BOOK
Faust's Anesthesiology Review E-Book
Michael J. Murray | Steven H. Rose | Denise J. Wedel | C. Thomas Wass | Barry A Harrison | Jeff T Mueller | Terence L Trentman
(2014)
Additional Information
Book Details
Abstract
Quickly expand your knowledge base and master your residency with Faust's Anesthesiology Review, the world’s best-selling review book in anesthesiology. Combining comprehensive coverage with an easy-to-use format, this newly updated medical reference book is designed to efficiently equip you with the latest advances, procedures, guidelines, and protocols. It’s the perfect refresher on every major aspect of anesthesia.
- Take advantage of concise coverage of a broad variety of timely topics in anesthesia.
- Focus your study time on the most important topics , including anesthetic management for cardiopulmonary bypass, off-pump coronary bypass, and automatic internal cardiac defibrillator procedures; arrhythmias; anesthesia for magnetic resonance imaging; occupational transmission of blood-borne pathogens; preoperative evaluation of the patient with cardiac disease; and much more.
- Search the entire contents online at Expert Consult.com.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front cover | Cover | ||
| Inside front cover | IFC | ||
| Front matter | i | ||
| Faust’s anesthesiology review | i | ||
| Copyright | iv | ||
| Dedication | v | ||
| Contributors | vii | ||
| Preface | xv | ||
| Table of contents | xvii | ||
| I Operating room | 1 | ||
| 1 Medical gas supply | 1 | ||
| Suggested readings | 2 | ||
| 2 Electrical supply | 3 | ||
| Electrical safety in the operating room | 3 | ||
| Power systems | 3 | ||
| Grounded power systems | 3 | ||
| Isolated power systems | 3 | ||
| Line isolation monitors | 3 | ||
| Electrical requirements in the operating room | 4 | ||
| Suggested readings | 4 | ||
| Suggested readings | 5 | ||
| Prevention | 6 | ||
| Preparation | 6 | ||
| Management of an operating room fire | 6 | ||
| Suggested readings | 6 | ||
| 5 Operating room management | 8 | ||
| Operating room governance | 8 | ||
| Operating room efficiency | 8 | ||
| Operating room utilization | 8 | ||
| Cost management | 9 | ||
| Conclusion | 9 | ||
| Suggested readings | 9 | ||
| II Equipment | 11 | ||
| 6 Vaporizers | 11 | ||
| Concentration-calibrated vaporizers | 11 | ||
| Vaporization methods | 12 | ||
| Flow over | 12 | ||
| Bubble through | 12 | ||
| Injection | 12 | ||
| Temperature compensation | 12 | ||
| Thermostatic compensation | 12 | ||
| Computer controlled | 12 | ||
| Supplied heat | 12 | ||
| Suggested readings | 12 | ||
| Physical principles | 13 | ||
| Pressure change across the constriction | 13 | ||
| Physical properties of the gas | 13 | ||
| Effects of temperature and pressure | 13 | ||
| Types of indicators | 13 | ||
| Arrangement of flowmeters | 14 | ||
| Problems | 14 | ||
| Inaccuracy | 14 | ||
| Back pressure | 14 | ||
| Improper alignment | 14 | ||
| Improper sequence | 14 | ||
| Static electricity | 14 | ||
| Hidden floats | 14 | ||
| Erratic movement of the float | 15 | ||
| Suggested readings | 15 | ||
| Benefits | 16 | ||
| Degradation of inhaled anesthetic agents | 16 | ||
| Thermal injuries and CO production | 16 | ||
| New absorbents | 16 | ||
| Suggested readings | 16 | ||
| 9 Carbon dioxide retention and capnography | 17 | ||
| CO2 retention | 17 | ||
| Capnography | 17 | ||
| Terminology | 17 | ||
| Sidestream versus mainstream sampling | 17 | ||
| CO2 measurement methods | 18 | ||
| Capnograms | 18 | ||
| Suggested readings | 19 | ||
| 10 Tracheal tubes | 20 | ||
| Supraglottic airways | 22 | ||
| Facemasks | 23 | ||
| Pharyngeal airways | 23 | ||
| Suggested readings | 24 | ||
| Esophageal intubation | 25 | ||
| Bronchial intubation | 25 | ||
| Tracheal or bronchial rupture | 25 | ||
| Complications that occur with the tracheal tube in place | 25 | ||
| Excessive leak or resistance | 25 | ||
| Obstruction | 25 | ||
| Migration | 25 | ||
| Mucosal ulceration or necrosis | 25 | ||
| Ignition | 25 | ||
| Dehydration/hypothermia | 25 | ||
| Nasal alar necrosis | 25 | ||
| Sinusitis | 25 | ||
| III Monitoring | 31 | ||
| 14 Pulse oximetry | 31 | ||
| Technology | 31 | ||
| Accuracy | 31 | ||
| Response time | 31 | ||
| Low-amplitude states | 31 | ||
| Dyshemoglobins | 32 | ||
| Dyes and pigments | 32 | ||
| Ambient light | 32 | ||
| Skin pigment | 32 | ||
| Electrocautery | 32 | ||
| Motion artifact | 32 | ||
| Fingernail polish | 32 | ||
| Other useful data | 32 | ||
