In ancient Rome, the Forum was the heart of the city, an open space or marketplace where business was conducted, be it judicial, civic or religious. The Forum was where everyone went to find out what was new and what was happening in every important facet of Roman life. Just like in ancient times, the ASA Clinical Forums are the place to find out what is happening in your specialty. The Clinical Forum sessions at the ASA 2004 Annual Meeting will be held Monday through Wednesday, October 25-27, at the Las Vegas Convention Center in Las Vegas, Nevada.

Over the years, the forums have become one of the best educational tools of the Annual Meeting. The format allows a panel of experts to discuss one or two cases in a thought-provoking manner. But just as in ancient Rome, everyone in the audience is invited to participate in the clinical decision-making. In fact it is the audience participation that really makes the forums interesting and fun. Furthermore there is no charge for this activity!

All of the Clinical Forum cases will appear in the 2004 Annual Meeting program book, allowing participants a chance to review the cases before the sessions. Expanded outlines and important controversial issues will be available at the sessions themselves for those who attend. Each Clinical Forum is scheduled to last 90 minutes, and most will discuss two cases in the specific area of interest. There will be no audiovisual aids used by the panelists — discussion is the operative word.

We have taken your suggestions and comments from last year and incorporated them in this year’s programming. Traditionally we have had forums covering all of the subspecialties in anesthesiology, and we will be running nine this year. Because of the new obstetric anesthesia and critical care medicine tracks (see page 15 for details), those forums will be held during their own special time periods.

We look forward to your participation in the Clinical Forums this year and your many questions, ideas and suggestions. Feel free to add your “thumbs up” or “thumbs down” opinions to what is being said. We cannot promise you togas, but we can promise that the discussions will be lively. The panelists are looking forward to the prospect of feeling like they have been moved from the Forum to the Coliseum to be fed to the lions!

A young healthy woman is having a breast lumpectomy. General endotracheal anesthesia is induced and the surgeon injects isosulfan blue dye. Thirty minutes later, blood pressure is 60/40. What is happening?

Trauma Clinical Forum. Moderator: Albert J. Varon, M.D., University of Miami School of Medicine, Miami, Florida

A 65-year-old man is hit by a car while walking intoxicated. He weighs 300 pounds and has evidence of head trauma, closed bilateral tibia and fibula fractures and spleen laceration. What is your management?

Ethics Clinical Forum. Moderator: Gail A. Van Norman, M.D., University of Washington, Seattle, Washington.

A noncompliant patient with diabetes mellitus arrives in the intensive care unit with sepsis from a gangrenous right toe. The patient refuses amputation of any kind and is becoming dangerously ill. What duties do intensive care physicians have with respect to honoring patient autonomy, medical care and the costs of care?

Neuroanesthesia Clinical Forum. Moderators: Gregory Crosby, M.D., Harvard Medical School, Boston, Massachusetts, and Verna L. Baughman, M.D., University of Illinois, Chicago, Illinois.

A man with leg weakness, renal failure and anemia is brought to the operating room for emergency spinal decompression. He has multiple myeloma with tumor progression intradurally in the lumbar region. What are your management concerns and plans?

Cardiothoracic Clinical Forum. Moderator: Christopher J. O’Connor, M.D., Rush-Presbyterian, Chicago, Illinois.

A 68-year-old man with many comorbidities presents to the operating room for repair of a supraceliac aortic aneurysm. What kind of management challenges do you foresee?

Pediatric Clinical Forum. Moderator: Nancy L. Glass, M.D., Baylor College of Medicine and Texas Children’s Hospital, Houston, Texas.

The patient is a 4-year-old boy having tonsillectomy and adenoidectomy. He weighs 32 kg and snores loudly at night. Concerns?

Practice Management Clinical Forum. Moderator: Joseph W. Szokol, M.D., Northwestern University, Chicago, Illinois.

You are part of a group of anesthesiologists who have a 73-year-old partner. He is starting to have minor problems in the operating room but insists he wants to continue to practice. How do you handle this?

Geriatrics. Moderator: G. Alec Rooke, M.D., University of Washington, Seattle, Washington.

A 74-year-old woman presents for total abdominal hysterectomy/bilateral salpingo-oophorectomy. She smokes, has gastroesophageal reflux disease, S/P angioplasty for angina and she drinks “a bit.” For what perioperative complications is she at risk?

Pain Management Clinical Forum. Moderator: John C. Rowlingson, M.D., University of Virginia, Charlottesville, Virginia.

Two weeks after surgery for carpal tunnel, a woman presents with burning pain in the operative hand. She needs help in order to fully participate in PT. Initial treatments are only temporarily effective, and the insurance company claims that further treatment is experimental and will not pay for it. What are your/her choices?

Saundra E. Curry, M.D., is Associate Clinical Professor of Anesthesiology, Columbia University, New York Presbyterian Hospital, New York, New York.