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Book Details
Abstract
The undisputed leading text in its market, Basics of Anesthesia, 7th Edition, provides comprehensive coverage of both basic science and clinical topics in anesthesiology. Drs. Manuel C. Pardo, Jr. and Ronald D. Miller, in conjunction with many new contributors, have ensured that all chapters are thoroughly up to date and reflect the latest advances in today’s practice. Unparalleled authorship, concise text, easy-to-read chapters, and a user-friendly format make this text the #1 primer on the scope and practice of anesthesiology.
- Presents the combined expertise of two of the most prolific and renowned anesthesia experts worldwide, along with more than 80 expert contributing authors.
- Uses a concise, at-a-glance format to cover both the basic science and essential clinical aspects of the field, including pathophysiology, pharmacology, regional anesthesia, anesthetic management, and special problems and patient groups.
- Features high-quality images that offer a detailed visual understanding of regional anesthesiology and much more.
- Includes new topics and chapters on Neurotoxicity of Anesthesia, Palliative Care, Sleep Medicine, Perioperative Surgical Home, Trauma, and Natural/Human-Induced Disasters.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | Cover | ||
| IFC | ES1 | ||
| Basics of ANESTHESIA | i | ||
| Basics of ANESTHESIA | iii | ||
| Copyright | iv | ||
| CONTRIBUTORS | v | ||
| FOREWORD | xiii | ||
| PREFACE TO THE SEVENTH EDITION | xv | ||
| CONTENTS | xvii | ||
| Basics of ANESTHESIA | xxi | ||
| I - INTRODUCTION | 1 | ||
| 1 - SCOPE OF ANESTHESIA PRACTICE | 3 | ||
| DEFINITION OF ANESTHESIOLOGY AS A SPECIALTY | 3 | ||
| EVOLUTION OF ANESTHESIA AS A MULTIDISCIPLINARY MEDICAL SPECIALTY | 4 | ||
| Pain Management | 4 | ||
| Critical Care Medicine | 4 | ||
| Pediatric Anesthesia | 4 | ||
| Cardiac Anesthesia | 5 | ||
| Obstetric Anesthesia | 5 | ||
| Other Surgical Areas of Anesthesia | 5 | ||
| PERIOPERATIVE PATIENT CARE | 5 | ||
| Preoperative Evaluation | 5 | ||
| Operating Room Theaters | 5 | ||
| Postanesthesia Care Unit | 6 | ||
| TRAINING AND CERTIFICATION IN ANESTHESIOLOGY | 6 | ||
| Postgraduate (Residency) Training in Anesthesiology | 6 | ||
| American Board of Anesthesiology | 6 | ||
| Credentialing and Privileging | 7 | ||
| OTHER ANESTHETIC PROVIDERS | 7 | ||
| Certified Registered Nurse Anesthetists | 7 | ||
| Anesthesiologist Assistants | 7 | ||
| QUALITY OF CARE AND SAFETY IN ANESTHESIA | 7 | ||
| Continuous Quality Improvement | 7 | ||
| ORGANIZATIONS WITH EMPHASIS ON ANESTHESIA QUALITY AND SAFETY | 8 | ||
| Anesthesia Patient Safety Foundation | 8 | ||
| Anesthesia Quality Institute | 8 | ||
| American Society of Anesthesiologists Closed Claims Project and Its Registries | 8 | ||
| Foundation for Anesthesia Education and Research | 8 | ||
| PROFESSIONAL LIABILITY | 8 | ||
| Adverse Events | 9 | ||
| RISKS OF ANESTHESIA | 9 | ||
| HAZARDS OF WORKING IN THE OPERATING ROOM | 10 | ||