| Complications of pulse oximetry | 32 | ||
| Suggested readings | 32 | ||
| 15 The pulmonary artery catheter | 33 | ||
| Indications for the use of pulmonary artery catheter | 33 | ||
| Insertion and complications of pulmonary artery catheter | 33 | ||
| Data and interpretation | 33 | ||
| The cardiac output | 33 | ||
| The pulmonary artery occlusion pressure | 34 | ||
| The mixed venous oxygen saturation | 34 | ||
| Right ventricular function | 34 | ||
| The pulmonary artery catheter controversy | 34 | ||
| Suggested readings | 34 | ||
| 16 The arterial waveform | 35 | ||
| Equipment and cannulation | 35 | ||
| Waveform interpretation | 35 | ||
| Dynamic indexes of fluid responsiveness | 35 | ||
| Cardiac output derived from the arterial pressure waveform | 36 | ||
| Suggested readings | 36 | ||
| 17 Intermittent noninvasive blood pressure monitoring | 37 | ||
| Methods of obtaining blood pressure | 37 | ||
| Palpation | 37 | ||
| Auscultation | 37 | ||
| Doppler | 37 | ||
| Finger plethysmography | 37 | ||
| Tonometry | 37 | ||
| Oscillometry | 37 | ||
| Equipment for oscillometric blood pressure monitoring | 37 | ||
| Oscillometry operation and function | 37 | ||
| Factors affecting the accuracy of oscillometric blood pressure monitoring | 38 | ||
| Relationship between the size of the cuff and the size of the arm | 38 | ||
| Site of monitoring | 38 | ||
| Arm positioning | 38 | ||
| Arrhythmias | 38 | ||
| Potential adverse events during oscillometric blood pressure monitoring | 38 | ||
| Suggested readings | 38 | ||
| Incidence of intraoperative awareness | 39 | ||
| Risk factors for intraoperative awareness | 39 | ||
| Prevention of awareness | 39 | ||
| Brain-function monitoring | 39 | ||
| Summary | 40 | ||
| Suggested readings | 40 | ||
| 19 Monitoring integrity of the neuromuscular junction | 41 | ||
| Neuromuscular transmissions | 41 | ||
| Clinical indicators of neuromuscular blockade | 41 | ||
| Neuromuscular monitoring | 41 | ||
| Nerve stimulators | 41 | ||
| Sites for monitoring | 41 | ||
| Modes of stimulation | 42 | ||
| Single twitch | 42 | ||
| Train of four | 42 | ||
| Tetanus | 43 | ||
| Posttetanic facilitation | 43 | ||
| Double-burst stimulation | 43 | ||
| Techniques to monitor muscular response | 43 | ||
| Electromyography | 43 | ||
| Mechanomyography | 43 | ||
| Acceleromyography | 43 | ||
| Phonomyography | 43 | ||
| Suggested readings | 43 | ||
| 20 Evoked potential monitoring | 44 | ||
| The evoked potential waveform | 44 | ||
| Brainstem auditory evoked responses | 44 | ||
| Somatosensory evoked potentials | 45 | ||
| Motor evoked potentials | 45 | ||
| Visual evoked potentials | 46 | ||
| Intraoperative changes in evoked potential signals | 46 | ||
| Suggested readings | 46 | ||
| IV Physiology | 47 | ||
| 21 Oxygen transport | 47 | ||
| The oxyhemoglobin dissociation curve | 47 | ||
| Suggested readings | 48 | ||
| CO2 dissociation curve | 49 | ||
| Suggested readings | 49 | ||
| 23 Interpretation of arterial blood gases | 50 | ||
| Acid-base disturbances | 50 | ||
| Ventilation | 50 | ||
| Oxygenation | 50 | ||
| Case examples | 51 | ||
| Acute respiratory acidosis—buffering | 51 | ||
| V Anatomy | 117 | ||
| 51 Anatomy of the larynx | 117 | ||
| Description | 117 | ||
| Laryngeal skeleton | 117 | ||
| Joints, ligaments, and membranes of the larynx | 117 | ||
| Interior of the larynx | 117 | ||
| Innervation | 118 | ||
| Muscles | 118 | ||
| Blood supply | 118 | ||
| Considerations with the infant larynx | 118 | ||
| Suggested readings | 118 | ||
| 52 Coronary circulation and the myocardial conduction system | 119 | ||
| Coronary circulation | 119 | ||
| Myocardial conduction system | 119 | ||
| Suggested readings | 122 | ||
| Standard views | 123 | ||
| Thoracic aorta | 124 | ||
| Suggested readings | 124 | ||
| Clinical perioperative applications | 125 | ||
| Assessment of left ventricular and right ventricular function | 125 | ||
| Detection of myocardial ischemia | 126 | ||
| Preload assessment | 126 | ||
| Cardiac operations | 126 | ||
| Thoracic aortic surgery | 126 | ||
| Atherosclerotic disease of the aorta | 126 | ||
| Transplant surgery | 126 | ||
| Neurosurgery | 126 | ||
| Use in the emergency department and intensive care unit | 127 | ||
| Suggested readings | 127 | ||
| Clinical considerations | 128 | ||
| Suggested readings | 128 | ||
| 56 Anatomy of the posterior fossa | 129 | ||
| Boundaries | 129 | ||
| Structures | 129 | ||
| Veins | 129 | ||
| Arteries | 129 | ||
| Suggested readings | 132 | ||
