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COVID-2019 Alert

The latest information about the 2019 Novel Coronavirus, including vaccine clinics for children ages 5 years old and older.

La información más reciente sobre el nuevo Coronavirus de 2019, incluidas las clínicas de vacunación para niños de 5 años en adelante.

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F. Fabian Okonski, MD

  • Fernando Fabian Okonski

Specialties

Anesthesia, Pediatric

Regional Anesthesia

Anesthesia

Work and Education

Professional Education

University of Southern California Keck School of Medicine, Los Angeles, CA, 06/01/1990

Internship

Santa Clara Valley Medical Center Internal Medicine Residency, San Jose, CA, 06/30/1991

Residency

Stanford University Anesthesiology Residency, Stanford, CA, 06/30/1994

Board Certifications

Anesthesia, American Board of Anesthesiology

Pediatric Anesthesia, American Board of Anesthesiology

Services

Anesthesia

All Publications

THE USE OF EPHEDRINE TO TREAT ANESTHESIA-ASSOCIATED HYPOTENSION IN PINNIPEDS. Journal of zoo and wildlife medicine : official publication of the American Association of Zoo Veterinarians Trumbull, E. J., Okonski, F., Field, C. L., Casper, D., McClain, A. M., Pattison, S., Whitmer, E. R., Whoriskey, S., Johnson, S. P. 2021; 52 (3): 1054-1060

Abstract

Hypotension is a common adverse effect of general anesthesia that has historically been difficult to measure in pinniped species due to technical challenges. A retrospective case review found seven pinniped cases that demonstrated anesthesia-associated hypotension diagnosed by direct blood pressure measurements during general anesthesia at The Marine Mammal Center (Sausalito, CA) between 2017 and 2019. Cases included five California sea lions (CSL: Zalophus californianus), one Hawaiian monk seal (HMS: Neomonachus schauinslandi), and one northern elephant seal (NES: Mirounga angustirostris). Patients were induced using injectable opioids, benzodiazepines, and anesthetics including propofol and alfaxalone. Excluding the HMS, all patients required supplemental isoflurane with a mask to achieve an anesthetic plane allowing for intubation. Each patient was maintained with inhalant isoflurane in oxygen for the duration of the anesthetic event. Each patient was concurrently administered continuous IV fluids and four patients received fluid boluses prior to administration of ephedrine. All hypotensive anesthetized patients were treated with IV ephedrine (0.05-0.2 mg/kg). The average initial systolic (SAP) and mean (MAP) arterial blood pressures for the CSL prior to ephedrine administration were 71 14 mmHg and 48 12 mmHg respectively. The average SAP and MAP for the CSL increased to 119 32 mmHg and 90 34 mmHg respectively within 5 m of ephedrine administration. The NES initial blood pressure measurement was 59/43 (50) (SAP/diastolic [MAP]) mmHg and increased to 80/51 (62) mmHg within 5 m. The initial HMS blood pressure was 79/68 (73) mmHg and increased to 99/78 (85) mmHg within 5 m following ephedrine administration. All patients recovered from anesthesia. These results support the efficacy of IV ephedrine for the treatment of anesthesia-associated hypotension in pinnipeds.

View details for DOI 10.1638/2020-0219

View details for PubMedID 34687524

Droplet evacuation strategy for simulated coughing during aerosol-generating procedures in COVID-19 patients. British journal of anaesthesia Tsui, B. C., Deng, A., Lin, C., Okonski, F., Pan, S. 2020

View details for DOI 10.1016/j.bja.2020.06.009

View details for PubMedID 32600805