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  • Abdelazeem E. During covid era, is ERAS program still performed as planned or there is some modification?

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    • Abdelazeem E. pls describe your opioid free anesthesia protocol?

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      • Samah A. Thank you for sharing your experience with us.
        In our reality is not easy to select one team for all opeartins

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        • Abdelazeem E. in my setting we use moderate NMB and everybody happy with it. Even the recovery is excellent using it. Do you have a comment on moderate NMB?

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          • Nebojsa G. At what level of spine you place epidural for colorectal surgery?

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            • Jan Paul M. low opioid dose intra operative is nice concept but only on one condition and that is "giving other drugs or using loco regional infiltration in combination to block sympathetic and humoral reactions." The very high dose opioids intraoperative were needed when no other drugs were given to block these unwanted reflexes, certainly in major surgery.

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              • Jan Paul M. toxic dose is described at dose of 5 mg/kg or higher although this overdose is just giving deep anesthesia as you said totally different from levobupivacaine that is cardio and cerebral toxic on overdose

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                • Jan Paul M. Be very careful that no drapes are laying between skin and bump of trend guard !! or patient slides off

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                  • Jan Paul M. IL 6 / IL 10 ratio is all about peritoneal inflammation and this is indeed dramatic reduced when IAP is kept below 8 mmHg. The big interesting question is indeed if this reduced IAP by improving bowel perfusion reduces also the ileus. However you have to control for opioids as these are the number one factor inducing ileus. If you use OFA it would be easier to verify the hypothesis...

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                    • Jan Paul M. the CO2 absorption through the peritoneum increases after 30 min PP. Airseal can reduce the absorption by reducing the ischemia as air leaks slowly inside, and just 4 % O2 is already enough to keep the peritoneum longer alive when IAP are higher than 8 mmHg.

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                      • Jan Paul M. surgeon is faster in recognizing as PTC is not automatic and the diaphragm can still move when PTC = 1

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                        • Jan Paul M. Matthieu understood the physiology very good. congratulations

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                          • Jan Paul M. congrats to all

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                            • Abdulla Rasheed Hassan Ahmed A. Nice lectures which increasing our knowledge, my appreciation to all the lecturers. thanks.

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                              • Gazi C. Thanks a ton for very informative presentation.Kindly share the PowerPoint presentations.

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