| SUMMARY AND FUTURE OUTLOOK | 10 | ||
| QUESTIONS OF THE DAY | 10 | ||
| REFERENCES | 11 | ||
| 2 - LEARNING ANESTHESIA | 12 | ||
| COMPETENCIES AND MILESTONES | 12 | ||
| STRUCTURED APPROACH TO ANESTHESIA CARE | 13 | ||
| Preoperative Evaluation | 13 | ||
| Creating the Anesthesia Plan | 14 | ||
| Preparing the Operating Room | 14 | ||
| Managing the Intraoperative Anesthetic | 14 | ||
| Patient Follow-up | 15 | ||
| LEARNING STRATEGIES | 15 | ||
| Learning Orientation Versus Performance Orientation | 17 | ||
| TEACHING ANESTHESIA | 17 | ||
| QUESTIONS OF THE DAY | 18 | ||
| REFERENCES | 18 | ||
| 3 - ANESTHESIA AND HEALTH INFORMATION TECHNOLOGY | 19 | ||
| HISTORY OF ANESTHESIA DOCUMENTATION AND AIMS | 20 | ||
| THE DEMAND FOR DATA | 20 | ||
| PROFESSIONAL PERFORMANCE DATA REPORTING WITH HEALTH IT | 21 | ||
| FEATURES OF THE ELECTRONIC HEALTH RECORD IN ANESTHESIA AND PERIOPERATIVE CARE | 22 | ||
| HEALTH CARE INFORMATION PRIVACY AND SECURITY | 22 | ||
| SELECTED KEY TOPICS FOR HEALTH IT | 24 | ||
| Interoperability | 24 | ||
| System Design, User Interface, and Usability | 24 | ||
| Clinical Decision Support | 26 | ||
| Transitioning to Health IT: From Paper Records to an AIMS, and Beyond | 26 | ||
| Legal Issues and Responsibilities of the AIMS User | 28 | ||
| CONCLUSION AND THE FUTURE | 29 | ||
| QUESTIONS OF THE DAY | 29 | ||
| REFERENCES | 29 | ||
| II - PHARMACOLOGY AND PHYSIOLOGY | 31 | ||
| 4 - BASIC PHARMACOLOGIC PRINCIPLES | 33 | ||
| PHARMACOKINETIC PRINCIPLES | 33 | ||
| Fundamental Pharmacokinetic Concepts | 34 | ||
| Volume of Distribution | 34 | ||
| Clearance | 35 | ||
| Front-End Kinetics | 37 | ||
| Compartmental Pharmacokinetic Models | 38 | ||
| Multicompartment Models | 38 | ||
| Back-End Kinetics | 41 | ||
| Biophase | 41 | ||
| PHARMACODYNAMIC PRINCIPLES | 42 | ||
| Potency and Efficacy | 43 | ||
| Anesthetic Drug Interactions | 45 | ||
| SPECIAL POPULATIONS | 47 | ||
| Influence of Obesity on Anesthetic Drugs | 47 | ||
| Propofol | 48 | ||
| Dosing Scalars for Propofol | 48 | ||
| Other Sedatives | 49 | ||
| Opioids | 49 | ||
| Remifentanil | 49 | ||
| Dosing Scalars | 49 | ||
| Fentanyl | 49 | ||
| Other Opioids | 50 | ||
| Inhaled Anesthetics | 50 | ||
| Influence of Increasing Age on Anesthetic Drug Pharmacology | 50 | ||
| SUMMARY | 51 | ||
| QUESTIONS OF THE DAY | 51 | ||
| REFERENCES | 51 | ||
| 5 - CLINICAL CARDIAC AND PULMONARY PHYSIOLOGY | 53 | ||
| HEMODYNAMICS | 53 | ||
| Arterial Blood Pressure | 53 | ||
| Physiologic Approach to Hypotension | 54 | ||
| Systemic Vascular Resistance | 54 | ||
| Cardiac Output | 54 | ||
| Heart Rate | 54 | ||
| Ejection Fraction and Stroke Volume | 54 | ||
| Preload | 54 | ||
| Frank-Starling Mechanism | 55 | ||
| Causes of Low Preload | 55 | ||
| Contractility | 55 | ||
| Afterload | 55 | ||
| CARDIAC REFLEXES | 56 | ||
| Autonomic Nervous System | 56 | ||
| Baroreceptors | 57 | ||
| CORONARY BLOOD FLOW | 57 | ||
| PULMONARY CIRCULATION | 57 | ||
| Pulmonary Artery Pressure | 57 | ||
