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# NYSSA-PGA's Sphere Quarterly Newsletter

## Sitemaps

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## Posts

- [Quarterly Issues](https://sphere.nyssa-pga.org/issues/)
- [Looking Ahead to PGA80](https://sphere.nyssa-pga.org/2026/nyssa-pga80-preview-and-meeting-update-for-sphere-readers/) - In December (11-14th), we will celebrate the eightieth anniversary of the PGA, our Society’s Annual Meeting, at NYC’s Marriot Marquis.
- [Remimazolam at Westchester Medical Center: Early Adoption, Safety Insights, and Applications](https://sphere.nyssa-pga.org/2026/remimazolam-at-westchester-medical-center-early-adoption-safety-insights-and-applications/) - As the case volume of non-operating room anesthesia (NORA) continues to grow, anesthesiologists must balance patient safety, efficiency and the unique organizational challenges within NORA procedural environments. Remimazolam, an ultra-short-acting benzodiazepine, is a new drug that may be safely used in non-OR settings.
- [Advocacy Day: Your Voice Made a Difference!](https://sphere.nyssa-pga.org/2026/nyssa-41st-annual-advocacy-day-in-albany/) - NYSSA’s 41st Annual Advocacy Day in Albany included 70 members representing all NYSSA districts—our strongest turnout ever in hosting this event! Preserving physician-led anesthesia care requires involvement of us all. Looking ahead, we are ready to assist you in scheduling meetings with your legislators in their local district offices.
- [Honoring Our Past, Building Our Future](https://sphere.nyssa-pga.org/2026/honoring-our-past-building-our-future/) - Assistant Executive Director of Operations Lisa ONeill reflects on NYSSA’s 2026 leadership transition, welcoming Babette Atkins as Executive Director and bidding farewell to Stuart Hayman—who has been her friend, mentor and trusted colleague for more than 25 years.
- [Governmental and Legal Affairs Committee](https://sphere.nyssa-pga.org/2026/governmental-and-legal-affairs-committee/) - GLAC serves as the central advocacy arm of our society, shaping how anesthesiologists engage with legislation, regulation and healthcare policy across New York State. Its core mission is to advance patient safety by advocating for high-quality, physician-led anesthesia care and opposing policies that may compromise safety.
- [Celebrating David J. Wlody, MD, FASA 2025 NYSSA Distinguished Service Award Recipient](https://sphere.nyssa-pga.org/2026/celebrating-david-j-wlody-nyssa-distinguished-service-award-recipient/) - The quarterly feature showcases a career marked by extraordinary service to patients, to trainees, and to the entire profession of anesthesiology. Other must-reads include a preview of PGA80, updates on NYSSA’s successful Advocacy Day and other professional collaborations, important clinical articles—and more.
- [Vol 78 #2](https://sphere.nyssa-pga.org/2026/dont-miss-topics-vol-78-2/) - NYSSA-PGA80 preview and meeting update for Sphere readers Registration is open and we encourage everyone to visit https://www.pga.nyc, to register and sign up early before the exciting (and many new) hands-on and small-group learning opportunities fill up. This is especially important if you need MOCA simulation and patient safety credits. Keep reading NYSSA at the
- [Case Study from MLMIC Insurance Company](https://sphere.nyssa-pga.org/2026/case-study-from-mlmic-insurance-company/) - Clinical judgment is often a factor contributing to malpractice allegations. In this case, neither the internist, the gastroenterologist nor the anesthesiologist met the standard of care in their treatment of the patient.
- [Supporting Safe Breastfeeding Through Anesthesia and Surgery](https://sphere.nyssa-pga.org/2026/supporting-safe-breastfeeding-through-anesthesia-and-surgery/) - In honor of August being National Breastfeeding Month, I’m using this editorial to highlight the perioperative care of lactating patients—a topic I have been passionate about since breastfeeding my son in 2014.
- [Vol 78 #2](https://sphere.nyssa-pga.org/2026/case-studies-vol-78-2/) - Nasotracheal Intubation and Oral to Nasal Intubation Conversion Nasotracheal intubation is a fundamental skill in which anesthesia providers should be proficient. Control of epistaxis is essential, and risk factors including history of recurrent epistaxis, anticoagulant use and coagulopathy must be considered. Keep reading Perfusion Paradox: Balancing Hemodynamic Priorities In the rare setting of concurrent acute
- [Photo Gallery](https://sphere.nyssa-pga.org/2026/photo-gallery-78-2/) - 2026 NYSSA Advocacy Day NYSSA @ LegCon26
- [Vertebral Compression Fractures: Indications, Technique and Complications of Vertebral Augmentation](https://sphere.nyssa-pga.org/2026/vertebral-compression-fractures-indications-technique-and-complications-of-vertebral-augmentation/) - Vertebral augmentation is a minimally invasive procedure performed by chronic-pain trained anesthesiologists in patients who have not improved with conservative management. Early vertebral augmentation has been associated with improved survival rates, reduced pain and reduced infections.
- [Insights from the Literature](https://sphere.nyssa-pga.org/2026/insights-from-the-literature/) - This quick four-minute read summarizes four new articles focused on ambulatory anesthesia. It includes bolded take-home points that you can apply in your ambulatory practice tomorrow!
- [Perfusion Paradox: Balancing Hemodynamic Priorities](https://sphere.nyssa-pga.org/2026/perfusion-paradox-balancing-hemodynamic-priorities/) - In the rare setting of concurrent acute aortic dissection and hypoperfusion-related cerebral infarction during hemodynamic modulation, blood pressure management is particularly complex. This case illustrates the importance collaborating across disciplines in complex vascular emergencies.
- [An Exemplar of Service and Mentorship](https://sphere.nyssa-pga.org/featured/celebrating-david-j-wlody-md-fasa-2025-nyssa-distinguished-service-award-recipient/) - NYSSA is proud to recognize David J. Wlody, MD, FASA as the recipient of the 2025 NYSSA Distinguished Service Award. Presented at PGA79, this award celebrates a career marked by extraordinary service to patients, to trainees, and to the entire profession of anesthesiology.
- [Annual Anesthesiology Jeopardy and Poster Presentation Event](https://sphere.nyssa-pga.org/2026/annual-anesthesiology-jeopardy-and-poster-presentation-event/) - The anesthesiology section of the New York Academy of Medicine holds an annual Anesthesiology Jeopardy Competition and Poster Presentation Night for anesthesiology residents at area institutions. This popular event encourages residents to study and improve their knowledge on both the subject and the history of the specialty.
- [The Role of Amisulpride in PONV Management](https://sphere.nyssa-pga.org/2026/the-role-of-amisulpride-in-ponv-management/) - The prevention of postoperative nausea and vomiting (PONV) often seems straightforward—until prophylaxis fails. Amisulpride, a dopamine antagonist and originally an antipsychotic medication, is now being extensively studied for its antiemetic properties.
- [Intraoperative Monitoring of Neuromuscular Blockade](https://sphere.nyssa-pga.org/2026/intraoperative-monitoring-of-neuromuscular-blockade/) - Neuromuscular blocking agents (NMBAs)— both depolarizing and nondepolarizing—are an integral component of general anesthesia. Their purpose is to induce reliable, reversible skeletal muscle paralysis in order to facilitate endotracheal intubation, optimize surgical exposure and maintain immobility during surgical procedures.
- [Compartment Syndrome and the Use of Regional Anesthesia](https://sphere.nyssa-pga.org/2026/compartment-syndrome-and-the-use-of-regional-anesthesia/) - There is controversy surrounding use of regional anesthesia for orthopedic patients due to the belief that local anesthetics could mask the symptoms of compartment syndrome in at-risk patients. This article examines the clinical process, reviews the literature and suggests recommendations for its safe use.
- [NYSSA at the 2026 SCA](https://sphere.nyssa-pga.org/2026/nyssa-at-the-2026-sca/) - The New York State Society of Anesthesiologists (NYSSA) was represented prominently at both TAS and SCA, and several of our leaders took on influential roles as board members, scientific planners and educators—underscoring NYSSA’s burgeoning influence on the national stage.
- [Implications of New York’s Physician-Assisted Suicide Law](https://sphere.nyssa-pga.org/2026/implications-of-new-yorks-physician-assisted-suicide-law/) - New York's Medical Aid in Dying Act permits mentally competent adults who are terminally ill and have six months or less to live to self-administer prescribed medication to end their lives. The law assigns specific responsibilities and challenges to anesthesiologists and requires an extensive grasp of the clinical and ethical aspects of physician-assisted suicide.
- [Nasotracheal Intubation and Oral to Nasal Intubation Conversion](https://sphere.nyssa-pga.org/2026/nasotracheal-intubation-and-oral-to-nasal-intubation-conversion/) - Nasotracheal intubation is a fundamental skill in which anesthesia providers should be proficient. Control of epistaxis is essential, and risk factors including history of recurrent epistaxis, anticoagulant use and coagulopathy must be considered.
- [Applying Yourself to the APPLIED Exam](https://sphere.nyssa-pga.org/2026/applying-yourself-to-the-applied-exam/) - The two-component APPLIED Examination is designed to assess real-world judgment, communication and professionalism rather than foundational knowledge alone. Understanding the structure and evolution of the board certification process helps candidates prepare more effectively and perform with confidence.
- [Reduce Your Reliance on Single-use Plastic](https://sphere.nyssa-pga.org/tip-of-the-quarter/sustainability-tip-of-the-quarter-78-2/) - While the health impacts of microplastics are largely unknown, their prevalence continues to increase. some individual and institutional strategies for (safely) cutting back on their usage during your anesthetic.
- [Looking Ahead to PGA80](https://sphere.nyssa-pga.org/2026/looking-ahead-to-pga80/) - "As summer winds down, I find myself looking ahead with great excitement to what promises to be an outstanding PGA80 meeting this December."
- [Advancing Hands-On Education: Highlights from the PGA Workshop Committee](https://sphere.nyssa-pga.org/2026/advancing-hands-on-education-highlights-from-the-pga-workshop-committee/) - The Post Graduate Assembly (PGA) Workshop Committee plays a central role in advancing the educational mission of the New York State Society of Anesthesiologists (NYSSA). Through immersive, hands-on learning experiences, our workshops translate emerging science, evolving technology and best clinical practices into practical skills that anesthesiologists can apply in their daily work immediately.
- [Enhancing Patient Outcomes through Collaboration - Recapping PGA79  ](https://sphere.nyssa-pga.org/featured/enhancing-patient-outcomes-through-collaboration-recapping-pga79/) - NYSSA’s 79th Post Graduate Assembly in Anesthesiology—one of the largest annual gatherings for anesthesiologists worldwide—brought together thousands of clinicians, researchers and industry leaders. More than twenty percent of attendees traveled from outside the United States, strengthening collaboration across borders, institutions and practice settings.