| 57 Spinal cord anatomy and blood supply | 133 | ||
| Anatomy | 133 | ||
| Ligaments | 133 | ||
| Epidural space | 133 | ||
| Meninges | 133 | ||
| Blood supply | 134 | ||
| Suggested readings | 134 | ||
| 58 Brachial plexus anatomy | 135 | ||
| Simplifying brachial plexus anatomy | 135 | ||
| Non-neural brachial plexus anatomy | 136 | ||
| Suggested readings | 136 | ||
| Reducing the morbidity and mortality rates associated with central venous cannulation | 137 | ||
| Suggested readings | 137 | ||
| VI Pharmacology | 139 | ||
| 60 Molecular and cellular mechanisms of anesthesia | 139 | ||
| Lipid-based hypotheses | 139 | ||
| Protein-based hypotheses | 139 | ||
| Cellular effects | 140 | ||
| Central nervous system effects | 141 | ||
| Suggested readings | 141 | ||
| Cardiac output | 142 | ||
| Ventilation | 142 | ||
| Second-gas effect | 142 | ||
| Suggested readings | 143 | ||
| 62 Minimum alveolar concentration | 144 | ||
| Important concepts related to minimum alveolar concentration | 144 | ||
| Alveolar concentration | 144 | ||
| Steady state | 144 | ||
| Ambient pressure | 144 | ||
| Stimulus | 144 | ||
| Response | 144 | ||
| Determination of minimum alveolar concentration | 144 | ||
| Dose-response relationship | 145 | ||
| Factors affecting minimum alveolar concentration | 145 | ||
| Anesthetic requirement to blunt responses to various stimuli | 145 | ||
| Clinical relevance | 146 | ||
| Suggested readings | 146 | ||
| Left-to-right shunt | 147 | ||
| Mixed shunt (right-to-left and left-to-right) | 147 | ||
| Suggested readings | 147 | ||
| 64 Inhalation anesthetic agents | 148 | ||
| Pharmacokinetics | 148 | ||
| Uptake | 148 | ||
| Excretion | 148 | ||
| Distribution | 148 | ||
| Minimum alveolar concentration | 148 | ||
| Blood-gas partition coefficient | 148 | ||
| Concentration effect and second-gas effect | 149 | ||
| Shunts | 149 | ||
| Alveolar—mixed venous partial pressure difference | 149 | ||
| The effect of co on uptake and emergence | 150 | ||
| Suggested readings | 150 | ||
| Hematologic and immune toxicity | 151 | ||
| Occupational exposure | 151 | ||
| Neurologic toxicity | 151 | ||
| Myocardial effects | 151 | ||
| N2O and closed air spaces | 151 | ||
| Compliant spaces increase volume | 151 | ||
| Noncompliant spaces increase pressure | 151 | ||
| Examples | 151 | ||
| Bowel gas and bowel obstruction | 151 | ||
| Pneumothorax and communicating blebs | 151 | ||
| Venous air emboli | 151 | ||
| Balloon-tipped catheters | 151 | ||
| Tracheal tube cuffs | 152 | ||
| Middle ear | 152 | ||
| Intraocular pressure | 152 | ||
| Dural closure | 152 | ||
| Suggested readings | 152 | ||
| Sensitivity to epinephrine | 153 | ||
| Coronary vasodilation | 154 | ||
| Anesthetic effect on diastolic dysfunction | 154 | ||
| Right ventricular function | 154 | ||
| Suggested readings | 154 | ||
| Nitrous oxide | 155 | ||
| Cerebral metabolic rate and cerebral blood flow | 155 | ||
| Electroencephalogram | 155 | ||
| Evoked potentials | 155 | ||
| Pneumocephalus | 155 | ||
| Isoflurane | 156 | ||
| VII Colloids and blood products | 229 | ||
| 100 Albumin, hetastarch, and pentastarch | 229 | ||
| The colloid controversy | 229 | ||
| Albumin | 229 | ||
| Hetastarch and pentastarch | 229 | ||
| Pharmacokinetics and pharmacodynamics of hetastarch and pentastarch | 229 | ||
| Adverse effects of hetastarch and pentastarch | 230 | ||
| Clinical usefulness of colloids | 230 | ||
| Contraindications to the use of colloid solutions | 230 | ||
| Acknowledgment | 230 | ||
| Suggested readings | 230 | ||
| Screen | 231 | ||
| Crossmatch | 231 | ||
| Incompatibility risk and emergency transfusion | 231 | ||
| Suggested readings | 231 | ||
| 102 Red blood cell and platelet transfusion | 232 | ||
| Red blood cells | 232 | ||
| Collection, storage, and administration | 232 | ||
| Autologous blood transfusion and directed transfusion | 232 | ||
| Synthetic hemoglobins | 232 | ||
| Red blood cell transfusion | 232 | ||
| Indications for transfusion of red blood cells | 232 | ||
| Platelet transfusions | 233 | ||
| Platelet preparation and storage | 233 | ||
| Platelet matching | 233 | ||
| Indications for platelet transfusion | 233 | ||
| Risks of platelet transfusion | 233 | ||
| Platelet alloimmunization and platelet refractoriness | 233 | ||
| Other risks of platelet transfusion | 234 | ||
| Suggested readings | 234 | ||
| Postoperative complications | 235 | ||
| Treatment of coagulopathy | 236 | ||
| Suggested readings | 236 | ||
| Pathophysiology | 237 | ||