| Pulmonary Vascular Resistance | 57 | ||
| Hypoxic Pulmonary Vasoconstriction | 58 | ||
| Pulmonary Emboli | 58 | ||
| Arteriolar Thickening | 58 | ||
| Zones of the Lung | 58 | ||
| Pulmonary Edema | 59 | ||
| PULMONARY GAS EXCHANGE | 59 | ||
| Oxygen | 59 | ||
| Measurements of Oxygenation | 59 | ||
| Oxyhemoglobin Dissociation Curve | 59 | ||
| Arterial Oxygen Content | 60 | ||
| Multiwavelength Pulse Oximetry | 60 | ||
| Determinants of Alveolar Oxygen Partial Pressure | 60 | ||
| Venous Admixture | 61 | ||
| Carbon Dioxide | 63 | ||
| Hypercapnia | 63 | ||
| Determinants of Arterial Carbon Dioxide Partial Pressure | 63 | ||
| Differential Diagnosis of Increased Arterial Carbon Dioxide Partial Pressure | 65 | ||
| PULMONARY MECHANICS | 65 | ||
| Static Properties | 65 | ||
| Dynamic Properties and Airway Resistance | 65 | ||
| CONTROL OF BREATHING | 66 | ||
| Central Integration and Rhythm Generation | 66 | ||
| Central Chemoreceptors | 66 | ||
| Peripheral Chemoreceptors | 66 | ||
| Hypercapnic Ventilatory Response | 67 | ||
| Hypoxic Ventilatory Response | 67 | ||
| Effects of Anesthesia | 67 | ||
| Disorders of Ventilatory Control | 68 | ||
| INTEGRATION OF THE HEART AND LUNGS | 68 | ||
| Oxygen Delivery | 68 | ||
| Oxygen Extraction | 68 | ||
| Anemia | 68 | ||
| Metabolic Demand | 68 | ||
| QUESTIONS OF THE DAY | 68 | ||
| REFERENCES | 69 | ||
| 6 - AUTONOMIC NERVOUS SYSTEM | 70 | ||
| ANATOMY OF THE AUTONOMIC NERVOUS SYSTEM | 70 | ||
| The Sympathetic Nervous System | 70 | ||
| The Parasympathetic Nervous System | 72 | ||
| ADRENERGIC PHARMACOLOGY | 73 | ||
| Endogenous Catecholamines | 73 | ||
| Norepinephrine | 73 | ||
| Epinephrine | 73 | ||
| Dopamine | 75 | ||
| Synthetic Catecholamines | 75 | ||
| Isoproterenol | 75 | ||
| Dobutamine | 75 | ||
| Fenoldopam | 77 | ||
| Noncatecholamine Sympathomimetic Amines | 77 | ||
| Ephedrine | 77 | ||
| SELECTIVE Α-ADRENERGIC RECEPTOR AGONISTS | 77 | ||
| α1-Adrenergic Agonists | 77 | ||
| Phenylephrine | 77 | ||
| α2-Adrenergic Agonists | 77 | ||
| Clonidine | 78 | ||
| Dexmedetomidine | 78 | ||
| Β2-ADRENERGIC RECEPTOR AGONISTS | 78 | ||
| Α-ADRENERGIC RECEPTOR ANTAGONISTS | 78 | ||
| Phenoxybenzamine | 78 | ||
| Prazosin | 78 | ||
| Yohimbine | 79 | ||
| Β-ADRENERGIC ANTAGONISTS | 79 | ||
| Adverse Effects of β-Adrenergic Blockade | 79 | ||
| Specific β-Adrenergic Blockers | 80 | ||
| Propranolol | 80 | ||
| Metoprolol | 80 | ||
| Labetalol | 80 | ||
| Esmolol | 80 | ||
| CHOLINERGIC PHARMACOLOGY | 80 | ||
| Muscarinic Antagonists | 80 | ||
| Cholinesterase Inhibitors | 81 | ||
| QUESTIONS OF THE DAY | 81 | ||
| REFERENCES | 81 | ||
| 7 - INHALED ANESTHETICS | 83 | ||
| HISTORY | 83 | ||
| THE FIRST INHALED ANESTHETICS | 83 | ||
| Nitrous Oxide | 83 | ||
| Diethyl Ether | 84 | ||
| Chloroform | 85 | ||
| INHALED ANESTHETICS BETWEEN 1920 AND 1940 | 85 | ||
| FLUORINE CHEMISTRY AND MODERN INHALED ANESTHETICS | 85 | ||
| Halothane | 85 | ||
| Methoxyflurane | 86 | ||
| Enflurane | 86 | ||
| Isoflurane | 86 | ||
| Sevoflurane and Desflurane | 86 | ||