- [Vol. 78 #1](https://sphere.nyssa-pga.org/2026/dont-miss-topics-vol-78-1/) - An Early Exposure to Anesthesia, a Formal Training Before the Textbooks When my application to medical school was rejected straight out of college, I felt as though my whole world got upended. What I did not realize at the time was that this unexpected detour would become one of the most formative experiences of my
- [An Exciting and Productive Year for NYSSA](https://sphere.nyssa-pga.org/2026/an-exciting-and-productive-year-for-nyssa/) - As we move through an exciting and productive year for NYSSA, I am continually reminded that our greatest strength is our collective commitment to one another and to the patients we serve. This spring marked the launch of the Empire Project, an initiative that reflects the innovation, dedication and intellectual curiosity within our community. We
- [PGA79: Photos from Attendees](https://sphere.nyssa-pga.org/2026/pga79-photos-from-attendees/)
- [PGA79: Professional Photos](https://sphere.nyssa-pga.org/2026/pga79-photos/) - RFS Workshop Scientific Panel Exhibit Hall Intl Scholars HOD Sunday Posters Gallery General Cocktail Reception Rovenstine HOD Saturday Robertazzi Spotlights President’s reception WPC happy hour Jesse Ehrenfeld Past Presidents lunch EWEs RFS Workshops Scientific Panels Exhibit hall Intl. Scholars HOD Sunday Posters General Prof. Diversity cocktail reception Rovenstine HOD Saturday Robertazzi Spotlights President's reception WPC
- [The 42nd Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine](https://sphere.nyssa-pga.org/2026/the-42nd-annual-international-symposium-clinical-update-in-anesthesiology-surgery-and-perioperative-medicine/) - The 42nd Annual Update in Anesthesiology, Surgery and Perioperative Medicine, organized by the Department of Anesthesiology at the Icahn School of Medicine at Mount Sinai in New York, was held January 18th –23rd, 2026 at the Royal Sonesta San Juan in San Juan, Puerto Rico.
- [The Role of Anesthesiology Assistants in the Anesthesiology Care Team Model](https://sphere.nyssa-pga.org/2026/the-role-of-anesthesiology-assistants-in-the-anesthesiology-care-team-model/) - This article seeks to answer the fundamental questions surrounding the training and credentialing of CAAs and explore their equivalence to CRNAs.
- [Highlights from the 2025 Young Investigator Research Contest](https://sphere.nyssa-pga.org/2026/highlights-from-the-2025-young-investigator-research-contest/) - The 2025 Young Investigator Research Contest during PGA79 was a huge success! We were excited to have a large number of high-quality submissions, eight of which were selected for presentation during an engaging two-hour session.
- [An Early Exposure to Anesthesia, a Formal Training Before the Textbooks](https://sphere.nyssa-pga.org/2026/an-early-exposure-to-anesthesia-a-formal-training-before-the-textbooks/) - When my application to medical school was rejected straight out of college, I felt as though my whole world got upended. What I did not realize at the time was that this unexpected detour would become one of the most formative experiences of my medical journey.
- [Myths from NYSANA and the Facts from NYSSA](https://sphere.nyssa-pga.org/2026/myths-from-nysana-and-the-facts-from-nyssa/) - The New York State Society of Anesthesiologists, Inc. (NYSSA) is committed to providing quality anesthesia care to all New York state patients.
- [How District Bylaws Promote Leadership and Safe Practice: Framework for a Successful Future](https://sphere.nyssa-pga.org/2026/how-district-bylaws-promote-leadership-and-safe-practice-framework-for-a-successful-future/) - What could put a room full of anesthesiologists to sleep faster than a slug of propofol? Reading the district bylaws aloud.
- [Selective Use of Venovenous Bypass During Liver Transplantation in a Patient with Severe Aortic Stenosis](https://sphere.nyssa-pga.org/2026/selective-use-of-venovenous-bypass-during-liver-transplantation-in-a-patient-with-severe-aortic-stenosis/) - A 71-year-old man with metabolic dysfunction–associated steatohepatitis cirrhosis (MELD 3.0 score 41) underwent expedited evaluation for liver transplantation. His medical history included refractory ascites, portal vein thrombosis, recurrent hepatic encephalopathy, prior transjugular intrahepatic portosystemic shunt (TIPS) with revision, hepatorenal syndrome requiring intermittent hemodialysis, chronic kidney disease and prior epidural abscess status post laminectomy.
- [Vol. 78 #1](https://sphere.nyssa-pga.org/2026/case-reports-vol-78-1/) - Read the Case Reports from SPHERE Volume 78 Number 1.
- [The Launch of NYSSA’s Advocacy Track for Residents](https://sphere.nyssa-pga.org/2026/the-launch-of-nyssas-advocacy-track-for-residents/) - To overcome this deficiency, the NYSSA RFS has launched the GAS advocacy program open to all New York State anesthesiology residents.
- [Our Power, Our Planet](https://sphere.nyssa-pga.org/tip-of-the-quarter/sustainability-tip-of-the-quarter-78-1/) - Happy Earth Month! This spring’s theme–"Our Power, Our Planet"—is a repeat from last year. But this year’s focus is less on specific energy practices and more on highlighting our power as individuals and a collective to make a difference in the world. There is also an emphasis shift from awareness to action.
- [The Lung Microbiome During Cocktail Hour](https://sphere.nyssa-pga.org/2026/the-lung-microbiome-during-cocktail-hour/) - At a recent family celebration, I found myself in conversation with a cousin about his research interests: the lung microbiome. The lung microbiome? I asked him to elaborate...
- [A Look at the 79th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2026/a-look-at-the-79th-pga/) - A Look at the 79th PostGraduate Assembly in Anesthesiology
- [Dr. Gertie Florentine Marx: The Mother of Obstetrics Anesthesiology (1912–2004)](https://sphere.nyssa-pga.org/2025/gertie-florentine-marx/) - Dr. Marx was born in Frankfurt, Germany on Feb. 13, 1912, where she spent her childhood and later entered the University of Frankfurt as a medical student. After attending a rally where Adolf Hitler spoke, she convinced her Jewish family to leave Germany. They moved to Switzerland and she finished medical school at the University of Bern in 1937.
- [An Interview With Dr. Anoushka Afonso](https://sphere.nyssa-pga.org/2025/an-interview-with-dr-anoushka-afonso/) - Dr. Anoushka Afonso is a dedicated anesthesiologist, mother, researcher, and the president of the American Society for Enhanced Recovery and Perioperative Medicine (ASER PM). She has published extensively on topics ranging from enhanced recovery after surgery to anesthesiologist burnout, and she advocates for systemic changes in healthcare to better support clinician well-being and, ultimately, enhance patient care.
- [NYSSA at ASA](https://sphere.nyssa-pga.org/2026/nyssa-at-asa-photo-gallery/)
- [Keeping Patients Warm in the Winter](https://sphere.nyssa-pga.org/tip-of-the-quarter/sustainability-tip-of-the-quarter-77-4/) - As the temperature drops outside, let’s think about how to sustainably keep our patients warm in the OR or procedural suite.
- [Mitochondrial Genetic Susceptibility to Anesthetics in Patients with Venezuelan Heritage](https://sphere.nyssa-pga.org/2026/mitochondrial-genetic-susceptibility-to-anesthetics-in-patients-with-venezuelan-heritage/) - On January 27th, the American Society of Anesthesiologists (ASA) and Society of Pediatric Anesthesia (SPA) released their 2nd Consensus Statement regarding a group of unexpected deaths or severe neurological outcomes in patients of Venezuelan lineage—predominantly children— who had undergone uncomplicated general anesthetics for routine surgical procedures.
- [Safer and Healthier Workplaces](https://sphere.nyssa-pga.org/2026/safer-and-healthier-workplaces/) - The Quarterly Feature explores complementary learning-oriented systems that strengthen safety and trust in the workplace. When used together, these two frameworks—Just Culture and the U-TURN conflict management model—help create a safer, more resilient healthcare environment.
- [Reducing OR Delays by Optimizing the Regional Anesthesia Team in an Orthopedic Ambulatory Surgery Center: A Quality Improvement Project](https://sphere.nyssa-pga.org/2026/reducing-or-delays-by-optimizing-the-regional-anesthesia-team-in-an-orthopedic-ambulatory-surgery-center-a-quality-improvement-project/) - Our Ambulatory Anesthesiology Division has expanded significantly over the past two years with the creation of a specialized orthopedic ambulatory surgery center (ASC), leading to a substantial increase in patient volume and regional anesthesia procedures. This growth has enhanced opportunities for anesthesiology resident education, as our ambulatory sites serve the regional rotation for our residency program. However, this growth also underscores the need to optimize our anesthesia services to meet rising clinical demands while upholding high educational standards.
- [Celebrating Connection and Excellence: Highlights from the 2025 ASA Annual Meeting in San Antonio](https://sphere.nyssa-pga.org/2026/celebrating-connection-and-excellence-highlights-from-the-2025-asa-annual-meeting-in-san-antonio/) - The American Society of Anesthesiologists (ASA) annual meeting and the Post Graduate Assembly of the NYSSA remain the premier events for anesthesiology, uniting thousands of colleagues from across the country to advance our specialty, foster collaboration, and celebrate our shared achievements. This year, the historic and vibrant city of San Antonio, Texas hosted the ASA Annual meeting.
- [CMS TEAM in New York: What Anesthesiologists Need to Know](https://sphere.nyssa-pga.org/2026/cms-team-in-new-york-what-anesthesiologists-need-to-know/) - On July 31, 2025, the Centers for Medicare and Medicaid Services (CMS) finalized the Transforming Episode Accountability Model (TEAM)—a mandatory, five-year bundled payment model that begins January 1, 2026, and ends December 31, 2030.
- [Concerns of Artificial Intelligence in Medicine](https://sphere.nyssa-pga.org/2026/concerns-of-artificial-intelligence-in-medicine/) - In the past few years, AI has increased its presence exponentially in every aspect of life. Our 2024 article, "Optimising artificial intelligence ultrasound tools in anesthesiology and perioperative medicine: The next frontier for advanced technology application," explained the role AI would be playing in the future of anesthesiology and preoperative medicine.
- [Vol 77 #4](https://sphere.nyssa-pga.org/2026/dont-miss-topics-vol-77-4/) - Perioperative care—particularly for surgical and non-operative room procedures—is a vastly expanding field that will require even more anesthesia providers in the future. A shortage of anesthesiologists and certified registered nurse anesthetists (CRNAs) has resulted in the creation and utilization of a new category of anesthesia mid-level provider: certified anesthesiology assistants (CAAs).
- [Focus on Advocacy](https://sphere.nyssa-pga.org/2026/focus-on-advocacy/) - Broadly speaking, advocacy is the act of publicly supporting or recommending a cause, policy or group to influence decisions and promote change. From an NYSSA perspective, advocacy can be defined as the strategic effort to influence policymakers in support of physician-led anesthesia care and initiatives that uphold patient safety.
- [PGA Scientific Exhibits and Poster Committee](https://sphere.nyssa-pga.org/2026/pga-scientific-exhibits-and-poster-committee/) - Over the past three years, the Scientific Exhibits and Posters Committee has been working diligently to increase the number of in-person presentations, the quality of the program and the geographical diversity of presenters for the abstracts and posters sessions. The results can be seen in PGA79’s outstanding turnout and impressive presentations across the board.
- [Committee on Professional Diversity: Building Bridges Beyond the Operating Room](https://sphere.nyssa-pga.org/2026/committee-on-professional-diversity/) - In March of 2025, Dr. Uchenna O. Umeh led a two-day Healthcare Immersion Program at the Hospital for Special Surgery (HSS) in Manhattan, offering high school students hands-on experiences in anesthesiology, orthopedics, nursing, physical therapy and other specialties. This unique opportunity allowed students to engage directly with healthcare professionals who reflect their identities and aspirations, sparking curiosity and confidence in their future paths.
- [NYSSA Committee on Economic Affairs](https://sphere.nyssa-pga.org/2026/nyssa-committee-on-economic-affairs/) - The NYSSA Committee on Economic Affairs is comprised of 41 members who represent all eight NYSSA districts and 22 distinct anesthesia departments across New York State. Our committee serves a dual mission.
- [Vol 77 #4](https://sphere.nyssa-pga.org/2026/committee-spotlight-vol-77-4/) - The New York State Society of Anesthesiologists (NYSSA) is dedicated to advancing scientific progress and the clinical practice of anesthesiology through education, collaboration and advocacy. The Post Graduate Assembly (PGA) in Anesthesiology annual meeting embodies this mission, serving as a national and international forum for anesthesiology practitioners to network, engage and learn.