| Signs and symptoms | 237 | ||
| Complications | 237 | ||
| Prevention | 238 | ||
| Treatment | 238 | ||
| Suggested readings | 238 | ||
| 105 Nonhemolytic transfusion reactions | 239 | ||
| Febrile reactions | 239 | ||
| Mild allergic reactions | 239 | ||
| Anaphylactic reactions | 239 | ||
| Transfusion-related acute lung injury | 239 | ||
| Immunomodulation | 240 | ||
| Suggested readings | 240 | ||
| VIII Preoperative and postoperative issues | 241 | ||
| 106 Preoperative evaluation of the patient with cardiac disease for noncardiac operations | 241 | ||
| Defining comorbid conditions | 241 | ||
| Assessing surgical risk | 241 | ||
| Evaluating functional status | 242 | ||
| Applying the revised american college of cardiology/american heart association guidelines | 242 | ||
| Perioperative β-adrenergic receptor blockade | 242 | ||
| Patients with prior percutaneous coronary interventions | 243 | ||
| Patients with cardiac-rhythm management devices | 244 | ||
| Suggested readings | 244 | ||
| Cardiovascular outcomes | 245 | ||
| Respiratory outcomes | 245 | ||
| Wound-healing and bone-healing outcomes | 245 | ||
| Surgery represents an excellent opportunity for smoking cessation | 245 | ||
| Helping patients quit smoking | 245 | ||
| Summary | 246 | ||
| Suggested readings | 246 | ||
| Obstructive sleep apnea, obesity, cardiovascular risk, and metabolic syndrome | 248 | ||
| Anesthetic management of patients with obstructive sleep apnea | 248 | ||
| Summary | 251 | ||
| Suggested readings | 251 | ||
| 109 Postoperative nausea and vomiting | 252 | ||
| Physiology | 252 | ||
| Risk factors | 252 | ||
| Treatment | 252 | ||
| Conclusion | 253 | ||
| Suggested readings | 253 | ||
| 110 Anesthesia for drug abusers | 254 | ||
| Suggested readings | 254 | ||
| 111 Acute and chronic alcoholism and anesthesia | 258 | ||
| Metabolism | 258 | ||
| Acute central nervous system effects | 258 | ||
| Chronic alcoholism | 258 | ||
| Anesthetic management of patients with alcohol use disorders | 258 | ||
| Delirium tremens | 259 | ||
| Alcoholic abstinence | 259 | ||
| Disulfiram | 259 | ||
| Acamprosate | 259 | ||
| Naltrexone | 259 | ||
| Suggested readings | 260 | ||
| Risk factors for latex allergy | 261 | ||
| Treatment of latex allergy | 261 | ||
| Prevention of latex allergy | 261 | ||
| Suggested readings | 261 | ||
| 113 The evaluation and management of prolonged emergence from anesthesia | 262 | ||
| Pharmacologic causes of delayed emergence | 262 | ||
| Anesthetic agents | 262 | ||
| Neuromuscular blockade | 263 | ||
| Pharmacokinetic and pharmacodynamic factors | 263 | ||
| Metabolic disturbances of delayed emergence | 263 | ||
| Acid-base disorders | 263 | ||
| Endocrine disorders | 263 | ||
| Electrolyte abnormalities | 263 | ||
| Neurologic causes of delayed emergence | 263 | ||
| Suggested readings | 264 | ||
| Diagnosis | 265 | ||
| Prevention | 265 | ||
| Treatment | 265 | ||
| Outcomes and long-term consequences | 266 | ||
| Suggested readings | 266 | ||
| IX Specialty anesthesia | 267 | ||
| A Regional anesthesia | 267 | ||
| 115 Local anesthetic agents: Mechanism of action | 267 | ||
| Anatomy of A nerve cell | 267 | ||
| Nerve cell membrane and depolarization | 267 | ||
| Structure of local anesthetic agents | 267 | ||
| Action of local anesthetic agents | 267 | ||
| Suggested readings | 267 | ||
| 116 Local anesthetic agents: Pharmacology | 269 | ||
| Physiochemical properties | 269 | ||
| Physiologic disposition | 269 | ||
| Esters | 270 | ||
| Amides | 270 | ||
| Clinical use of local anesthetic agents | 271 | ||
| Esters | 271 | ||
| Benzocaine | 271 | ||
| Procaine | 271 | ||
| Chloroprocaine | 271 | ||
| Tetracaine | 271 | ||
| Amides | 271 | ||
| Prilocaine | 271 | ||
| Lidocaine | 271 | ||
| Mepivacaine | 271 | ||
| Etidocaine | 271 | ||
| Bupivacaine | 271 | ||
| Pure isomeric agents | 271 | ||
| Levobupivacaine | 271 | ||
| Ropivacaine | 271 | ||
| Suggested readings | 271 | ||
| 117 Toxicity of local anesthetic agents | 272 | ||
| Factors influencing blood levels of local anesthetic agents | 272 | ||
| Site of injection | 272 | ||
| Choice of local anesthetic agent | 272 | ||
| Dose of local anesthetic agent | 272 | ||
| Coadministration of vasoconstrictors | 272 | ||
| Metabolism | 272 | ||
| Systemic toxicity | 272 | ||
| Central nervous system toxicity | 272 | ||
| Cardiovascular system toxicity | 273 | ||
| Allergy to local anesthetic agents | 273 | ||
| Neural toxicity | 273 | ||
| Methemoglobinemia | 273 | ||