| MECHANISM OF ACTION | 86 | ||
| Measurable Characteristics | 86 | ||
| Immobility | 87 | ||
| Amnestic Effects (Also See Chapter 47) | 87 | ||
| Central Nervous System Depression and Ion Channels | 87 | ||
| PHYSICAL PROPERTIES | 87 | ||
| Molecular Structure | 87 | ||
| Vapor Pressure and Delivery | 87 | ||
| Variable-Bypass Vaporizers (Also See Chapter 15) | 87 | ||
| Heated Vaporizer | 88 | ||
| Economic and Environmental Considerations | 88 | ||
| Stability | 88 | ||
| Metabolism and Degradation | 88 | ||
| Carbon Dioxide Absorbents and Exothermic Reactions | 88 | ||
| RELATIVE POTENCY OF INHALED ANESTHETICS | 89 | ||
| PHARMACOKINETICS OF INHALED ANESTHETICS | 89 | ||
| Factors That Determine the Alveolar Partial Pressure | 90 | ||
| Inspired Anesthetic Partial Pressure | 90 | ||
| Second Gas Effect | 90 | ||
| Alveolar Ventilation | 90 | ||
| Anesthetic Breathing System (Also See Chapter 15) | 91 | ||
| Solubility | 91 | ||
| Blood-Gas Partition Coefficient | 91 | ||
| Tissue-Blood Partition Coefficients | 91 | ||
| Anesthetic Transfer by Intertissue Diffusion | 92 | ||
| Nitrous Oxide and Methionine Synthase Inactivation | 92 | ||
| Nitrous Oxide Transfer to Closed Gas Spaces | 92 | ||
| Cardiac Output | 92 | ||
| Shunt | 92 | ||
| Wasted Ventilation | 93 | ||
| Alveolar-to-Venous Partial Pressure Differences | 93 | ||
| Recovery From Anesthesia | 93 | ||
| How Does Recovery Differ From Induction of Anesthesia? | 94 | ||
| Tissue Concentrations | 94 | ||
| Metabolism | 94 | ||
| Context-Sensitive Half-Time (Also See Chapter 4) | 94 | ||
| Diffusion Hypoxia | 95 | ||
| Feasibility of Inhaled Anesthetic Use for Sedation in ICU | 95 | ||
| EFFECTS ON ORGAN SYSTEMS | 95 | ||
| Circulatory Effects | 95 | ||
| Responses During Maintenance of Anesthesia | 95 | ||
| Mean Arterial Pressure | 95 | ||
| Heart Rate | 95 | ||
| Cardiac Index | 97 | ||
| Circulatory Effects With Rapid Concentration Increase | 97 | ||
| Administration With Nitrous Oxide and Oxygen Versus 100% Oxygen | 98 | ||
| Myocardial Conduction and Dysrhythmogenicity | 98 | ||
| QT Interval | 98 | ||
| Patients With Coronary Artery Disease (Also See Chapter 25) | 98 | ||
| Anesthetic Preconditioning | 98 | ||
| Mechanisms of Ischemic Preconditioning | 99 | ||
| Ventilation Effects | 99 | ||
| Chest Wall Changes | 99 | ||
| Hypoxic Pulmonary Vasoconstriction | 100 | ||
| Airway Resistance | 100 | ||
| Airway Irritant Effects | 100 | ||
| Central Nervous System Effects | 100 | ||
| Cerebral Blood Flow (Also See Chapter 30) | 100 | ||
| Intracranial Pressure (Also See Chapter 30) | 100 | ||
| Evoked Potentials | 101 | ||
| Electroencephalographic Effects | 101 | ||
| Neuromuscular Effects | 101 | ||
| Malignant Hyperthermia | 101 | ||
| Hepatic Effects | 101 | ||
| Immune-Mediated Liver Injury | 101 | ||
| Mild Liver Injury | 101 | ||
| History of Prior Anesthesia-Related Hepatic Dysfunction | 102 | ||
| Renal Effects | 102 | ||
| QUESTIONS OF THE DAY | 102 | ||
| REFERENCES | 102 | ||
| 8 - INTRAVENOUS ANESTHETICS | 104 | ||