- [Successful Neurolysis and Decompression of the Brachial Plexus for Parsonage-Turner Syndrome Precipitated by Remote Surgery](https://sphere.nyssa-pga.org/2026/successful-neurolysis-and-decompression-of-the-brachial-plexus-for-parsonage-turner-syndrome-precipitated-by-remote-surgery/) - Parsonage–Turner Syndrome (PTS)—or idiopathic brachial neuritis—is a rare, immune-mediated peripheral nerve disorder characterized by acute-onset shoulder pain followed by progressive weakness and sensory changes.
- [Emergency Anesthetic Management of Patients with Fontan Circulation: Systems-Based  Approach and Clinical Pearls](https://sphere.nyssa-pga.org/2026/emergency-anesthetic-management-of-patients-with-fontan-circulation-systems-based-approach-and-clinical-pearls/) - A 36-year-old male with a past medical history of congenital double inlet left ventricle with hypoplastic right ventricle outflow tract, status post-Fontan surgery with arterial pulmonary connection at age 2, with subsequent revision to an external conduit, presents to the emergency department after a few days of abdominal pain, nausea and vomiting.
- [New-Onset Stress-Induced Cardiomyopathy at Emergence from Anesthesia after Ambulatory Laparoscopic Bilateral Salpingo-Oophorectomy: A Case of Broken Heart Syndrome](https://sphere.nyssa-pga.org/2026/case-of-broken-heart-syndrome/) - We present a case report of SICM triggered by emergence from anesthesia after minimally invasive gynecologic surgery. This case highlights the importance of perioperative vigilance even in low-risk surgical settings, and risk stratification especially among patients with known emotional or physiologic vulnerabilities.
- [Vol. 77 #4](https://sphere.nyssa-pga.org/2026/vol-77-4-case-reports/) - New-Onset Stress-Induced Cardiomyopathy at Emergence from Anesthesia after Ambulatory Laparoscopic Bilateral Salpingo-Oophorectomy: A Case of Broken Heart Syndrome Stress-induced cardiomyopathy (SICM) was first described as “Takotsubo cardiomyopathy” 35 years ago in Japan. Since the initial report, SICM has been increasingly diagnosed during the perioperative period, including in ambulatory surgery.1,2 It is associated with sympathetic nervous system
- [ASA-Lifebox Resident Challenge: An Annual Fundraiser to Increase Global Access to Essential Safety Monitors](https://sphere.nyssa-pga.org/2026/asa-lifebox-resident-challenge-an-annual-fundraiser-to-increase-global-access-to-essential-safety-monitors/) - In the United States, it is mandatory to monitor all patients receiving anesthesia care for adequate oxygenation and ventilation. But in low-resource countries, patients regularly undergo surgery in operating rooms that lack pulse oximeters and capnographs. This absence of essential safety monitors leads to high rates of surgical complications—including death—for millions of patients worldwide.
- [Just Culture and the U-TURN Model: Building Safer, Healthier Workplaces in Healthcare](https://sphere.nyssa-pga.org/featured/just-culture-and-the-u-turn-model-building-safer-healthier-workplaces-in-healthcare/) - In modern healthcare, mistakes and conflicts are inevitable. What matters is not whether they occur, but rather how organizations respond when they do. A punitive or blame-driven approach drives errors underground and leaves staff demoralized, while a learning-oriented system strengthens safety and trust. Two frameworks—Just Culture and the U-TURN conflict management model—offer complementary solutions.
- [Practicing What I Teach](https://sphere.nyssa-pga.org/2026/practicing-what-i-teach/) - Before every lecture, I practice my talk for my husband to get his feedback. Over the years, he has picked up quite a bit himself—from perioperative lactation safety to non-operating room anesthesia in the outpatient setting. But I think his favorite was the time I practiced my active listening and empathy talk before the 2024 Post-Graduate Assembly.
- [The Power of the Team](https://sphere.nyssa-pga.org/2026/the-power-of-the-team/) - This year’s message was not a painstakingly crafted speech, expertly reviewed and rehearsed to sound just right. Instead, it came straight from the heart—rooted in pride. My remarks began with a single theme: Team.
- [Building the Next Chapter Together](https://sphere.nyssa-pga.org/2026/building-the-next-chapter-together/) - As I step into my role as Executive Director of the NYSSA, I want to take a moment to introduce myself and share how excited I am to serve this community.
- [Vol 77 #4](https://sphere.nyssa-pga.org/2026/leadership-forecast-vol-77-4/) - This issue's Leadership Forecast comes from Tracey Straker, M.D., M.S., M.P.H., FASA and Babette M. Atkins.
- [Achieving Sustainability in Anesthesiology](https://sphere.nyssa-pga.org/2024/achieving-sustainability-in-anesthesiology/) - Those of us in healthcare have acknowledged our carbon footprint and its potential to cause harm over time. Within our field of anesthesiology, there are champions of sustainability initiatives who understand that it is imperative to embrace sustainable practices in order to ensure the health of our community, both now and in the future.
- [PGA Case-Based Learning Discussions Foster Active Participation and Learning](https://sphere.nyssa-pga.org/2025/pga-case-based-learning-discussions-foster-active-participation-and-learning/) - The PGA’s Case-Based Learning Discussions (CBLDs) are small group discussions led by experienced clinicians. CBLDs allow participants to explore a specific clinical problem and to learn from the moderator and one another. CBLDs are an amazing way to fulfill scholarship obligations or to get started on an exciting career in academics. These presentations can bolster your resume and get you noticed!
- [Winning From Within](https://sphere.nyssa-pga.org/featured/winning-from-within/) - As the NYSSA embarks on 2025, a new year filled with certain change that will undoubtedly impact our lives and our specialty, I am honored to be your president. I respect this office and the mantle that I have been elected to carry. Many of you have given me your support and mentorship for greater than 20 years as I served in numerous positions that have readied me for this day.
- [A Day in the Life of an Anesthesiologist: Four-part Feature](https://sphere.nyssa-pga.org/2025/a-day-in-the-life/) - In This Issue
- [A Look at the 78th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2025/spring-2025-sphere/) - In this issue: photos and reports from the 78th PGA, the new NYSSA president’s inaugural address, a message from Sphere’s new editor, the sustainability tip of the quarter, a look at the effect of a leadless pacemaker on the timing of surgery for a rural patient, and a critical review of the new guidance on GLP-1RAs.
- [Reducing Our Carbon Footprint](https://sphere.nyssa-pga.org/2024/reducing-our-carbon-footprint/) - In this issue: the importance of physicians advocating for themselves, how three institutions are addressing the environmental impact of anesthesia practice, the sustainability tip of the quarter, and working hard to preserve physician-led anesthesia care.
- [Caring for Our Colleagues and Ourselves](https://sphere.nyssa-pga.org/2024/caring-for-our-colleagues-and-ourselves/) - In this issue: the well-being of the perioperative physician, addressing physician suicide, the challenges of lactation in the workplace, resuscitating kindness, and a case of paradoxical breathing in a patient undergoing CT-guided needle biopsy under propofol sedation.
- [A Look at the 77th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2024/past-presidents-of-the-ny-state-society-of-anesthesiologists/) - In this issue: photos from the 77th PGA, the new NYSSA president's inaugural address, and a look back at 30 years of the International Scholars Program.
- [GLP-1 Agonists: When Fasting Before Surgery Is No Longer Enough](https://sphere.nyssa-pga.org/2024/glp-1-agonists-when-fasting-before-surgery-is-no-longer-enough/) - In this issue: the NYSSA executive director's year in review, the perioperative management of GLP-1 receptor agonists, scenes from the ASA annual meeting, and a case of intraoperative fire originating in the thoracic cavity.
- [The Advantages of Ambulatory Extended Recovery Facilities](https://sphere.nyssa-pga.org/2023/the-advantages-of-ambulatory-extended-recovery-facilities/) - In this issue: the advantages of ambulatory extended recovery facilities, finding fulfillment in family and professional life as an anesthesiologist mom, and a look at artificial intelligence integration in point-of-care ultrasound.
- [The Promise and Perils of Technology](https://sphere.nyssa-pga.org/2023/the-promise-and-perils-of-technology/) - In this issue: examining the impact of artificial intelligence in medicine, how to recognize a phone scam, an interview with Dr. Tracey Straker, and new ASA guidelines for neuromuscular blockade.
- [A Look at the 76th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2023/past-presidents-of-the-new-york-state-society-of-anesthesiologists/) - In this issue: photos from the 76th PGA, the new NYSSA president’s inaugural address, and key considerations when selling your healthcare practice to a private equity firm.
- [The Well-Being of the Perioperative Physician](https://sphere.nyssa-pga.org/2024/the-well-being-of-the-perioperative-physician/) - Tazeen Beg, M.D., and Katrina Kerolus, M.D. An anesthesiology resident on overnight call receives a pager call for a trauma arriving at his level 1 trauma center. He takes the airway box and runs to the ER. However, the trauma is called off. Apparently, it was an elderly man on anticoagulants who fell in the
- [How We Did It: Decommissioning Central Nitrous Oxide Pipes at Three Institutions](https://sphere.nyssa-pga.org/2024/how-we-did-it-decommissioning-central-nitrous-oxide-pipes-at-three-institutions/) - Nicholas Gadsden, M.D., Ellen Brand, M.D., Vittoria Arslan-Carlon, M.D., and Deirdre C. Kelleher, M.D. Anesthetic gases are responsible for up to 50% of perioperative emissions, contributing substantially to hospital scope 1 greenhouse gas (GHG) emissions (direct emissions).1 To decrease the environmental impact of anesthesia practice, the World Federation of Societies of Anesthesiologists (WFSA) encourages all
- [One Institution’s Response to the Perioperative Risk of GLP-1 Receptor Agonists](https://sphere.nyssa-pga.org/2024/one-institutions-response-to-the-perioperative-risk-of-glp-1-receptor-agonists/) - Since approval of glucagon-like peptide-1 (GLP-1) receptor agonists for the treatment of type 2 diabetes mellitus, these drugs have become widely prescribed for the specific purpose of weight loss. A recent study estimated that 2% of all adult residents in the area surrounding Mount Sinai Hospital were prescribed one of these agents.
- [Achieving Fulfillment in Family and Professional Life as an Anesthesiologist Mom](https://sphere.nyssa-pga.org/2023/achieving-fulfillment-in-family-and-professional-life-as-an-anesthesiologist-mom/) - Facing demands from family, friends, and patients, and without enough hours in a day, having children as a full-time physician anesthesiologist seems impossible. Can we really “have it all”?
- [The Impact of Artificial Intelligence: Beyond the OR](https://sphere.nyssa-pga.org/2023/editorial-the-impact-of-artificial-intelligence-beyond-the-or/) - Artificial intelligence (AI), where machines employ algorithms to reason and perform functions, including problem-solving and decision-making, is rapidly finding a foothold in the practice of medicine. The specialties of radiology, cardiology and surgery are already using AI applications.
- [Snooze Button Not Included: Chronicles of an Anesthesiology Resident](https://sphere.nyssa-pga.org/2025/snooze-button-not-included-chronicles-of-an-anesthesiology-resident/) - "One of the greatest rewards of being an anesthesia resident is the significant portion of our day that is spent providing direct patient care. We become one of their most fierce advocates. We provide a voice to those under anesthesia and ensure safety throughout the case."