| Diagnosis, prevention, and treatment of toxic reactions | 273 | ||
| Cauda equina syndrome | 273 | ||
| Transient neurologic symptoms | 273 | ||
| Special populations | 273 | ||
| Liposuction | 273 | ||
| Suggested readings | 273 | ||
| 118 Preservatives in local anesthetic solutions | 274 | ||
| Sulfites | 274 | ||
| Disodium ethylenediaminetetraacetate | 274 | ||
| Parabens | 274 | ||
| Substitution of preservative-containing solutions for preservative-free solutions | 274 | ||
| Suggested readings | 274 | ||
| 119 Cocaine pharmacology | 275 | ||
| Pharmacology | 275 | ||
| Actions | 275 | ||
| Local anesthetic actions | 275 | ||
| Sympathomimetic actions | 275 | ||
| Central nervous system actions | 275 | ||
| Cardiovascular actions | 275 | ||
| Anesthetic uses and considerations | 275 | ||
| Management of toxic side effects | 276 | ||
| Suggested readings | 276 | ||
| Acetaminophen | 277 | ||
| Steroids | 277 | ||
| Regional anesthesia | 277 | ||
| α2-receptor agonists | 277 | ||
| Ketamine | 277 | ||
| Opioids | 277 | ||
| α2δ ligands | 277 | ||
| Suggested readings | 277 | ||
| 121 Needle blocks of the eye | 278 | ||
| Anatomy | 278 | ||
| Terminology | 278 | ||
| Local anesthetic agents | 278 | ||
| Types of eye blocks | 278 | ||
| Intraconal block | 278 | ||
| Extraconal block | 278 | ||
| Sub-tenon block | 278 | ||
| Contraindications | 278 | ||
| Complications | 278 | ||
| Retrobulbar hemorrhage | 278 | ||
| Oculocardiac reflex | 280 | ||
| Diplopia | 280 | ||
| Central retinal artery occlusion | 280 | ||
| Puncture of posterior globe | 280 | ||
| Penetration of the optic nerve | 280 | ||
| Inadvertent brainstem anesthesia | 280 | ||
| Epinephrine toxicity | 281 | ||
| Suggested readings | 281 | ||
| Other factors affecting the level of blockade | 282 | ||
| Spinal anesthetic agents | 282 | ||
| Cardiovascular effects | 282 | ||
| Pulmonary effects | 282 | ||
| Gastrointestinal effects | 282 | ||
| Genitourinary effects | 282 | ||
| Cerebral blood flow | 282 | ||
| Contraindications to spinal anesthesia | 282 | ||
| Suggested readings | 283 | ||
| Selection and dose of local anesthetic agent | 284 | ||
| Complications | 285 | ||
| Suggested readings | 286 | ||
| Advantages | 287 | ||
| Disadvantages | 287 | ||
| Equipment and technique | 287 | ||
| Epidural test doses | 287 | ||
| Complications | 288 | ||
| Suggested readings | 288 | ||
| Low-molecular-weight heparin | 289 | ||
| Oral anticoagulants | 290 | ||
| Antiplatelet medications | 290 | ||
| Conclusion | 290 | ||
| Suggested readings | 291 | ||
| Anatomic technique | 292 | ||
| Position | 292 | ||
| Landmarks | 292 | ||
| Block performance | 292 | ||
| Nerve stimulation technique | 292 | ||
| Ultrasound guidance | 293 | ||
| Choice of local anesthetic agent | 293 | ||
| Complications | 293 | ||
| Suggested readings | 293 | ||
| Technique | 294 | ||
| Side effects and complications | 295 | ||
| Supraclavicular block | 295 | ||
| Technique | 295 | ||
| Side effects and complications | 296 | ||
| Axillary block | 296 | ||
| Technique | 296 | ||
| Side effects and complications | 297 | ||
| Suggested readings | 297 | ||
| 128 Lower extremity block: Psoas compartment block | 298 | ||
| Clinical applications | 298 | ||
| Relevant anatomy | 298 | ||
| Technique | 298 | ||
| Patient position | 298 | ||
| Needle insertion site | 298 | ||
| Needle redirection cues | 299 | ||
| Ultrasound-guided posterior lumbar plexus block | 299 | ||
| Side effects and complications | 299 | ||
| Suggested readings | 299 | ||
| Clinical applications | 301 | ||
| Technique | 301 | ||
| X Pain medicine | 495 | ||
| 210 Preemptive analgesia and postoperative pain: The transition from an acute to a chronic state | 495 | ||
| Persistent pain states | 495 | ||
| Underlying mechanisms | 495 | ||
| Prevention of the facilitated state | 496 | ||
| Role of regional anesthesia | 497 | ||
| Acknowledgment | 497 | ||
| Suggested readings | 497 | ||
| Choice of opioids | 499 | ||
| Initial setup | 499 | ||
| Adverse effects and outcomes | 499 | ||
| Conclusion | 500 | ||
| Suggested readings | 500 | ||
| Suggested readings | 501 | ||
| 213 Complex regional pain syndrome | 502 | ||
| Terminology | 502 | ||
| Etiology | 502 | ||
| Diagnosis | 502 | ||
| Treatment | 502 | ||
| Occupational therapy | 502 | ||
| Psychiatric therapy | 503 | ||
| Pharmacologic therapy | 503 | ||
| Procedural techniques | 503 | ||
| Suggested readings | 503 | ||
| 214 Postoperative headache | 504 | ||
| Postdural puncture headache | 504 | ||