| PROPOFOL | 105 | ||
| Physicochemical Characteristics | 105 | ||
| Pharmacokinetics | 105 | ||
| Continuous Intravenous Infusion | 106 | ||
| Compartmental Model | 106 | ||
| Pharmacodynamics | 106 | ||
| Central Nervous System | 106 | ||
| Cardiovascular System | 107 | ||
| Respiratory System | 107 | ||
| Other Effects | 107 | ||
| Clinical Uses | 107 | ||
| Induction and Maintenance of General Anesthesia | 107 | ||
| Sedation | 107 | ||
| Antiemetic | 108 | ||
| FOSPROPOFOL | 108 | ||
| III - PREOPERATIVE PREPARATION AND INTRAOPERATIVE MANAGEMENT | 187 | ||
| 13 - PREOPERATIVE EVALUATION AND MEDICATION | 189 | ||
| PREOPERATIVE ASSESSMENT: OVERVIEW | 189 | ||
| History and Physical Examination | 189 | ||
| Investigations and Testing | 191 | ||
| Consultations | 192 | ||
| ANESTHETIC IMPLICATIONS OF COMMON COMORBID CONDITIONS | 193 | ||
| Hypertension | 193 | ||
| Coronary Artery Disease | 194 | ||
| Heart Failure | 196 | ||
| Valvular Disease | 196 | ||
| Cardiac Implantable Electronic Devices | 198 | ||
| Pulmonary Disease | 199 | ||
| Obstructive Sleep Apnea | 200 | ||
| Obesity | 201 | ||
| Diabetes Mellitus | 201 | ||
| Renal Disease | 201 | ||
| Anemia | 202 | ||
| Elderly Patients | 202 | ||
| FORMULATION OF AN ANESTHETIC PLAN | 202 | ||
| Risk Assessment and Informed Consent | 202 | ||
| Medications | 202 | ||
| Fasting Guidelines | 209 | ||
| CONCLUSION | 210 | ||
| QUESTIONS OF THE DAY | 210 | ||
| REFERENCES | 210 | ||
| 14 - CHOICE OF ANESTHETIC TECHNIQUE | 213 | ||
| TYPES OF ANESTHESIA | 213 | ||
| CHOOSING AN APPROPRIATE ANESTHETIC TECHNIQUE | 214 | ||
| PRACTICAL ASPECTS OF ANESTHESIA CHOICE | 216 | ||
| General Anesthesia | 216 | ||
| Regional Anesthesia | 218 | ||
| Monitored Anesthesia Care | 218 | ||
| ENVIRONMENTAL IMPACT | 219 | ||
| QUESTIONS OF THE DAY | 219 | ||
| REFERENCES | 219 | ||
| 15 - ANESTHESIA DELIVERY SYSTEMS | 220 | ||
| ANESTHESIA WORKSTATION | 220 | ||
| Fail-Safe Valve | 221 | ||
| Compressed Gases | 221 | ||
| Calculation of Cylinder Contents | 223 | ||
| Flowmeters | 223 | ||
| VAPORIZERS | 224 | ||
| Physics of Vaporization | 224 | ||
| Vaporizer Classification and Design | 224 | ||
| ANESTHETIC BREATHING SYSTEMS | 225 | ||
| Mapleson Breathing Systems | 226 | ||
| IV - SPECIAL ANESTHETIC CONSIDERATIONS | 413 | ||
| 25 - CARDIOVASCULAR DISEASE | 415 | ||
| CORONARY ARTERY DISEASE | 415 | ||
| Patient History | 416 | ||
| Cardiac Reserve | 416 | ||
| Angina Pectoris | 416 | ||
| Prior Myocardial Infarction | 417 | ||
| Current Medications | 417 | ||
| Electrocardiogram | 418 | ||
| Risk Stratification Versus Risk Reduction | 418 | ||
| Perioperative Cardiac Risk Reduction Therapy | 420 | ||
| Management of Anesthesia | 421 | ||
| Monitoring (Also See Chapter 20) | 422 | ||
| Induction of Anesthesia | 422 | ||
| Maintenance of Anesthesia | 423 | ||
| Neuromuscular Blocking Drugs (Also See Chapter 11) | 424 | ||
| Treatment of Myocardial Ischemia | 424 | ||
| Postoperative Care | 425 | ||
| VALVULAR HEART DISEASE | 425 | ||
