional dyspnea, and subtle stridor. The question isn’t just how you’re going to secure the airway—it’s what could happen if you take away the things currently keeping it open.
In this episode of The Anesthesia Playbook, we work through the case from pre-op evaluation to the PACU. We’ll reason through the difficult airway, awake intubation, anesthetic planning, thyroid physiology, and the recognition and treatment of thyroid storm. Then, just when the case seems finished, new postoperative problems force us to rethink the differential: hoarseness, neck swelling, and stridor.
Along the way, we’ll tackle the kinds of questions that matter both in the OR and on oral boards:
Would you sedate this patient? Would you induce general anesthesia before securing the airway? How would you recognize thyroid storm—and distinguish it from malignant hyperthermia? What would you do if she developed an expanding neck hematoma after surgery?
This isn’t about memorizing a list of answers. It’s about understanding the physiology, anticipating what could happen next, and making a defensible clinical decision.
Follow The Anesthesia PlaybookInstagram / TikTok / YouTube: @TheAnesthesiaPlaybookWebsite: TheAnesthesiaPlaybook.com
Understand more. Memorize less.
The Anesthesia Playbook is intended for education only and does not replace clinical judgment, institutional protocols, or appropriate supervision.