| Prevention | 504 | ||
| Treatment | 504 | ||
| Other postoperative headaches | 504 | ||
| Suggested readings | 505 | ||
| Interventional therapy | 506 | ||
| Neuraxially administered analgesia | 507 | ||
| Nerve blocks and ablative procedures | 507 | ||
| Surgical procedures | 507 | ||
| Other approaches | 507 | ||
| Suggested readings | 508 | ||
| 216 Postherpetic neuralgia | 509 | ||
| Description of the syndrome | 509 | ||
| Pathophysiology | 509 | ||
| Treatment | 509 | ||
| Pharmacotherapy | 509 | ||
| Nerve blocks | 510 | ||
| Surgical procedures | 510 | ||
| Suggested readings | 510 | ||
| Site of injection | 511 | ||
| Technique | 511 | ||
| Medications used | 511 | ||
| Contraindications and adverse effects | 511 | ||
| Conclusion | 511 | ||
| Suggested readings | 511 | ||
| Suggested readings | 513 | ||
| 219 Lumbar sympathetic blockade | 514 | ||
| Relevant anatomy | 514 | ||
| Indications | 514 | ||
| Technique | 514 | ||
| Brown single-needle technique | 514 | ||
| Lateral approach first described by reid | 514 | ||
| Mandl technique | 515 | ||
| Adverse events | 516 | ||
| Suggested readings | 516 | ||
| Expected side effects | 518 | ||
| Adverse effects | 518 | ||
| Suggested readings | 518 | ||
| Outcome studies | 519 | ||
| Complications | 520 | ||
| Future directions | 520 | ||
| Suggested readings | 520 | ||
| XI Critical care medicine | 523 | ||
| 222 Advanced cardiac life support | 521 | ||
| Suggested readings | 523 | ||
| Mode of mechanical ventilation | 524 | ||
| Volume control mechanical ventilation | 524 | ||
| Pressure control mechanical ventilation | 524 | ||
| Intraoperative mechanical ventilation: Which mode should we use? | 525 | ||
| Transpulmonary pressure in volume or pressure control mechanical ventilation | 525 | ||
| Inspiratory time, respiratory rate, and i:e ratio | 525 | ||
| Exhalation | 525 | ||
| Clinical application of intraoperative mechanical ventilation | 526 | ||
| Mechanical ventilation in patients with airway obstruction | 526 | ||
| Mechanical ventilation in patients with decreased respiratory compliance | 527 | ||
| Intraoperative mechanical ventilation and acute lung injury | 527 | ||
| Summary | 528 | ||
| Suggested readings | 528 | ||
| Central nervous system effects | 529 | ||
| Cardiovascular effects | 529 | ||
| Effects on air-containing cavities | 529 | ||
| Effects on blood sugar | 530 | ||
| Anesthetic management in an HBOT chamber | 530 | ||
| Suggested readings | 530 | ||
| 225 Nutrition support in the hospitalized patient | 531 | ||
| Feeding the critically ill: The when and how | 531 | ||
| Nutrition goals | 531 | ||
| Protein | 531 | ||
| Branched-chain amino acids | 531 | ||
| Arginine | 532 | ||
| Glutamine | 532 | ||
| Carbohydrate | 532 | ||
| Lipids | 532 | ||
| Specific critical illness | 532 | ||
| Conclusions | 532 | ||
| Suggested readings | 532 | ||
| 226 Perioperative management of blood glucose | 533 | ||
| Preoperative management of glycemic control | 533 | ||
| Intraoperative management of glycemic control | 534 | ||
| Postoperative management of glycemic control | 534 | ||
| Blood glucose measurement | 534 | ||
| Treatment protocols | 534 | ||
| Summary | 535 | ||
| Suggested readings | 535 | ||
| Treatment | 536 | ||
| Diuresis | 536 | ||
| Recruitment maneuvers | 536 | ||
| Permissive hypercapnia | 537 | ||
| Tracheal gas insufflation | 537 | ||
| Inhaled nitric oxide and prostaglandin E1 | 538 | ||
| Prone positioning | 539 | ||
| High-frequency oscillatory ventilation | 539 | ||
| Extracorporeal membrane oxygenation | 539 | ||
| Other therapeutic interventions | 539 | ||
| Mortality and morbidity | 539 | ||
| Suggested readings | 539 | ||
| Treatment | 541 | ||
| Pharmacologic treatment | 541 | ||
| Anesthetic management of the patient with pulmonary arterial hypertension | 541 | ||
| Preoperative evaluation | 541 | ||
| Intraoperative management | 541 | ||
| Postoperative management | 542 | ||
| Conclusion | 542 | ||
| Suggested readings | 542 | ||
| Anesthetic management | 543 | ||
| Preoperative evaluation | 543 | ||
| Intraoperative monitoring | 543 | ||
| Postoperative management | 543 | ||
| Suggested readings | 543 | ||
| 230 Carbon monoxide poisoning | 544 | ||
| Pathophysiology | 544 | ||
| Signs and symptoms | 544 | ||
| Treatment | 544 | ||
| Carbon monoxide production from CO2 absorbers | 544 | ||
| Suggested readings | 544 | ||
| 231 Acute renal failure | 545 | ||
| Incidence and signs and symptoms | 545 | ||