| Mitral Stenosis | 425 | ||
| Management of Anesthesia | 426 | ||
| Mitral Regurgitation | 427 | ||
| Management of Anesthesia | 427 | ||
| Aortic Stenosis | 427 | ||
| Management of Anesthesia | 428 | ||
| Aortic Regurgitation | 428 | ||
| V - THE RECOVERY PERIOD | 673 | ||
| 39 - POSTANESTHESIA RECOVERY | 675 | ||
| ADMISSION TO THE POSTANESTHESIA CARE UNIT | 676 | ||
| EARLY POSTOPERATIVE PHYSIOLOGIC DISORDERS | 676 | ||
| UPPER AIRWAY OBSTRUCTION | 676 | ||
| Loss of Pharyngeal Muscle Tone | 676 | ||
| Residual Neuromuscular Blockade | 676 | ||
| Laryngospasm | 677 | ||
| Airway Edema | 678 | ||
| Obstructive Sleep Apnea | 678 | ||
| Management of Airway Obstruction | 678 | ||
| Monitoring Airway Patency During Transport | 679 | ||
| HYPOXEMIA IN THE POSTANESTHESIA CARE UNIT | 679 | ||
| Alveolar Hypoventilation | 679 | ||
| Decreased Alveolar Partial Pressure of Oxygen | 680 | ||
| Ventilation-to-Perfusion Mismatch and Shunt | 680 | ||
| Increased Venous Admixture | 680 | ||
| Decreased Diffusion Capacity | 680 | ||
| PULMONARY EDEMA IN THE POSTANESTHESIA CARE UNIT | 680 | ||
| Postobstructive Pulmonary Edema | 681 | ||
| Transfusion-Related Acute Lung Injury | 681 | ||
| OXYGEN SUPPLEMENTATION | 681 | ||
| Oxygen Delivery | 681 | ||
| Continuous Positive Airway Pressure and Noninvasive Positive-Pressure Ventilation | 681 | ||
| HEMODYNAMIC INSTABILITY | 682 | ||
| Systemic Hypertension | 682 | ||
| Systemic Hypotension | 682 | ||
| Hypovolemia (Decreased Preload) | 682 | ||
| Cardiogenic Hypotension (Intrinsic Pump Failure) | 683 | ||
| Distributive Hypotension (Decreased Afterload) | 683 | ||
| Iatrogenic Sympathectomy | 683 | ||
| Critically Ill Patients | 683 | ||
| Allergic Reactions | 683 | ||
| Sepsis | 683 | ||
| Myocardial Ischemia | 683 | ||
| Low-Risk Patients | 683 | ||
| High-Risk Patients | 683 | ||
| Routine Postoperative 12-Lead Electrocardiogram and Troponin Measurement | 684 | ||
| Cardiac Dysrhythmias | 684 | ||
| Tachydysrhythmias | 684 | ||
| Atrial Dysrhythmias | 684 | ||
| Atrial Fibrillation | 684 | ||
| Ventricular Dysrhythmias | 684 | ||
| Bradydysrhythmias | 684 | ||
| Treatment | 684 | ||
| DELIRIUM | 685 | ||
| Risk Factors | 685 | ||
| Management | 685 | ||
| Emergence Agitation | 686 | ||
| RENAL DYSFUNCTION | 686 | ||
| Oliguria | 686 | ||
| Postoperative Urinary Retention | 686 | ||
| Decreased Intravascular Volume | 686 | ||
| Intra-Abdominal Hypertension | 687 | ||
| Rhabdomyolysis | 687 | ||
| Contrast Nephropathy | 687 | ||
| BODY TEMPERATURE AND SHIVERING | 687 | ||
| Mechanism | 687 | ||
| Treatment | 687 | ||
| POSTOPERATIVE NAUSEA AND VOMITING | 687 | ||
| High-Risk Patients | 688 | ||
| Prevention and Treatment | 688 | ||
| DELAYED AWAKENING | 689 | ||
| Treatment | 689 | ||
| DISCHARGE CRITERIA | 689 | ||
| QUESTIONS OF THE DAY | 690 | ||
| REFERENCES | 690 | ||
| 40 - PERIOPERATIVE PAIN MANAGEMENT | 692 | ||
| COMMON TERMINOLOGY | 693 | ||
| Pain Services | 694 | ||
| NEUROBIOLOGY OF PAIN | 694 | ||
| Nociception | 694 | ||