- [A Day in the Life of a Dental Anesthesiology Resident](https://sphere.nyssa-pga.org/2025/a-day-in-the-life-of-a-dental-anesthesiology-resident/) - “Anesthesiology residency programs have been training dentist anesthesiologists to help meet demand since the mid 20th century. Currently, dental anesthesiology training requires a dentist to complete a dedicated three-year residency with at least 800 cases of deep sedation or general anesthesia.”
- [A Day in the Life of an Ambulatory Anesthesiologist](https://sphere.nyssa-pga.org/2025/a-day-in-the-life-of-an-ambulatory-anesthesiologist/) - “More than two decades ago, my mother’s friend—a seasoned ambulatory anesthesiologist—gave me what she considered sage advice: ‘Don’t go into anesthesiology. It’s boring. All I do is sedate healthy patients for colonoscopies.’ Looking back, I am so grateful I followed my heart—and not my mom’s friend’s advice.”
- [A Day in the Life of a Academic Anesthesiologist](https://sphere.nyssa-pga.org/2025/a-day-in-the-life-of-a-academic-anesthesiologist/) - “Learning never ends; it is a path intertwined with moments of challenge, growth and discovery. And so here I am today, in an academic medical center, taking care of patients while teaching anesthesiology to residents, medical students and sometimes Certified Nurse Anesthetists (CRNAs). And I, in turn, learn something new every day.”
- [A Day in the Life of an Anesthesiologist](https://sphere.nyssa-pga.org/featured/a-day-in-the-life-of-an-anesthesiology-resident/) - A Day in the Life: Academic Anesthesiologist “Learning never ends; it is a path intertwined with moments of challenge, growth and discovery. And so here I am today, in an academic medical center, taking care of patients while teaching anesthesiology to residents, medical students and sometimes Certified Nurse Anesthetists (CRNAs). And I, in turn, learn
- [Celebrating NYSSA Women: Pioneers in Anesthesiology](https://sphere.nyssa-pga.org/2025/celebrating-women-pioneers-in-anesthesiology/) - In This Issue: a special feature on three extraordinary NYSSA woman anesthesiologists: Drs. Virginia Apgar, Gertie Marx and Rebecca Twersky. Each of these pioneers saw opportunity—and boldly forged a path that helped shape modern anesthesiology into a safer and more inclusive field.
- [Dr. Rebecca S. Twersky: A Pioneer in Ambulatory Anesthesia Safety (1955–2023)](https://sphere.nyssa-pga.org/2025/dr-rebecca-s-twersky/) - Rebecca Twersky, M.D., MPH, FASA, affectionately known as Riki, grew up as the third of four children in an Orthodox Jewish household in Los Angeles. Her father, a Holocaust survivor, was a prominent rabbi, and her mother was daughter of a rabbi who had emigrated to the United States after World War I. Dr. Twersky’s
- [Dr. Virginia Apgar: A Leader Born Through Adversity and Innovation (1909–1974)](https://sphere.nyssa-pga.org/2025/dr-virginia-apgar/) - Dr. Virginia Apgar is a pioneering figure in medicine—not only for her contributions to neonatal care, but also for the resilience and vision that she embodied in a male-dominated field. Her most well-known contribution, the Apgar Score, has become the universal tool for evaluating newborns. Behind this life-saving innovation is a story of determination, adaptability
- [Past Women Anesthesiology Leaders of NYSSA](https://sphere.nyssa-pga.org/featured/forging-the-path-in-research-and-practice/) - Take a few minutes to meet three extraordinary NYSSA woman anesthesiologists: Drs. Virginia Apgar, Gertie Marx and Rebecca Twersky. Each of these pioneers saw opportunity—and boldly forged a path that helped shape modern anesthesiology into a safer and more inclusive field.
- [Carrying the NYSSA Forward](https://sphere.nyssa-pga.org/2024/carrying-the-nyssa-forward/) - I am honored and grateful to serve as president of the New York State Society of Anesthesiologists this year. I appreciate the responsibilities of this position, and I am ready to meet the challenges we face in the year ahead.
- [Get to Know Two Anesthesiology Leaders in New York](https://sphere.nyssa-pga.org/2025/get-to-know-two-anesthesiology-leaders-in-new-york/) - In this issue: a time for reflection and transition, two anesthesiology leaders in New York share their insights, the sustainability tip of the quarter, reimagining the retirement model, and enhancing surgical outcomes for patients with complex comorbidities.
- [Leadless Pacemakers: A New Source of Delays for Rural Surgical Patients?](https://sphere.nyssa-pga.org/2025/leadless-pacemakers-a-new-source-of-delays-for-rural-surgical-patients/) - Joyce Liu, M. Eng., Ismat Mrad, M.D., and William Roberts, M.D., Ph.D. Introduction Leadless pacemakers (LPs) are an emerging technology with the potential to significantly improve outcomes in patients who need long-term pacing. As recently as 2017, only two LPs were available. The Nanostim™ was among the first of these devices. It is no longer
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/tip-of-the-quarter/sustainability-tip-of-the-quarter-76-04/) - Energy use constitutes approximately 12% of total global healthcare greenhouse gas (GHG) emissions and 15% of total U.S. healthcare GHG emissions, with more of these emissions stemming from energy-intensive ORs and ICUs. Reducing our energy-related emissions requires thoughtful use of current products and proactive changes system-wide.
- [Reimagining the Retirement Model to Mitigate Workforce Shortages](https://sphere.nyssa-pga.org/featured/reimagining-the-retirement-model-to-mitigate-workforce-shortages/) - The surgical care needs of New York state’s residents are expected to increase continuously over the next decade. Even with efforts to expand training of certified registered nurse anesthetists, potential utilization of certified anesthesiologist assistants, and an increase in the number of anesthesiology residency programs and residents, a significant gap will remain between available anesthesia providers and the anesthetic demands of future patients.
- [NYSSA Leaders at SAMBA National Conference](https://sphere.nyssa-pga.org/2025/nyssa-leaders-at-samba-national-conference/) - The Society for Ambulatory Anesthesia (SAMBA) met in Phoenix, Arizona in May 2025. The conference is well known for its breadth of exposure to national ambulatory anesthesia practice—including podium talks, abstract presentations, poster sessions, problem-based learning discussions and networking opportunities with renowned leaders in the field.
- [Lighting the Path: A Multi-Level Mentorship Approach to Anesthesiology](https://sphere.nyssa-pga.org/2025/lighting-the-path-a-multi-level-mentorship-approach-to-anesthesiology/) - Led by academic organizations including the National Medical Association, American Medical Association and Liaison Committee on Medical Education, pathway programs were developed over 60 years ago. The goal of these cross-sectional efforts is to diversify the workforce based on projected nationwide physician shortages.
- [Inspiring the Next Generation: Anesthesiologists Sparking Interest in STEM Careers](https://sphere.nyssa-pga.org/2025/inspiring-the-next-generation-anesthesiologists-sparking-interest-in-stem-careers/) - Anesthesiologists are uniquely positioned to serve as STEM ambassadors. Their expertise in physiology, pharmacology and physics—combined with their leadership roles in patient care and team coordination—makes them ideal mentors to inspire students through real-world applications of science.
- [Committee on Patient Safety & Quality Improvement](https://sphere.nyssa-pga.org/2025/committee-on-patient-safety-quality-improvement/) - The NYSSA Committee on Patient Safety & Quality Improvement (PSQI) provides a forum for anesthesiologists who are local safety champions to exchange notes and identify concerning trends. The committee is made up of quality and safety leaders from across the state; the membership focuses on systemic solutions to common safety concerns seen in daily practice.
- [Legislative Update](https://sphere.nyssa-pga.org/2025/legislative-update-77-02/) - The NYSSA’s in-person Advocacy Day was held in Albany on May 13, 2025 and included 65 members representing every NYSSA district.
- [Reading Your Patient’s Mind During Anesthesia: Discover How at December’s PGA](https://sphere.nyssa-pga.org/2025/reading-your-patients-mind-during-anesthesia-discover-how-at-decembers-pga/) - This December, the PGA is offering a new workshop that will demystify EEG monitoring in the operating room. After you participate, you will be able to read your patient’s mind—well, almost—anytime you decide to use the monitor.
- [Scenes From PGA78](https://sphere.nyssa-pga.org/2025/scenes-from-pga78/)
- [Enhancing Patient Outcomes: The Value of a Multidisciplinary Approach and Shared Decision-Making for Surgical Patients With Complex Comorbidities](https://sphere.nyssa-pga.org/2025/enhancing-patient-outcomes-the-value-of-a-multidisciplinary-approach-and-shared-decision-making-for-surgical-patients-with-complex-comorbidities/) - In the United States, approximately one in every 33 hospitalizations for major noncardiac surgery results in a major adverse cardiovascular event, equating to approximately 150,000 perioperative events annually. Patients with coronary artery disease (CAD) face even greater perioperative risk, particularly those with recent myocardial infarctions or unstable angina who may require urgent intervention.
- [Photo Gallery](https://sphere.nyssa-pga.org/2024/photo-gallery-76-03/)
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2024/sustainability-tip-of-the-quarter-76-03/) - Nitrous Oxide (N2O) is a potent greenhouse gas and ozone destroyer. Due to the large volume of gas needed to achieve clinical effects, N2O’s negative environmental impact approaches that of desflurane.1 INDIVIDUAL Reduce or eliminate N2O use: Use IV meds to smooth emergence (or total intravenous anesthesia!). Try distraction techniques and pre-medication for pediatric inductions.
- [Photo Gallery](https://sphere.nyssa-pga.org/2024/photo-gallery-76-02/)
- [Scenes From the 2023 ASA Annual Meeting](https://sphere.nyssa-pga.org/2024/scenes-from-the-2023-asa-annual-meeting/) - Checkout various photos from the 2023 ASA Annual Meeting.
- [NYSSA Legislative Day in Albany](https://sphere.nyssa-pga.org/2023/nyssa-legislative-day-in-albany/) - MSSNY House of Delegates and ASA Legislative Conference
- [Highlights From the 2024 Young Investigator Research Contest](https://sphere.nyssa-pga.org/2025/highlights-from-the-2024-young-investigator-research-contest/) - The 2024 Young Investigator Research Contest, held during PGA78, was a huge success! We were excited to have a large number of high-quality submissions, eight of which were selected for presentation during an engaging two-hour session. The presenters represented multiple countries, including the United States, Poland, and Germany. First place was awarded to Dr. Megan
- [Collaboration with the Medical Society of the State of New York (MSSNY)](https://sphere.nyssa-pga.org/2025/collaboration-with-the-medical-society-of-the-state-of-new-york-mssny/) - “Over the years, the NYSSA advocacy team—led by Stuart Hayman, Lisa ONeill, Bob Reid and I—have developed and benefited from a long and constructive relationship with Moe Auster, Senior Vice President and Chief Legislative Counsel for the Medical Society of the State of New York (MSSNY) and his Albany based team.”
- [Legislative Update](https://sphere.nyssa-pga.org/2024/legislative-update-76-03/) - Two California Hospitals Face the Consequences of Allowing Nurse Anesthetists to Practice Unsupervised Reports of patient harm and anesthesia-related deaths led to the loss of CMS accreditation for two California hospitals that allowed nurse anesthetists to practice unsupervised. The California Department of Health’s investigations of the two hospitals resulted in a finding of “immediate jeopardy”
- [Legislative Update](https://sphere.nyssa-pga.org/2025/legislative-update-76-04/) - In my last Legislative Update, I summarized cases of patient harm and anesthesia-related deaths at two California hospitals that utilized nurse anesthetists as their primary anesthesia providers. This led to a CMS investigation, a finding of "immediate jeopardy", and the loss of accreditation at both hospitals because they allowed nurse anesthetists to administer anesthesia beyond the scope of their authority and with inadequate credentialing procedures.
