43rd Western Anesthesia Residents Conference.  University of California at Irvine, Orange, California. April 29–May 1, 2005.

The 43rd Western Anesthesia Residents Conference (WARC) was hosted by the Anesthesiology Department of the University of California, Irvine, California. WARC was held from April 29 to May 1, 2005, at the Hyatt Regency Hotel (Garden Grove, California). The conference started with registration and a welcome reception on Friday evening followed by a Chief Residents and Chairs dinner. An overview of the conference was given by Peter Breen, M.D. (Chair, UCI Medical Center, Orange, California), in the Chairs dinner.

One hundred eighty-five residents, researchers, and faculty members preregistered for the conference. In all, more than 220 people participated in various parts of the conference. The conference attracted a record number of participants, which was evident by the 33% increase in the number of abstracts that were presented during the conference. For the first time at WARC, we had to divide abstracts into two groups for awards because of an overwhelming number of abstracts (a record 120 submissions this year). The abstracts were separated into research and case report (including computer model and retrospective analysis) categories. Incidentally, we had an equal number of abstracts in both categories. Research abstracts were presented in four oral sessions and a poster discussion encompassing three concurrent sessions. Case reports were presented two different times, using three concurrent sessions at each time. The abstracts were categorized based on the subspecialty of anesthesiology. Studies from almost all subspecialties were presented during the conference, which gave every participant something to look forward to in relation to his or her subspecialty of interest. An attempt was made to have a faculty moderator with experience in a subspecialty moderate that session throughout the conference to offer each investigator an opportunity to present his or her work to a moderator experienced in that particular field of research.

Saturday morning's program started with a brief welcome address by Dr. Breen. He welcomed all of the attendees and wished the presenters all the best. He also acknowledged overwhelming support from various exhibitors. The conference is sponsored by all the academic institutions in the Western region. The presence of exhibitors made the conference more lively and offered the attendees an opportunity to learn about new products. Nitin Shah, M.D. (Director, WARC 2005, UCI Medical Center), gave detailed information about abstract presentations and awards. The scientific program followed, with two oral sessions of research abstracts and a break to view the posters and to visit the exhibits. This was followed by lunch. The whole afternoon was dedicated to the poster discussion sessions. Between 1:00 and 5:30 pm, three poster discussion sessions were arranged to cover a large number of abstracts, with a break after each session to visit with the exhibitors. A total of approximately 110 abstracts were presented during the day.

Saturday evening included an entertaining and informative presentation on “Wine, Health, and History” by Philip J. DiSaia, M.D. (Dorothy J. Marsh Chair in Reproductive Biology, UCI Medical Center). Participants thoroughly enjoyed the history of wine and the relation of wine and health while sipping wine before dinner. A sumptuous dinner marked the end of Saturday.

Sunday morning included two oral sessions, with a break in between to visit with the exhibitors. The remaining research abstracts were presented during these oral sessions. The conference ended with lunch, during which three awards in each category were presented.

1. Mohab M. Ibrahim, Ph.D., University of Arizona, Tucson, Arizona. “CB2 Cannabinoid Receptor Activation Produces Antinociception by Stimulating Peripheral Release of Endogenous Opioids.” 

• This rat study suggests that CB2 receptor activation stimulates release from keratinocytes of B-endorphin, which acts at local neuronal μ-opioid receptors to inhibit nociception. This mechanism allows for the local release of B-endorphin where CB2 receptors are present, leading to anatomical specificity of opioid effects.

2. Jason Miller, M.D., UCI Medical Center, Orange, California. “Subanesthetic Sevoflurane Preferentially Inhibits Human Emotional Memory.” 

• This volunteer study suggests that sevoflurane at 0.25% end-tidal concentration may help to prevent cases of awareness by preferentially blocking recall of emotionally laden information.

3. Edward Lee, M.D., Harbor-UCLA Medical Center, Los Angeles, California. “Pelvic Colocalization within Dorsal Root Ganglion.” 

• This rat study demonstrates that neural input from two different pelvic organs (uterus and colon) projected to the same cell body within the same dorsal root ganglion. It is plausible that this population of dichotomizing (branching) neurons plays a vital role in the mechanism of nociceptive transduction at the level of primary afferent neurons.

1. Nathan Kudrick, M.D., UCI Medical Center, Orange, California. “Inadvertent Breathing Bag Obstruction Causes Decreased Tidal Volume during Mechanical Ventilation with the Draeger Narkomed 6000 Anesthesia Machine.” 

• This case report identified that the Narkomed system uses the reservoir bag as a component of the compensation mechanism, and an obstruction of the bag may impair proper ventilator function.

2. Brian Pitts, M.S., M.D., UC Davis Medical Center, Sacramento, California. “Development of an Interactive Multimedia Software Program that Models the Cardiac Pressure-Volume Relationship.” 

• The author has developed a computer-aided instruction model that teaches the hemodynamic variations throughout the cardiac cycle by correlating intracardiac pressure with volume and time.

3. Judi Cain, M.D., Loma Linda University Medical Center and Children's Hospital, Loma Linda, California. “Airway Management of Newborns with Pierre Robin Sequence: The Use of Disposable vs. Multiple Use Laryngeal Mask Airways (LMA) for Fiberoptic Intubations.” 

• Two cases revealed that a 3.0-mm endotracheal tube can pass through a No. 1 multiuse LMA, whereas only a 2.5-mm endotracheal tube could pass through a No. 1 disposable LMA.

The annual meeting concluded after the awards ceremony. The 2006 WARC will be hosted by the University of Utah, Salt Lake City, Utah.

The author thanks the faculty, staff, and residents of the Department of Anesthesiology, University of California at Irvine Medical Center, Orange, California.

University of California at Irvine Medical Center, Orange, California, and Long Beach Veterans Affairs Healthcare System, Long Beach, California. nitin.shah@med.va.gov