| Risk factors | 545 | ||
| Laboratory analysis | 545 | ||
| Causes and treatment | 545 | ||
| Prerenal acute renal failure | 545 | ||
| Intrinsic renal failure | 545 | ||
| Postrenal azotemia | 545 | ||
| Management | 545 | ||
| Complications | 546 | ||
| Suggested readings | 546 | ||
| Initial resuscitation | 547 | ||
| Diagnosis | 548 | ||
| Antibiotic therapy and source control | 548 | ||
| Vasopressors and inotropes | 548 | ||
| Corticosteroids | 550 | ||
| Recombinant human activated protein C | 550 | ||
| Supportive therapy | 550 | ||
| Suggested readings | 550 | ||
| 233 Anesthesia for burn-injured patients | 551 | ||
| Acute injury | 551 | ||
| General burn care | 551 | ||
| Excision and grafting | 551 | ||
| Preoperative evaluation of the patient with burns | 551 | ||
| Airway | 551 | ||
| Pulmonary care | 552 | ||
| Circulation | 552 | ||
| Neurologic care | 552 | ||
| Vascular access | 552 | ||
| Nutrition | 552 | ||
| Parenteral infusions | 552 | ||
| Care in the operating room | 552 | ||
| Setup | 552 | ||
| Patient care | 552 | ||
| Postoperative care | 552 | ||
| Care outside of the operating room | 553 | ||
| Electrical injuries | 553 | ||
| Nonthermal skin diseases | 553 | ||
| Conclusion | 553 | ||
| Suggested readings | 553 | ||
| 234 Perioperative corticosteroids | 554 | ||
| The role of corticosteroids in attenuating stress response | 554 | ||
| Treatment of adrenal suppression | 555 | ||
| Treatment of airway edema | 555 | ||
| Timing of administration of the dose of corticosteroids | 555 | ||
| Treatment of postoperative nausea and vomiting | 555 | ||
| The use of corticosteroids for antiinflammatory properties | 555 | ||
| Adverse effects associated with the use of corticosteroids | 556 | ||
| Suggested readings | 557 | ||
| XII Risk management | 559 | ||
| 235 Medical ethics | 559 | ||
| Principles of medical ethics | 559 | ||
| Autonomy | 559 | ||
| Beneficence | 559 | ||
| Nonmaleficence | 559 | ||
| Justice | 559 | ||
| A method of resolving an ethical dilemma | 559 | ||
| Ethical dilemmas encountered in anesthesia practice | 559 | ||
| Suggested readings | 560 | ||
| The informed-consent process | 561 | ||
| Obtaining informed consent when treating the incompetent or minor patient | 561 | ||
| Obtaining informed consent in emergent circumstances | 561 | ||
| Suggested reading | 561 | ||
| 237 Medicolegal principles: Medical negligence | 562 | ||
| Elements of malpractice actions | 562 | ||
| Types of claims against anesthesia personnel | 562 | ||
| Lack of informed consent | 562 | ||
| The process | 562 | ||
| Managing legal risk | 562 | ||
| Acknowledgment | 563 | ||
| Suggested readings | 563 | ||
| Trends in injury | 564 | ||
| Respiratory monitoring | 564 | ||
| Difficult intubation | 564 | ||
| Obstetric anesthesia | 564 | ||
| Lessons learned from the ASA closed claims project | 565 | ||
| Suggested readings | 565 | ||
| Medication errors, assessment, and prevention | 566 | ||
| Programs to improve outcome | 566 | ||
| Disclosure of errors to patients | 566 | ||
| Suggested readings | 566 | ||
| 240 Management of the difficult airway | 567 | ||
| Preoperative evaluation | 567 | ||
| Tongue versus pharyngeal size | 567 | ||
| Atlanto-occipital extension | 567 | ||
| Anterior mandibular space | 567 | ||
| Defining the difficult airway | 567 | ||
| Management of the difficult airway | 567 | ||
| Suggested readings | 568 | ||
| 241 Perioperative pulmonary aspiration | 570 | ||
| Importance of pulmonary aspiration | 570 | ||
| Pulmonary aspiration in children | 570 | ||
| Use of medications and preoperative fasting | 570 | ||
| Occurrence of aspiration in the perioperative period | 570 | ||
| Management of perioperative pulmonary aspiration | 571 | ||
| Conclusion | 571 | ||
| Suggested readings | 571 | ||
| 242 Eye and dental complications | 572 | ||
| Eye injury | 572 | ||
| Corneal injury | 572 | ||
| Postoperative visual loss | 572 | ||
| Reducing the risk of postoperative visual loss | 573 | ||
| Blood pressure management | 573 | ||
| Management of intraoperative fluids | 573 | ||
| Management of anemia | 573 | ||
| Use of vasopressors | 573 | ||
| Patient positioning | 573 | ||
| Recognizing and treating postoperative visual loss | 573 | ||
| Dental injury | 573 | ||
| Etiology | 573 | ||
| Patient factors | 573 | ||
| Anesthetic factors | 573 | ||
| Prevention | 573 | ||
| Treatment and management of dental injury | 574 | ||
| Suggested readings | 574 | ||
| 243 Intraoperative patient positioning | 575 | ||