- [Building on a Strong Foundation](https://sphere.nyssa-pga.org/2025/building-on-a-strong-foundation/) - It is an honor to step into the role of Sphere editor and chair of the NYSSA Communications Committee. This marks an exciting opportunity to build on the strong foundation put in place by our former editor and communications chair, Dr. Sonia Pyne. I would like to thank Dr. Pyne, who served as chair for
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/tip-of-the-quarter/sustainability-tip-of-the-quarter-77-01/) - Reducing the environmental impact of perioperative care can feel like an overwhelming task, as there are opportunities for improvement almost everywhere you look. Rather than trying to fix everything at once, choose instead to focus on one area of waste at a time. High-impact areas include supply waste reduction, oxygen conservation, proper waste sorting, and
- [PGA Scientific Exhibits and Poster Presentations: A Vital Tool for Professional Development](https://sphere.nyssa-pga.org/2025/pga-scientific-exhibits-and-poster-presentations-a-vital-tool-for-professional-development/) - Poster presentations offer a wealth of benefits for medical students and trainees, making them a vital tool for professional development, particularly in the early stages of the presenters’ careers. The presentations provide a platform to enhance communication skills by requiring presenters to distill complex research into a visually appealing and concise format, thereby improving their
- [Legislative Update](https://sphere.nyssa-pga.org/2025/legislative-update-77-01/) - In my last Legislative Update, I summarized cases of patient harm and anesthesia-related deaths at two California hospitals that utilized nurse anesthetists as their primary anesthesia providers. This led to a CMS investigation, a finding of "immediate jeopardy", and the loss of accreditation at both hospitals because they allowed nurse anesthetists to administer anesthesia beyond the scope of their authority and with inadequate credentialing procedures.
- [Women Pioneers](https://sphere.nyssa-pga.org/2025/women-pioneers-in-anesthesiology/) - For the past 20 years, women have comprised roughly half of all medical school classes in the United States. Yet only 36% of today’s full-time academic anesthesiologists in this country are women—and even fewer women hold leadership roles within the specialty. Here in the 21st century, the gender gap in anesthesiology still persists.
- [Wellness Tools for Anesthesiologists](https://sphere.nyssa-pga.org/2025/wellness-tools-for-anesthesiologists/) - As doctors, we tend to be perfectionists who believe we are self-sufficient and able handle our own problems as effectively as we handle those of our patients. But help is available—and this overview provides a range of mental health resources for physicians.
- [Safety While Traveling: Carbon Monoxide Poisoning](https://sphere.nyssa-pga.org/2025/safety-while-traveling-carbon-monoxide-poisoning/) - Carbon monoxide is a true silent killer—odorless, colorless and tasteless. It claims over 1,000 lives each year in the United States. This is a timely issue with holiday and mid-winter vacations right around the corner.
- [Fireside Chat with Dr. Harter of ASA](https://sphere.nyssa-pga.org/2025/fireside-chat-with-dr-harter-of-asa/) - Dr. Ronald L Harter, M.D., F.A.S.A., past-president of the ASA, is a Professor of Anesthesiology at The Ohio State University College of Medicine in Columbus, Ohio and a practicing physician anesthesiologist at the University’s Wexner Medical Center. Over the past three decades, he has served ASA in numerous roles.
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2024/spring-2024-sustainability-tip-of-the-quarter/) - “Planet vs. Plastics” is the theme for Earth Day 2024. Plastic is incredibly important to the safe delivery of anesthesia, but it also contributes to global pollution and detrimental health effects on humans.
- [Legislative Update](https://sphere.nyssa-pga.org/2023/albany-report-legislative-update-3/) - The NYSSA’s in-person Legislative Day was held on May 9, 2023, and included members from every district. We greatly appreciate the efforts of these dedicated members. Conducting an in-person meeting requires additional planning and preparation.
- [Legislative Update](https://sphere.nyssa-pga.org/2024/albany-report-legislative-update/) - The physician anesthesiologist is the most qualified individual to administer anesthesia, either personally or through medical supervision of the nurse anesthetist, in nearly every surgical case requiring anesthesia.
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2024/winnter-2024-sustainability-tip-of-the-quarter/) - INDIVIDUAL Learn to sort OR waste properly. Up to 85% of OR waste can be placed in regular waste bins. Sharps bins and “red bag” regulated medical waste (RMW) must be transported to specialized facilities to beincinerated or autoclaved. Unnecessary use of these waste streams increases both costs and CO2 emissions by a factor of
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2023/summer-2023-sustainability-tip-of-the-quarter/) - INDIVIDUAL Lower your fresh gas flow during maintenance of anesthesia, regardless of anesthetic choice. Learnhow on the Anesthesia Patient Safety Foundation (APSF) website: https://www.apsf.org/apsf-technology-education-initiative/low-flow-anesthesia INSTITUTIONAL Create your Green Team!Choose a leader and invite sustainably minded clinicians from all divisions and roles within your department (including residents, CRNAs, and techs). Want to know more? Submit your
- [Legislative Update](https://sphere.nyssa-pga.org/2023/legislative-update/) - Under the leadership of Government and Legal Affairs Committee Chair Dr. Jonathan Gal and vice chairs Dr. Farzana Afroze and Dr. Ansara Vaz, and in collaboration with NYSSA Executive Director Stuart Hayman, Albany lobbyist Bob Reid, and me, the 2023 GLAC agenda was presented to the committee members during the annual PGA meeting in December 2022.
- [Supporting Your Lactating Colleagues in the Workplace](https://sphere.nyssa-pga.org/2024/supporting-your-lactating-colleagues-in-the-workplace/) - As physicians, we are all aware of the benefits of lactation for both mother and child,1 but lactating clinicians face many workplace barriers. A 2018 article by Cantu et al. identified the most common barriers reported by female physicians, including lack of time to pump, unpredictability of one’s schedule, and lack of an appropriate place
- [Legislative Update](https://sphere.nyssa-pga.org/2024/legislative-update-2/) - On December 19, 2023, various New York Assembly standing committees conducted a joint hearing on the status of the healthcare workforce in New York state.
- [Legislative Update](https://sphere.nyssa-pga.org/2024/legislative-update-76-02/) - NYSSA’s 39th Annual Legislative Day The NYSSA’s in-person Legislative Day was held on May 7, 2024, and included 50 members representing every NYSSA district. We greatly appreciate the efforts of these dedicated individuals. Based on the strong participation of our members, we were able to schedule appointments with or to drop off materials to various
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2024/sustainability-tip-of-the-quarter-76-02/) - Happy summer! Whether you are headed to the beach, across the ocean, or just to the call room, there are easy ways to avoid single‑use plastic while you’re on the go. INDIVIDUAL Be sure to pack these reusable items in your overnight [call] bag: Plastic-free travel utensils Reusable coffee tumbler Reusable water bottle Toiletry kit —
- [Legislative Update](https://sphere.nyssa-pga.org/2023/albany-report-legislative-update-2/) - Once again, there was intense lobbying by the New York State Association of Nurse Anesthetists (NYSANA) to move this legislation forward, as well as a last-minute amendment by New York state Sen. Toby Ann Stavisky, chair of the Committee on Higher Education, in an apparent attempt to move the legislation out of this committee in the final days of the session.
- [Sustainability Tip of the Quarter](https://sphere.nyssa-pga.org/2023/fall-2023-sustainability-tip-of-the-quarter-copy/) - “Planet vs. Plastics” is the theme for Earth Day 2024. Plastic is incredibly important to the safe delivery of anesthesia, but it also contributes to global pollution and detrimental health effects on humans.
- [Mourning](https://sphere.nyssa-pga.org/2024/mourning/) - Morning. It’s a special time of day. In Western New York, mornings generally are dark and chilly. Mornings have the smell of sleep, the sound of silence and safety. For me, mornings have been alone time while my husband and children sleep soundly.
- [A Frail Old Man](https://sphere.nyssa-pga.org/2023/a-frail-old-man/) - Knock Knock. I gently knock on the door, carefully walking in. From behind, he is a frail figure, his green hospital gown swallowing his being. He can’t quite swing his head fully around to look at me, so I move closer to the bed to be in his vision.
- [Every Patient Has a Unique Story: The Art of Anesthesiology](https://sphere.nyssa-pga.org/2024/every-patient-has-a-unique-story-the-art-of-anesthesiology/) - Anesthesiologists are often referred to as the “unsung heroes” of the medical world. Their critical role in patient care is undeniable, as they ensure a safe and pain-free surgical experience. However, beyond their technical expertise lies a profound truth: Every patient has a unique story that must be explored and understood.
- [Phasing Out Desflurane at Three New York State Institutions](https://sphere.nyssa-pga.org/2025/phasing-out-desflurane-at-three-new-york-state-institutions/) - Over the past decade, there has been movement towards eliminating desflurane usage both nationally and internationally, with Scotland, England, and the Canadian province of Newfoundland and Labrador officially phasing out the agent.
- [Catch the “Wave”: Resident Education in Point-of-Care Ultrasound](https://sphere.nyssa-pga.org/2025/catch-the-wave-resident-education-in-point-of-care-ultrasound/) - Five years after the launch of the first Objective Structured Clinical Examination, it has expanded to include a separate section dedicated to POCUS. Assessment for abdominal free fluid along with gastric content and volume are to begin during this year’s round of testing, and sonographic evaluation of airway-related structures will start in 2027.
- [Exploring Anesthesiology Through a Summer Research Fellowship at Memorial Sloan Kettering Cancer Center](https://sphere.nyssa-pga.org/2025/exploring-anesthesiology-through-a-summer-research-fellowship-at-memorial-sloan-kettering-cancer-center/) - “After our first year of medical school, we had the exciting opportunity to participate in the Foundation for Anesthesia Education and Research (FAER) Medical Student Anesthesia Research Fellowship (MSARF) at Memorial Sloan Kettering Cancer Center (MSK). This eight-week summer research program was an important step in our journey into anesthesiology.”
- [Perioperative Management of GLP-1 Receptor Agonists](https://sphere.nyssa-pga.org/2024/perioperative-management-of-glp-1-receptor-agonists/) - Glucagon-like peptide-1 (GLP-1) receptor agonists are a class of drugs approved by the Food and Drug Administration for treatment of type 2 diabetes mellitus, but they have recently emerged as a common (and even fashionable) drug for weight loss.
- [Physician Suicide: A Sad but Not Hopeless Reality](https://sphere.nyssa-pga.org/2024/physician-suicide-a-sad-but-not-hopeless-reality/) - By the time I was a chief resident, I had known three colleagues whose careers were interrupted by substance use disorder and addiction. This time was different. One of my classmates was found dead in the call room, beeper beeping, opiates and syringes sitting on the desk in front of him. He had a wife,
- [Key Considerations When Selling Your Healthcare Practice to a Private Equity Firm](https://sphere.nyssa-pga.org/2023/key-considerations-when-selling-your-healthcare-practice-to-a-private-equity-firm/) - Private equity investments in healthcare continue to trend upward. More than $150 billion of private equity capital surged into healthcare globally in 2022, more than double the prior year and more than seven times the volume of investment 10 years ago.
