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)

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:

• Jake and Alex discuss The non-clinical conversations every preceptor should be having, including finances, the post-graduation credentialing gap, and disability insurance
• Why student wellbeing directly affects learning and the small ways preceptors can protect it
• The difference between the right way, the wrong way, and just your way
• Why precepting is the highest-leverage thing you do as a CRNA and how one tip can ripple through generations of providers

💜 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)

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:

• Jake and Alex discuss the most important relationship in CRNA school and why the transition to preceptor happens before most new grads feel ready
• How to set the right tone from day one, give students an appropriate leash, and know when to step in
• Why letting students safely get into trouble is more powerful than telling them what not to do
• How to deliver honest, constructive feedback, including praise in public, correction in private, and debriefs that students lead themselves

💜 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)

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:

• Why your biggest limitation is often your mindset, not your intelligence, work ethic, or background
• How to build real confidence through action, overcome self-doubt, and break through limiting beliefs
• Why thinking bigger, embracing bold goals, and challenging your own ceiling creates new opportunities
• How true success is measured by the impact you have on others and using your achievements to elevate your community

💜 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.

💜 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 (info@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 major ventilation modes used on anesthesia machines, including volume control, pressure control, PCV-VG, and pressure support ventilation
• How each mode works, what it guarantees, and the key advantages and limitations of each
• How to choose the right mode for common OR scenarios like obesity, laparoscopic surgery, Trendelenburg positioning, and LMA cases
• Practical ventilation pearls, including lung-protective tidal volumes, PEEP, airway pressures, and recognizing changes in pulmonary compliance
• A simple framework for understanding any ventilator mode without memorizing manufacturer-specific names or buttons

💜 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)