| Modulation of Nociception | 694 | ||
| Preemptive and Preventive Analgesia | 695 | ||
| Opioid-Induced Hyperalgesia | 695 | ||
| Multimodal Approach to Perioperative Recovery | 696 | ||
| ANALGESIC DELIVERY SYSTEMS | 696 | ||
| Patient-Controlled Analgesia | 696 | ||
| SYSTEMIC THERAPY | 697 | ||
| Oral Administration | 697 | ||
| Intravenous Administration | 699 | ||
| Subcutaneous Administration | 699 | ||
| Transdermal/Iontophoretic Administration | 699 | ||
| Transmucosal Administration | 699 | ||
| NEURAXIAL ANALGESIA | 699 | ||
| Intrathecal Administration | 700 | ||
| Epidural Administration | 700 | ||
| Side Effects of Neuraxial Analgesic Drugs | 700 | ||
| Most Common Side Effects | 701 | ||
| Anticoagulation | 701 | ||
| Infection | 701 | ||
| SURGICAL SITE (INCISION) INFILTRATION | 701 | ||
| INTRA-ARTICULAR ADMINISTRATION | 702 | ||
| INTRAPLEURAL ANALGESIA | 702 | ||
| PERIPHERAL NERVE BLOCK | 702 | ||
| Techniques | 702 | ||
| Adjuvant Drugs | 702 | ||
| REGIONAL ANALGESIA | 702 | ||
| Catheter Versus Single-Shot Techniques | 702 | ||
| Upper Extremity | 702 | ||
| Lower Extremity | 703 | ||
| PARAVERTEBRAL BLOCKS | 703 | ||
| TRANSVERSUS ABDOMINIS PLANE BLOCK | 703 | ||
| QUESTIONS OF THE DAY | 703 | ||
| REFERENCES | 703 | ||
| VI - CONSULTANT ANESTHETIC PRACTICE | 705 | ||
| 41 - CRITICAL CARE MEDICINE | 707 | ||
| RESPIRATORY FAILURE | 707 | ||
| Mechanical Ventilation | 708 | ||
| Modes | 708 | ||
| Assist Control | 708 | ||
| Synchronized Intermittent Mandatory Ventilation | 708 | ||
| Pressure Support | 708 | ||
| Other Modes | 708 | ||
| Limits | 708 | ||
| Volume Control | 708 | ||
| Pressure Control | 708 | ||
| Dual Control | 708 | ||
| Cycle | 709 | ||
| Other Settings | 709 | ||
| Positive End-Expiratory Pressure | 709 | ||
| Trigger | 709 | ||
| Noninvasive Positive-Pressure Ventilation | 710 | ||
| High-Flow Nasal Cannula | 710 | ||
| Weaning From Mechanical Ventilation and Tracheal Extubation | 710 | ||
| Criteria for Weaning Trial | 710 | ||
| A-a Gradient | 710 | ||
| Maximum Inspiratory Force | 710 | ||
| Other Criteria | 711 | ||
| Weaning Strategies | 711 | ||
| Acute Respiratory Distress Syndrome | 711 | ||
| Management | 712 | ||
| Tracheostomies | 712 | ||
| SHOCK | 713 | ||
| Hypovolemic Shock | 713 | ||
| Clinical Manifestations | 713 | ||
| Treatment | 713 | ||
| Cardiogenic Shock | 714 | ||
| Clinical Manifestations | 714 | ||
| Treatment | 714 | ||
| Vasodilatory Shock | 714 | ||
| Clinical Manifestations | 715 | ||
| Treatment | 715 | ||
| Hemodynamic Monitoring | 715 | ||
| Arterial Pressure | 715 | ||
| Central Venous Pressure | 715 | ||
| Pulmonary Artery Catheter | 715 | ||
| Bedside Ultrasonography | 715 | ||
| Sepsis | 716 | ||
| ACUTE RENAL FAILURE | 716 | ||
| Epidemiology | 716 | ||
| Diagnosis | 717 | ||
| Treatment | 717 | ||
| Dialysis | 717 | ||
| PAIN AND SEDATION | 717 | ||
| Analgesia | 718 | ||
| Sedation | 718 | ||
| Benzodiazepines | 718 | ||
| Propofol | 718 | ||
| α2-Receptor Agonists | 719 | ||
| N-Methyl-d-Aspartate Receptor Antagonist | 719 | ||