- [The 41st Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine](https://sphere.nyssa-pga.org/2025/the-41st-annual-international-symposium-clinical-update-in-anesthesiology-surgery-and-perioperative-medicine/) - The 41st Annual Update in Anesthesiology, Surgery and Perioperative Medicine, organized by the Department of Anesthesiology at the Icahn School of Medicine at Mount Sinai in New York, was held January 19-24, 2025, at the Hilton Barbados Resort, Needham’s Point, Barbados. This event is intended to assist active professionals who wish to improve their knowledge
- [The 40th Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine](https://sphere.nyssa-pga.org/2024/the-40th-annual-international-symposium-clinical-update-in-anesthesiology-surgery-and-perioperative-medicine/) - The 40th Annual Update in Anesthesiology, Surgery and Perioperative Medicine, organized by the Department of Anesthesiology at the Icahn School of Medicine at Mount Sinai in New York, was held January 14-19, 2024, at the St. Kitts Marriott Resort, St. Kitts, West Indies. This event is designed for active professionals who wish to improve their
- [The 39th Annual International Symposium: Clinical Update in Anesthesiology, Surgery and Perioperative Medicine](https://sphere.nyssa-pga.org/2023/the-39th-annual-international-symposium-clinical-update-in-anesthesiology-surgery-and-perioperative-medicine/) - The 39th Annual Update in Anesthesiology, Surgery and Perioperative Medicine, organized by the Department of Anesthesiology at the Icahn School of Medicine at Mount Sinai in New York, was held January 15-20, 2023, at the Curaçao Marriott Beach Resort in Willemstad, Curaçao.
- [From the Executive Director: The Year in Review](https://sphere.nyssa-pga.org/2024/from-the-executive-director-the-year-in-review/) - I recently began my 16th year with the NYSSA and my 36th year working for professional medical associations. While I started my career as an accountant, switching career tracks early on led to a rewarding professional journey working with physicians, especially the last 15 years working with and for the NYSSA’s members.
- [The Future of Anesthesia: How Artificial Intelligence is Transforming Perioperative Care](https://sphere.nyssa-pga.org/2025/the-future-of-anesthesia-how-artificial-intelligence-is-transforming-perioperative-care/) - “Imagine a world where anesthesiologists can predict complications before they arise, optimize sedation levels with precision, and personalize pain management strategies in real-time. With artificial intelligence (AI), these possibilities are turning into reality.”
- [The Day I Almost Went to Jail](https://sphere.nyssa-pga.org/2023/the-day-i-almost-went-to-jail/) - A few months ago, my workday started normally. My assignment was in OB, as it usually is. As I took over from the night call doc, the obstetricians called a STAT CS on a patient who had just arrived.
- [Bylaws and Rules](https://sphere.nyssa-pga.org/2025/bylaws-and-rules/) - The Committee on Bylaws and Rules considers matters pertaining to the society’s bylaws and rules—and makes recommendations to the Board of Directors and House of Delegates (HOD) to amend the bylaws when needed.
- [Farewell Address to the NYSSA House of Delegates](https://sphere.nyssa-pga.org/2023/farewell-address-to-the-nyssa-house-of-delegates/) - In 2006, I attended my first NYSSA HOD meeting as the District 2 director. It was David Bronheim who encouraged me to be more involved with the NYSSA. At the time, I found the environment extremely intimidating. Everyone seemed to know their roles and the process seemed so complicated. Later, while attending my first board meeting, I met a gentleman from upstate who, without the NYSSA, I would never have an occasion to meet.
- [From Flat Earth to Round: Rethinking Ventilation with Time-Controlled Adaptive Ventilation (TCAV)](https://sphere.nyssa-pga.org/2025/from-flat-earth-to-round-rethinking-ventilation-with-time-controlled-adaptive-ventilation-tcav/) - “During the COVID-19 pandemic, I faced some of the most challenging cases of my career—patients with profound hypoxemia and lungs so stiff they seemed impossible to ventilate. Despite adhering to low tidal volume (LVt) protocols (i.e., ARDS Net), I found myself losing ground. So I challenged my beliefs, searched for new information, and listened to colleagues willing to share different ideas.”
- [Clearing the Confusion: New Multisociety Practice Guidance and a Critical Review of GLP-1RA Literature](https://sphere.nyssa-pga.org/2025/new-multisociety-practice-guidance-for-glp-1ras/) - As of January 2025, GLP-1RAs, including semaglutide and liraglutide, have been approved for weight loss management, with ongoing studies exploring their benefits when used to treat other metabolic conditions and populations. Given the growing popularity of GLP-1RAs, it is crucial for anesthesiologists to understand their perioperative implications.
- [New ASA Guidelines for Neuromuscular Blockade: Contraceptive Considerations](https://sphere.nyssa-pga.org/2023/new-asa-guidelines-for-neuromuscular-blockade-contraceptive-considerations/) - Since obtaining FDA approval in 2015, the steroidal encapsulating agent sugammadex has become anesthesia providers’ neuromuscular blockade (NMB) reversal agent of choice.
- [Creating Opportunities to Learn and Connect](https://sphere.nyssa-pga.org/2023/creating-opportunities-to-learn-and-connect/) - The 2022 PGA is complete, and good times were had. The New York State Conference for Anesthesiology Residents and Fellows (NYSCARF) program featured an insightful interview on hospital administration, hands-on subspecialty workshops, an in-depth look into anesthesia contracts, and an interdisciplinary attending panel advising residents on career moves.
- [Looking Back on a Productive Year](https://sphere.nyssa-pga.org/2023/looking-back-on-a-productive-year/) - The NYSSA Resident and Fellow Section had a busy year. Our incredible officers for 2022-2023 accomplished a wide variety of initiatives that we believe will have a lasting, positive impact on anesthesiology in New York state.
- [Conservation Measures during the Baxter Fluid Shortage after Hurricane Helene](https://sphere.nyssa-pga.org/2025/conservation-measures-during-the-baxter-fluid-shortage-after-hurricane-helene/) - In September of 2024, Hurricane Helene damaged a Baxter manufacturing facility in North Carolina—halting production and disrupting national supply chain operations. In response, all hospitals in the New York-Presbyterian (NYP) enterprise set a goal to reduce IVF usage by 50% during the projected shortage period of three to four months.
- [Revitalizing Kindness: Strategies for Compassion, Patience and Respect in the Workplace](https://sphere.nyssa-pga.org/2024/revitalizing-kindness-strategies-for-compassion-patience-and-respect-in-the-workplace/) - Eileen Kodack, M.D., Teuta Marsic, M.D., Keith Lewis, M.D., and Alopi Patel, M.D. “In a world where you can be anything, be kind.”— Unknown Medicine has long been considered a noble field where physicians selflessly and tirelessly dedicate their lives to patient care. In today’s healthcare landscape, however, there are increasing reports of workplace harassment
- [Fire in the Hole! A Case of Intraoperative Fire Originating in the Thoracic Cavity](https://sphere.nyssa-pga.org/2023/case-report-fire-in-the-hole-a-case-of-intraoperative-fire-originating-in-the-thoracic-cavity/) - Operating room (OR) fires are rare but can be catastrophic. OR fires are considered “never events,” but even with practice advisories in place and training for OR staff, they continue to be a threat in the perioperative setting. Recent data from the Emergency Care Research Institute estimates that between 200 and 240 surgical fires occur annually in the U.S., with 20 to 30 resulting in severe injury and two to three resulting in mortality.
- [PGA Scientific Panels Offer Something for Everyone](https://sphere.nyssa-pga.org/2025/pga-scientific-panels-offer-something-for-everyone/) - The 78th PostGraduate Assembly in Anesthesiology (PGA) once again featured a wide range of topics with far-reaching appeal. From consistently popular subjects such as airway approaches and regional anesthesia to developing issues, including management of the patient on cannabinoids and the role of anesthesiology in blood management, the PGA offered something for every type of
- [Artificial Intelligence Integration in Point-of-Care Ultrasound](https://sphere.nyssa-pga.org/2023/artificial-intelligence-integration-in-point-of-care-ultrasound/) - Focused transthoracic echocardiography (FTTE) is an abridged echocardiographic exam performed by a non-cardiologist at the bedside to obtain diagnostic quality information in real time that can direct patient management in up to half of all critically ill patients.
- [Combined Use of Flexible Fiberoptic Bronchoscope and McGrath Video Laryngoscope to Perform Tracheal Intubation in a Case of Recurrent Squamous Cell Carcinoma of Tongue](https://sphere.nyssa-pga.org/2025/combined-use-of-flexible-fiberoptic-bronchoscope-and-mcgrath-video-laryngoscope-to-perform-tracheal-intubation-in-a-case-of-recurrent-squamous-cell-carcinoma-of-tongue/) - Tumors of the oral cavity pose significant airway challenges to anesthesiologists. Human Papillomavirus-related (HPV) oral cancers are linked to the rising morbidity and mortality in patients with oral cancer. Our patient was a 66-year-old male with a history of hypertension, schizophrenia and squamous cell carcinoma of the tongue.
- [Emergency Management of a Patient with Placenta Percreta Presenting Off-Hours in Labor](https://sphere.nyssa-pga.org/2025/emergency-management-of-a-patient-with-placenta-percreta-presenting-off-hours-in-labor/) - “We present the case of a parturient with known PAS who was admitted off-hours to our tertiary care hospital in preterm labor—highlighting the infrastructure, planning and preparedness that is required for optimal emergency care of PAS patients.”
- [Sustaining Our Mission](https://sphere.nyssa-pga.org/2024/presidents-message-sustaining-our-mission/) - The NYSSA was well represented at the ASA House of Delegates meeting in San Francisco in October, with 24 delegates and the NYSSA’s ASA director in attendance.
- [Advocating for Safe Anesthesia](https://sphere.nyssa-pga.org/2023/presidents-message-advocating-for-safe-anesthesia/) - This year marked the ninth anniversary of Physician Anesthesiologists Week (January 29-February 4). Once again, we took advantage of this opportunity to raise awareness about the important role anesthesiologists play in healthcare, whether serving as the patient’s advocate in the operating room, providing pain management, or protecting safe anesthesia care for veterans.
- [Making Connections and Building Bridges](https://sphere.nyssa-pga.org/2023/presidents-message-making-connections-and-building-bridges/) - This brief summary of my involvement in the NYSSA is an example of how I hope each of you will mentor your younger colleagues. If you are a director, please teach your assistant director; if you are a chair, guide your vice chair; if you are a delegate, advise your alternate delegate, and so on.
- [Farewell Address to the NYSSA House of Delegates](https://sphere.nyssa-pga.org/2024/farewell-address-to-the-nyssa-house-of-delegates-2/) - In my inaugural address last year, I talked about the importance of making connections, networking, and building bridges. I am happy to report that we were successful in all three of these activities this past year.
- [Strengthening Our Advocacy Efforts](https://sphere.nyssa-pga.org/2023/presidents-message-strengthening-our-advocacy-efforts/) - Looking back on the latest legislative session in New York, we were once again successful in preserving physician-led anesthesia care. I am grateful for the lobbying efforts of the nearly 50 volunteers who traveled to Albany on Legislative Day to make their voices heard.
- [Paradoxical Breathing in a Patient Undergoing CT-Guided Needle Biopsy Under Propofol Sedation](https://sphere.nyssa-pga.org/2024/paradoxical-breathing-in-a-patient-undergoing-ct-guided-needle-biopsy-under-propofol-sedation/) - Maricka Bennett, M.S., Joanna Serafin, Ph.D., and Kara M. Barnett, M.D., FASA, SAMBA-F Introduction Propofol is a commonly administered anesthetic due to its ease of titration to a desired level as well as its safety profile. However, propofol administration in a patient with a natural airway can lead to respiratory depression, hypoxia and, less commonly,
- [What a Global Health Experience in Rwanda Can Teach Us About Efficient, Impactful Anesthetic Care](https://sphere.nyssa-pga.org/2025/what-a-global-health-experience-in-rwanda-can-teach-us-about-efficient-impactful-anesthetic-care/) - “When I was invited to accompany the world-renowned thoracic surgeon, Dr. Valerie Rusch, for a needs assessment at King Faisal Hospital (KFH) in Kigali, Rwanda, I just could not pass up the opportunity. I had completed my thoracic fellowship at Memorial Sloan Kettering Cancer Center and was eager to share my expertise in a global health context.”
