Atomic Anesthesia

Regional anesthesia is one of the highest-yield, most heavily tested areas on the boards, but most review content buries the clinically useful details under anatomy that never gets asked. This episode breaks down the brachial plexus approaches boards actually tests, the truncal and lower extremity blocks showing up in modern multimodal protocols, and the complication patterns examiners use as answer traps.
In this episode:
The four brachial plexus approaches and why phrenic nerve risk drops as you move from interscalene to axillary
Why adductor canal block has replaced femoral nerve block for TKA, and the volume myths that trip up test-takers
The LAST risk hierarchy by injection site, and the Exparel interaction rules boards loves to test

FREE RESOURCES:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia.
Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page
Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.

Understanding opioid selection in the OR is all about recognizing pharmacokinetics and how they align with surgical needs and patient factors, rather than focusing solely on receptor effects. This episode explores the five opioids you use most—morphine, fentanyl, sufentanil, remifentanil, and hydromorphone—and offers a framework for choosing optimally among them.
Opioid receptor mechanisms and their clinical outcomes
Lipid solubility's role in opioid kinetics
Pharmacokinetics of morphine, fentanyl, sufentanil, remifentanil, and hydromorphone
Managing side effects like respiratory depression and opioid-induced hyperalgesia
Guidelines for opioid selection based on case specifics and patient renal function

Resources
Atomic Anesthesia Platform — In-depth lessons and quizzes on each opioid.
FREE RESOURCE FOR THIS EPISODE:
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Head to atomicanesthesia.com/freebies/gpcr-cheat-sheet to grab it free.
MORE FREE STUDY RESOURCES:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards
Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page
Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

A recently identified genetic mutation, passed down on the maternal line, can cause otherwise healthy patients to develop severe and often permanent neurological injury after routine sevoflurane exposure. This episode breaks down the underlying mitochondrial mechanism, why TIVA with propofol is the safer anesthetic strategy, and the family history red flags every provider should be screening for.
A newly identified genetic mutation that turns routine sevoflurane exposure into catastrophic, permanent neurological injury
The mitochondrial mechanism behind it, and why some patients have zero reserve capacity to absorb the hit
Why TIVA with propofol becomes the clear anesthetic choice once you understand what spares Complex I

Source: Sanz-Pons J, et al. "Effects of a Mitochondrial Genetic Variant on Sevoflurane Hypersensitivity." Anesthesiology 2026;144:1286–98.
FREE RESOURCE FOR THIS EPISODE:
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Head to atomicanesthesia.com/freebies/gpcr-cheat-sheet to grab it free.
MORE FREE STUDY RESOURCES:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards
Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page
Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

Propofol, a cornerstone in anesthesia practice, functions as a positive allosteric modulator at the GABA-A receptor. This episode explores its receptor pharmacology, the mechanisms behind its dose-dependent clinical effects, and addresses common questions like propofol infusion syndrome and pain on injection.
Receptor pharmacology and allosteric modulation
Pharmacokinetics and context-sensitive half-time
Cardiac and respiratory effects
Risk and management of propofol infusion syndrome
Handling egg allergy concerns
Strategies to reduce pain on injection

FREE RESOURCE FOR THIS EPISODE:
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia. Head to atomicanesthesia.com/freebies/gpcr-cheat-sheet to grab it free.
MORE FREE STUDY RESOURCES:
SEE/NCE Study Plan — A structured, week-by-week plan to pass your boards
Non-Opioid Pharmacology Cheat Sheet — Every non-opioid analgesic you need to know, on one page
Malignant Hyperthermia Reference Guide — Recognize MH fast. Treat it faster — one-page reference
WANT THE FULL PLATFORM?
Atomic Anesthesia is the all-in-one study platform built specifically for SRNAs — lessons, quizzes, flashcards, and more. Start your free trial at atomicanesthesia.com.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)

Welcome to the Atomic Anesthesia podcast hosted by CRNA professor Dr. Rhea Temmermand and Co-Founder Sachi Lord. On this show, you'll hear clear, clinically grounded discussions designed for nurse anesthesia residents and CRNAs who want to feel more confident in complex pharmacology, physiology, and real-world anesthesia decision-making.
Want more content like this? Become a member of our learning platform: http://atomicanesthesia.com
In this episode:
The critical distinction between high spinal and total spinal that everyone can define but few can actually tell apart
Why a negative aspiration on a labor epidural doesn't guarantee the catheter isn't sitting in CSF
The board favorite scenario where a spinal stacked on a failed epidural top off becomes one of the highest risk setups for total spinal
Why blood pressure stays normal in over half of total spinal cases and what the earliest reliable warning sign really is

💜 FREE DOWNLOADS: Grab your copy of customized study plans & worksheets.
SEE/NCE Study Plan — a structured, week-by-week plan to pass your boards
Non-Opioid Pharmacology Cheat Sheet — every non-opioid analgesic you need to know, one page
GPCR Cheat Sheet — G-protein coupled receptors decoded for anesthesia

💜 CONNECT: 📥 Email questions, comments or topic suggestions to Rhea or Sachi at hello@atomicanesthesia.com, follow us on social media, and sign up for our newsletter.
Mentioned in this episode:
💜 PARTNERS: The Incomologists®
https://theincomologists.com/
You work hard caring for others—let us take care of you. Whether you’re a W-2 employee or transitioning to a 1099 role, we understand the unique challenges healthcare professionals face, from insurance coverage to financial planning. That’s where we step in.
Like you, we are a team of healthcare providers who understand your needs and help you find tailored insurance plans and financial strategies without the hassle or pressure. And we’re a partner you can rely on, today and in the future.
We evaluate all available options and resources in the market to protect our clients, so contact us, and we’ll get started! - Jake Bevilacqua, CRNA (jake@theincomologists.com)