| Sedation Interruption | 719 | ||
| OTHER TOPICS IN CRITICAL CARE | 719 | ||
| Delirium | 719 | ||
| Nutrition | 720 | ||
| Glucose Control | 720 | ||
| Prophylaxis | 720 | ||
| Venous Thromboembolism | 720 | ||
| Gastrointestinal Prophylaxis | 721 | ||
| Hospital-Acquired Infections | 721 | ||
| Catheter-Associated Urinary Tract Infections | 721 | ||
| Ventilator-Associated Pneumonia | 721 | ||
| Catheter-Related Bloodstream Infections | 721 | ||
| ICU Staffing and Organization | 721 | ||
| QUESTIONS OF THE DAY | 722 | ||
| REFERENCES | 722 | ||
| 42 - ANESTHESIA FOR TRAUMA | 724 | ||
| INTRODUCTION | 724 | ||
| Background | 724 | ||
| Physiology in Trauma | 725 | ||
| INITIAL MANAGEMENT | 726 | ||
| Prearrival Preparation | 726 | ||
| Universal/Organization Preparation | 726 | ||
| Patient-Specific Preparation | 726 | ||
| Prearrival Briefing | 726 | ||
| Trauma Bay | 726 | ||
| Primary Survey | 726 | ||
| Airway and Oxygenation (Also See Chapter 16) | 727 | ||
| Management of the Airway and Trauma | 727 | ||
| Preoxygenation (Administration of Oxygen Before Induction of Anesthesia) | 727 | ||
| Fasting | 727 | ||
| Altered Physiology | 727 | ||
| Hemodynamic Status | 727 | ||
| Anesthetic Drug Choices | 728 | ||
| Manual In-Line Stabilization | 728 | ||
| Choice of Laryngoscope | 728 | ||
| Failed Endotracheal Intubation Drills | 728 | ||
| Posttracheal Intubation Care | 728 | ||
| Disability | 729 | ||
| Exposure | 729 | ||
| Adjuncts and Investigations | 729 | ||
| Definitive Care and Transport | 729 | ||
| Setting Priorities: What Is Next? | 730 | ||
| Local Care Versus Transfer | 730 | ||
| Decision Making in Trauma | 730 | ||
| Leadership and Followership | 730 | ||
| Graded Assertiveness | 730 | ||
| INTRAOPERATIVE MANAGEMENT | 731 | ||
| Phase 1: Uncontrolled Hemorrhage | 731 | ||
| Damage Control Resuscitation (Also See Chapter 24) | 733 | ||
| Access for Intravascular Resuscitation | 733 | ||
| Phase 2: Controlled Hemorrhage | 734 | ||
| Viscoelastic Testing | 735 | ||
| Phase 3: Restoration of Physiology | 736 | ||
| Anesthetics | 736 | ||
| SPECIAL GROUPS | 737 | ||
| Traumatic Brain Injury | 737 | ||
| Spinal Cord Injury | 739 | ||
| Burns | 740 | ||
| Burn Severity | 740 | ||
| Types of Burns: Chemical, Electrical, and Thermal | 740 | ||
| Chemical Burns: Special Considerations | 740 | ||
| Airway (Also See Chapter 16) | 741 | ||
| Pain (Also See Chapter 40) | 742 | ||
| Inhalation | 742 | ||
| Infection | 742 | ||
| Eshcarotomies | 742 | ||
| Transfer of Burn Patients | 742 | ||
| Extremes of Age | 742 | ||
| Pediatric Trauma (Also See Chapter 34) | 742 | ||
| INDEX | 869 | ||
| A | 869 | ||
| B | 874 | ||
| C | 876 | ||
| D | 882 | ||
| E | 883 | ||
| F | 886 | ||
| G | 887 | ||
| H | 887 | ||
| I | 890 | ||
| J | 892 | ||
| K | 892 | ||
| L | 892 | ||
| M | 894 | ||
| N | 897 | ||
| O | 899 | ||
| P | 901 | ||
| Q | 906 | ||
| R | 906 | ||
| S | 908 | ||
| T | 911 | ||
| U | 912 | ||
| V | 913 | ||
| W | 914 | ||
| X | 914 | ||
| Y | 914 |