- [The New York Academy of Medicine Hosts Jeopardy Competition and Poster Presentations](https://sphere.nyssa-pga.org/2024/the-new-york-academy-of-medicine-hosts-jeopardy-competition-and-poster-presentations/) - Continuing with a popular event, the New York Academy of Medicine Section on Anesthesiology hosted the annual Jeopardy Competition and Poster Presentation night on October 4, 2023.
- [The New York Academy of Medicine Hosts Jeopardy Competition and Poster Presentations](https://sphere.nyssa-pga.org/2025/ny-academy-of-medicine-hosts-jeopardy-competition-and-poster-presentations-2025/) - The New York Academy of Medicine Section on Anesthesiology held its eighth annual Jeopardy Competition and Poster Presentation Night on December 2, 2024. The evening began with a lively reception where residents were able to meet and chat over wine and plenty of enjoyable snacks. Posters were judged by Drs. Meg Rosenblatt, Elisabeth Abramowicz and David
- [Celebrating 30 Years of the International Scholars Program](https://sphere.nyssa-pga.org/2024/celebrating-30-years-of-the-international-scholars-program/) - The International Scholars Program was conceived in 1993 during the annual meeting of the European Society of Anaesthesiologists. At that time, the European meeting was not as comprehensive as it is today, and the PGA, although the second-largest assembly of anesthesiologists, was also not well-known abroad.
- [A Year in Reflection](https://sphere.nyssa-pga.org/2025/a-year-in-reflection/) - One year ago, I began this presidency with two key goals: to uphold the highest standards of patient safety by preserving physician-led anesthesia care in New York state, and to enhance engagement among NYSSA members. I am proud to report that we have made significant strides toward achieving both objectives.
- [Our Voices Matter](https://sphere.nyssa-pga.org/2024/our-voices-matter/) - “I learned a long time ago the wisest thing I can do is be on my own side, be an advocate for myself and others like me.” — Maya Angelou Earlier this year, a member of the NYSSA posted a question on the ASA community open forum regarding the need for anesthesiologists to fight for
- [Engaging With, Educating and Advocating for Our Members](https://sphere.nyssa-pga.org/2024/engaging-with-educating-and-advocating-for-our-members/) - It is hard to believe that my presidency is approaching the halfway point. Typically, the greatest amount of work and stress for the NYSSA’s officers occurs during the legislative session in the first half of the year. As this article is being written, our delegation has just returned from another successful Legislative Day in Albany. This year we had 53 attendees representing a wide geographic cross section of the state.
- [A Time for Transition](https://sphere.nyssa-pga.org/2025/a-time-for-transition/) - The American Society of Anesthesiologists (ASA) annual meeting was held in October in Philadelphia. NYSSA members and leadership were well represented at the meeting, with the NYSSA’s own Dr. Tracey Straker serving as vice speaker of the ASA House of Delegates.
- [Exploring the Future of Anesthesiology at the PGA](https://sphere.nyssa-pga.org/2024/exploring-the-future-of-anesthesiology-at-the-pga/) - As members of the NYSSA, and anesthesiologists committed to the pursuit of excellence in patient care, many of us look forward to the PGA every year. The meeting brings together experienced anesthesiologists as well as younger generations with innovative ideas.
- [Examining the Advantages of an Ambulatory Extended Recovery Facility](https://sphere.nyssa-pga.org/2023/examining-the-advantages-of-an-ambulatory-extended-recovery-facility/) - Ambulatory extended recovery facilities, which have evolved from ambulatory outpatient surgery programs, provide a unique set of benefits for many patients. Rather than limiting recoveries to just hours with a same day discharge, these facilities allow carefully selected complex procedures and patients to recover outside of the hospital for a one-night stay.
- [Adapting to Survive](https://sphere.nyssa-pga.org/2023/editorial-adapting-to-survive/) - As I write this piece, it’s mid-January and blustery here in upstate New York. We celebrated a new year since our last issue, saying farewell to 2022. It was another challenging year, marked by the desire to “get back to normal” in our work but still severely challenged by the ramifications of the pandemic.
- [It’s Time to Talk About Our Mental Health](https://sphere.nyssa-pga.org/2024/its-time-to-talk-about-our-mental-health/) - Those who choose medicine as their career usually recognize early on that this choice is about more than just a profession. We are driven by the desire to make a difference, to improve the lives of others, to treat and cure sickness, and to support those who may be going through the worst days of their lives.
- [Working Hard on Behalf of Our Profession](https://sphere.nyssa-pga.org/2024/editorial-working-hard-on-behalf-of-our-profession/) - In October 2023, the American Society of Anesthesiologists (ASA) hosted its annual conference. Held this year in San Francisco, the meeting drew thousands of people from around the world who came to learn, teach and network.
- [Exploring New Approaches to Providing Value-Added Care](https://sphere.nyssa-pga.org/2023/editorial-exploring-new-approaches-to-providing-value-added-care/) - Healthcare staffing, worsened to crisis levels by the pandemic, continues to deteriorate, affecting emergency departments, urgent care centers, clinics and hospitals alike. Healthcare systems have been forced to hire more expensive temporary healthcare workers in response to the deficit of long-term workers who left their jobs during the “Great Resignation.”
- [Ketamine for Pain Management: Mechanism and Analgesic Benefits in the Perioperative and Chronic Pain Settings](https://sphere.nyssa-pga.org/2025/ketamine-for-pain-management-mechanism-and-analgesic-benefits-in-the-perioperative-and-chronic-pain-settings/) - Ketamine has long been used as an anesthetic, but it is starting to gain significant attention for other indications. It has also become more important in the perioperative space as a potent analgesic and a potential tool for opioid-sparing anesthetics.
- [Primed for the WIN!](https://sphere.nyssa-pga.org/2025/primed-for-the-win/) - “As I reflect back on my year as NYSSA President, I am heartened by the accomplishments of the leaders who have worked with and supported me. Each Board member has poured their wisdom and expertise into my term so that I could be an effective leader for NYSSA.”
- [Don’t Become a Victim](https://sphere.nyssa-pga.org/2023/dont-become-a-victim/) - I want to thank Dr. Ellen Brand for sharing her story with us. While I am not a security expert, I will make the following comments:
- [Tracey Straker, M.D., M.S., M.P.H., FASA, Appointed to National Committee](https://sphere.nyssa-pga.org/2023/tracey-straker-m-d-m-s-m-p-h-fasa-appointed-to-national-committee/) - NYSSA member Tracey Straker, M.D., M.S., M.P.H., FASA, was recently appointed to the position of chairwoman of the National Committee on Foreign Medical Education and Accreditation (NCFMEA).
- [Perioperative Anaphylaxis: A Rare but Severe Reaction to Sugammadex in a High-Risk Patient](https://sphere.nyssa-pga.org/2025/perioperative-anaphylaxis-a-rare-but-severe-reaction-to-sugammadex-in-a-high-risk-patient/) - Perioperative anaphylaxis from sugammadex, a neuromuscular blockade reversal agent, is rare but serious. This report details a 63-year-old woman with multiple allergies who developed severe anaphylaxis following sugammadex administration during surgery.
- [In Honor of Energy Awareness Month](https://sphere.nyssa-pga.org/tip-of-the-quarter/in-honor-of-energy-awareness-month/) - In addition to turning off and unplugging equipment, it is important to evaluate battery use and disposal. Lithium batteries leach toxic chemicals that can contaminate water supplies if landfilled. They must be sent to a battery re-processing center.
- [NYSSA at SAMBA](https://sphere.nyssa-pga.org/2025/nyssa-at-samba/)
- [Vol. 77 #3](https://sphere.nyssa-pga.org/2025/dont-miss-topics-vol-77-3/) - Fireside Chat with Dr. Harter of ASA Dr. Ronald L Harter, M.D., F.A.S.A., past-president of the ASA, is a Professor of Anesthesiology at The Ohio State University College of Medicine in Columbus, Ohio and a practicing physician anesthesiologist at the University’s Wexner Medical Center. Over the past three decades, he has served ASA in numerous
- [Vol. 77 #3](https://sphere.nyssa-pga.org/2025/case-reports-vol-77-3/) - Combined Use of Flexible Fiberoptic Bronchoscope and McGrath Video Laryngoscope to Perform Tracheal Intubation in a Case of Recurrent Squamous Cell Carcinoma of Tongue Tumors of the oral cavity pose significant airway challenges to anesthesiologists. Human Papillomavirus-related (HPV) oral cancers are linked to the rising morbidity and mortality in patients with oral cancer. A primary
- [Vol. 77 #3](https://sphere.nyssa-pga.org/2025/resident-and-fellow-section-v77-03/) - Lighting the Path: A Multi-Level Mentorship Approach to Anesthesiology Pathway programs were developed over 60 years ago via cross sectional efforts to diversify the workforce based on projected nationwide physician shortages. These initiatives were led by academic organizations including the National Medical Association, American Medical Association and Liaison Committee on Medical Education. Keep reading Inspiring
- [Resident and Fellow Section](https://sphere.nyssa-pga.org/2025/resident-and-fellow-section/) - Catch the “Wave”: Resident Education in Point-of-Care Ultrasound In the late 1960s, just as the word “groovy” was becoming popular in America, a radiology group in Philadelphia proved they could diagnose free intraperitoneal fluid with ultrasound using a cadaver model.1 This is one of the earliest recordings of point-of-care ultrasound (POCUS). From that point forward,
- [ASA LegCon 2025 & NYSSA Legislative Day](https://sphere.nyssa-pga.org/2025/77-02-photo-gallery/) - ASA LegCon 2025 – Washington, DC NYSSA Legislative Day Albany NY
- [Don't Miss Topics:](https://sphere.nyssa-pga.org/2025/dont-miss-topics/) - Reading Your Patient’s Mind During Anesthesia: Discover How at December’s PGA We are already looking forward to PGA 79, NYSSA’s premier meeting—a weekend of learning, networking and socializing. This December, the PGA is offering a new workshop that will demystify EEG monitoring in the operating room. How exciting is that! After you participate, you will
- [A Look at the 70th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2017/past-presidents-of-the-ny-ssa/) - In this issue: photos from the 70th PGA, the new NYSSA president’s inaugural address, a case of improper patient screening for office-based surgery, addressing the opioid epidemic, and inequality in anesthesiology.
- [Perspectives on a Pandemic](https://sphere.nyssa-pga.org/2020/perspectives-on-a-pandemic/) - In this issue: living through challenging times, a message to the plague doctors of 2020, caring for COVID patients, and an appreciative inquiry case report on Apgars in the ICU.
- [Going Green in the OR: The Debate Continues](https://sphere.nyssa-pga.org/2020/going-green-in-the-or-the-debate-continues/) - In this issue: Black lives in medicine, to go green or not to go green in the OR, reflections of an ambulatory anesthesiologist from the COVID front lines, and an appreciative inquiry case report.
- [Drug Testing in the Age of Legal Marijuana](https://sphere.nyssa-pga.org/2021/drug-testing-in-the-age-of-legal-marijuana/) - In this issue: drug testing healthcare providers in the age of legal marijuana, the race to achieve inclusion, a case of single-lung transplant from a deceased donor sensitive to cold, and an intern’s perspective on the pandemic peak in Brooklyn.
- [The PGA Goes Virtual](https://sphere.nyssa-pga.org/2021/the-pga-goes-virtual/) - In this issue: the challenges related to and lessons learned from virtual conferences, utilization of the PACU/recovery room as an adjuvant overflow for critical care in the era of COVID-19, a profile of Distinguished Service Award recipient Dr. Rebecca Twersky, and a case of ketamine for the treatment of pain, delirium and wean of sedation in a critically ill COVID-19 patient.