| Commonly used positions | 575 | ||
| Complications resulting from incorrect positioning | 575 | ||
| Problems related to the trendelenburg position | 576 | ||
| Problems related to the sitting position | 576 | ||
| Problems related to head positioning | 576 | ||
| Correct positioning | 577 | ||
| Upper extremity positioning | 577 | ||
| Lower extremity positioning | 577 | ||
| Suggested readings | 577 | ||
| Timing of symptoms | 578 | ||
| Impact of elbow flexion | 578 | ||
| Anatomy and elbow flexion | 578 | ||
| Forearm supination and ulnar neuropathy | 578 | ||
| Outcomes of ulnar neuropathy | 578 | ||
| Brachial plexopathies | 578 | ||
| Brachial plexus entrapment | 578 | ||
| Prone positioning | 578 | ||
| Anatomy of shoulder abduction | 578 | ||
| Inflammatory plexopathy | 579 | ||
| Lower-extremity neuropathies | 579 | ||
| Impact of hip abduction on the obturator nerve | 579 | ||
| Impact of hip flexion on the lateral femoral cutaneous nerve | 579 | ||
| Practical considerations for perioperative peripheral neuropathies | 580 | ||
| Prevention | 580 | ||
| Follow-up care | 580 | ||
| Unique positioning problems with catastrophic results | 580 | ||
| Spinal cord ischemia | 580 | ||
| Thoracic outlet obstruction | 580 | ||
| Steep trendelenburg position | 580 | ||
| Postoperative visual loss | 580 | ||
| Suggested readings | 581 | ||
| Clinical presentation | 582 | ||
| Mechanism | 582 | ||
| Treatment of malignant hyperthermia crisis | 582 | ||
| Anesthesia for patients with malignant hyperthermia susceptibility | 582 | ||
| Evaluation of the patient with malignant hyperthermia susceptibility | 583 | ||
| Source for further assistance | 583 | ||
| Suggested readings | 583 | ||
| 246 Anaphylactic and anaphylactoid reactions | 584 | ||
| Pathophysiology | 584 | ||
| Clinical presentation | 584 | ||
| Diagnosis | 584 | ||
| Substances commonly implicated in anaphylactic and anaphylactoid reactions | 585 | ||
| Neuromuscular blocking agents | 585 | ||
| Latex | 585 | ||
| Antibiotics | 585 | ||
| Other substances | 585 | ||
| Treatment | 585 | ||
| Suggested readings | 585 | ||
| XIII Practice management | 587 | ||
| 247 Licensure, credentialing, and privileging | 587 | ||
| How health care organizations credential and privilege providers | 587 | ||
| License renewal, reappointment, and continuation of clinical privileges | 588 | ||
| Delegated credentialing | 588 | ||
| Suggested readings | 588 | ||
| 248 Board certification and maintenance of certification | 589 | ||
| Primary certification | 589 | ||
| Continuum of education in anesthesiology | 589 | ||
| Subspecialty certification | 590 | ||
| Maintenance of certification | 590 | ||
| Summary | 590 | ||
| Suggested readings | 590 | ||
| 249 Principles of medical professional liability insurance | 591 | ||
| Scope of coverage—what is covered? | 591 | ||
| Exclusions—what is not covered? | 591 | ||
| Limits of liability—how much is covered? | 591 | ||
| Occurrence versus claims-made coverage | 591 | ||
| Consent-to-settle clauses | 592 | ||
| Suggested readings | 592 | ||
| 250 Medicolegal principles: The anesthesia record | 592 | ||
| Suggested readings | 593 | ||
| 251 Anesthesia information management systems | 593 | ||
| Architecture and configuration | 593 | ||
| Prevalence and utilization | 593 | ||
| Benefits | 594 | ||
| Summary | 594 | ||
| Suggested readings | 594 | ||
| 252 Medical coding and payment systems | 595 | ||
| Medical diagnosis and procedure codes | 595 | ||
| CPT code development and valuation process | 595 | ||
| Anesthesia coding | 596 | ||
| Payment methodology illustrations—anesthesia | 596 | ||
| Illustration 1 | 596 | ||
| Illustration 2 | 596 | ||
| Payment methodology illustrations—resource-based relative value system | 596 | ||
| Illustration 3 | 597 | ||
| Conclusion | 597 | ||
| Suggested readings | 597 | ||
| Suggested readings | 598 | ||
| 254 Chemical dependency in anesthesia personnel | 599 | ||
| Recognizing impairment in a colleague | 599 | ||
| Intervention | 599 | ||
| Risk of relapse | 600 | ||
| Suggested readings | 600 | ||
| Index | 601 | ||
| A | 601 | ||
| B | 603 | ||
| C | 604 | ||
| D | 606 | ||
| E | 607 | ||
| F | 608 | ||
| G | 609 | ||
| H | 609 | ||
| I | 610 | ||
| J | 611 | ||
| K | 611 | ||
| L | 611 | ||
| M | 612 | ||
| N | 614 | ||
| O | 615 | ||
| P | 616 | ||
| Q | 618 | ||
| R | 618 | ||
| S | 619 | ||
| T | 621 | ||
| U | 622 | ||
| V | 622 | ||
| W | 623 | ||
| X | 623 | ||
| Z | 623 | ||
| Inside back cover | IBC |