- [Virtual Interviews: A Residency Program Perspective](https://sphere.nyssa-pga.org/2021/virtual-interviews-a-residency-program-perspective/) - In this issue: professional diversity in the NYSSA, a reflection from the front lines one year later, different populations require different COVID medical responses, an anesthesia residency program perspective on virtual interviews, a quality improvement project focuses on emergency C-section medications, and a case of hypokalemia, digoxin, and perioperative ventricular fibrillation arrest in a premature neonate.
- [Adapting to the Future of Learning](https://sphere.nyssa-pga.org/2021/adapting-to-the-future-of-learning/) - In this issue: the pandemic ushers in a new era of virtual learning, a look at the NYU Langone Health Diversity Committee, the history of the International Scholars Program, and a case of peculiar central line placement due to persistent left-sided superior vena cava.
- [Fear and Uncertainty During COVID](https://sphere.nyssa-pga.org/2022/fear-and-uncertainty-during-covid/) - In this issue: compassion and connection to LGBTQIA+ patients, the arguments for and against a 24/7 in-house intensivist, one physician’s reflections on COVID, and learning the difficult lessons from COVID ICU fires.
- [A Look at the 75th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2022/past-presidents-of-the-new-york-state-society-of-anesthesiologists-2/) - In this issue: photos from the 75th PGA, the new NYSSA president’s inaugural address, weekly well-being surveys and their impact on resident wellness, and a case of iatrogenic tracheal tear during upper gastrointestinal endoscopy in a patient with neurofibromatosis type 1.
- [Exploring the Future of Anesthesiology Training](https://sphere.nyssa-pga.org/2022/exploring-the-future-of-anesthesiology-training/) - In this issue: a look at the future of anesthesiology training, a profile of Dr. Elizabeth Frost, an update from the Patient Safety and Quality Improvement Committee, and choosing the right business structure for your needs.
- [Recognizing the Challenges for Black Men in Medicine](https://sphere.nyssa-pga.org/2022/recognizing-the-challenges-for-black-men-in-medicine/) - In this issue: one physician’s perspective on the challenges facing black men in medicine, a look at Euroanaesthesia 2022, and perioperative management of a patient with C1 deficient hereditary angiodedema.
- [Social Media: A Primer for Physicians](https://sphere.nyssa-pga.org/2023/social-media-a-primer-for-physicians/) - In this issue: the effective use of social media, a profile of Dr. Kathryn McGoldrick, scenes from the ASA annual meeting, and the New York Academy of Medicine hosts its annual poster presentation night.
- [A Look at the 78th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2025/a-look-at-the-78th-postgraduate-assembly-in-anesthesiology/) - PGA Scientific Exhibits and Poster Presentations: A Vital Tool for Professional Development Poster presentations offer a wealth of benefits for medical students and trainees, making them a vital tool for professional development, particularly in the early stages of the presenters’ careers. The presentations provide a platform to enhance communication skills by requiring presenters to distill
- [An Interview With Dr. Jonathan Gal](https://sphere.nyssa-pga.org/2025/an-interview-with-dr-jonathan-gal/) - Dr. Jonathan Gal’s service to his colleagues and the specialty of anesthesiology began more than a decade ago. Over the years, he has become well-versed in the economics of anesthesiology. Beyond holding administrative positions within the Mount Sinai Health System, he has served as chair of the NYSSA’s Government and Legal Affairs Committee and as a member of the Board of Directors.
- [The Oxcart Ambulance: A Medical Mission in Rural Nigeria](https://sphere.nyssa-pga.org/2017/the-oxcart-ambulance-a-medical-mission-in-rural-nigeria/) - In this issue: a medical mission to Nigeria, a look at the NYSSA’s advocacy efforts, and an inside look at the legislative process.
- [Addressing Disruptive Behavior in the Workplace](https://sphere.nyssa-pga.org/2017/addressing-disruptive-behavior-in-the-workplace/) - In this issue: addressing disruptive behavior in the workplace, a look at the NYSSA Ad Hoc Committee on Women Physicians, and patient safety should be fundamental in anesthesia.
- [A Journey to Serbia](https://sphere.nyssa-pga.org/2017/journey-to-serbia/) - In this issue: teaching regional anesthesia in Serbia, understanding third-party payor audits, and a case of neonatal respiratory depression after epidural fentanyl.
- [A Look at the 71st PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2018/past-presidents-of-the-nyssa-pga/) - In this issue: photos from the 71st PGA, the new NYSSA president’s inaugural address, appealing to legislators to “do no harm,” and understanding matters before the Office of Professional Medical Conduct (OPMC).
- [The Transition to Practice](https://sphere.nyssa-pga.org/2018/the-transition-to-practice/) - In this issue: easing the transition to practice, transitioning from residency to private practice, reflections on academic practice, and a profile of Distinguished Service Award recipient Dr. Ingrid Hollinger.
- [Time Management](https://sphere.nyssa-pga.org/2018/time-management/) - In this issue: recognizing the importance of time management, understanding physician employment contracts, and Jeopardy Night at the New York Academy of Medicine.
- [Women in Medicine: The Need for Change](https://sphere.nyssa-pga.org/2018/women-in-medicine-the-need-for-change/) - In this issue: recognizing the challenges faced by women in medicine, understanding family leave benefits in New York, and the annual anesthesiology residents’ night at the New York Academy of Medicine.
- [A Look at the 72nd PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2019/past-presidents-of-nyssa/) - In this issue: photos from the 72nd PGA, the new NYSSA president’s inaugural address, a profile of Distinguished Service Award recipient Dr. Scott Groudine, another successful year for the International Scholars Program, and an appreciative inquiry case report.
- [NYSSA Committees Serve the Members and the Mission](https://sphere.nyssa-pga.org/2019/nyssa-committees-serve-the-members-and-the-mission/) - In this issue: a look at the work of NYSSA committees and members, responding to a visit from an investigator, a case of balloon-occluded retrograde transvenous obliteration (BRTO) procedure balloon rupture, and an appreciative inquiry case report.
- [Legislative and Regulatory Advocacy: Giving Members a Voice](https://sphere.nyssa-pga.org/2019/legislative-and-regulatory-advocacy-giving-members-a-voice/) - In this issue: the benefits of NYSSA membership, the Government and Legal Affairs Committee advocates for all anesthesiologists, Medicare guidance on the use of extrapolation in audits, and an appreciative inquiry case report.
- [A Commitment to Continuing Medical Education](https://sphere.nyssa-pga.org/2020/a-commitment-to-continuing-medical-education/) - In this issue: meeting the educational needs of anesthesiologists worldwide, understanding the issues related to concierge medicine, scenes from the 2019 ASA annual meeting, and an appreciative inquiry case report.
- [A Look at the 73rd PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2020/past-presidents-of-the-nyssa/) - In this issue: photos from the 73rd PGA, the new NYSSA president’s inaugural address, a profile of Distinguished Service Award recipient Dr. Steven Schwalbe, and an appreciative inquiry case report.
- [The 77th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2024/the-77th-postgraduate-assembly-in-anesthesiology/) - Opening Session and R.W. Robertazzi Memorial Panel E.A. Rovenstine Memorial Lecture Poster Presentations Workshops House of Delegates Meeting Sessions Resident Program Women Physicians Committee Happy Hour Professional Diversity Committee Happy Hour Technical Exhibits Scenes From PGA77 Scenes From the President’s Reception
- [Rebecca S. Twersky, M.D., M.P.H., FASA](https://sphere.nyssa-pga.org/2023/in-memoriam-rebecca-s-twersky-m-d-m-p-h-fasa/) - It is with great sadness that we announce the passing of Dr. Rebecca Twersky, a longtime faculty member in the Department of Anesthesiology at SUNY Downstate. Dr. Twersky received her M.D. from Downstate in 1983.
- [A Look at the 76th PostGraduate Assembly in Anesthesiology](https://sphere.nyssa-pga.org/2023/a-look-at-the-76th-postgraduate-assembly-in-anesthesiology/) - Opening Session and R.W. Robertazzi Memorial Panel E.A. Rovenstine Memorial Lecture Workshops Poster Presentations House of Delegates Meeting Lectures NYSCARF and Resident Happy Hour Women Physicians Committee Happy Hour Technical Exhibits Scenes From PGA76 Scenes From the President’s Reception
- [Euroanaesthesia 2023](https://sphere.nyssa-pga.org/2023/euroanaesthesia-2023/)

## Pages

- [Home](https://sphere.nyssa-pga.org/)
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- [About](https://sphere.nyssa-pga.org/about/) - Sphere is published four times per year by the New York State Society of Anesthesiologists, Inc. Editors Paul M. Wood, M.D.1948 Vol. 1 Morris Bien, M.D.1949-1950 Vol. 1-2 Thomas F. McDermott, M.D.1950-1952 Vol. 2-4 Louis R. Orkin, M.D.1953-1955 Vol. 5-7 William S. Howland, M.D.1956-1960 Vol. 8-12 Robert G. Hicks, M.D1961-1963 Vol. 13-15 Berthold Zoffer, M.D.
- [Sphere Editorial Guidelines](https://sphere.nyssa-pga.org/editorial-guidelines/) - Thank you for your interest in submitting an article for Sphere – the quarterly online magazine for the New York State Society of Anesthesiologists, Inc. (NYSSA)
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## Categories

- [2023](https://sphere.nyssa-pga.org/category/2023/) - SPHERE newsletters published in 2023
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- [2022](https://sphere.nyssa-pga.org/category/2022/) - SPHERE newsletters published in 2023
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## Tags

- [In Memoriam](https://sphere.nyssa-pga.org/tag/in-memoriam/)
- [President's Message](https://sphere.nyssa-pga.org/tag/presidents-message/)
- [Editorial](https://sphere.nyssa-pga.org/tag/editorial/)
- [Albany Report](https://sphere.nyssa-pga.org/tag/albany-report/)
- [Resident and Fellow Section](https://sphere.nyssa-pga.org/tag/resident-and-fellow-section/)
- [Case Report](https://sphere.nyssa-pga.org/tag/case-report/)
- [Quarterly Feature](https://sphere.nyssa-pga.org/tag/quarterly-feature/)
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- [Sustainability](https://sphere.nyssa-pga.org/tag/sustainability/)
- [From the Editor](https://sphere.nyssa-pga.org/tag/from-the-editor/)
- ["Don't Miss" Topics](https://sphere.nyssa-pga.org/tag/dont-miss-topics/)
- [Photo Gallery](https://sphere.nyssa-pga.org/tag/photo-gallery/)
- [Subspecialty Highlight: Pain](https://sphere.nyssa-pga.org/tag/subspecialty-highlight-pain/)
- [Subspecialty Highlight: Critical Care](https://sphere.nyssa-pga.org/tag/subspecialty-highlight-critical-care/)
- [Subspecialty Highlight: Ambulatory Anesthesia](https://sphere.nyssa-pga.org/tag/subspecialty-highlight-ambulatory-anesthesia/)
- [Leadership Forecast](https://sphere.nyssa-pga.org/tag/leadership-forecast/)
- [Executive Director’s Message](https://sphere.nyssa-pga.org/tag/executive-directors-message/)
- [Special Alert](https://sphere.nyssa-pga.org/tag/special-alert/)
- [Committee Spotlight: By-Laws](https://sphere.nyssa-pga.org/tag/committee-spotlight-by-laws/)
- [Committee Spotlight: GLAC](https://sphere.nyssa-pga.org/tag/committee-spotlight-glac/)