Faust's Anesthesiology Review

6th Edition - September 6, 2023
Imprint: Elsevier
Editors: Terence L. Trentman, Brantley D. Gaitan, Bhargavi Gali, Rebecca L. Johnson, Jeffrey T. Mueller, J. Ross Renew, Toby N. Weingarten
Language: English
Paperback ISBN:
9 7 8 - 0 - 3 2 3 - 8 7 9 1 6 - 3
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 8 7 9 1 7 - 0

Authored by current and former physicians at the Mayo Clinic, Faust's Anesthesiology Review, 6th Edition, is an invaluable review source for success on exams and in practice. It… Read more

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Authored by current and former physicians at the Mayo Clinic, Faust's Anesthesiology Review, 6th Edition, is an invaluable review source for success on exams and in practice. It covers a broad range of important and timely topics in a succinct, easy-to-read format, providing the essential information you need to master the latest advances, procedures, guidelines, and protocols in anesthesiology.

Cover image
Title page
Table of Contents
Copyright
Dedication
Contributors
Preface
Video contents
List of Illustrations
List of Tables
SECTION I. Operating Room, Equipment, and Monitoring
1. Medical gas supply
Suggested readings
2. Electricity in the operating room
Electrical supply
Electrical injuries
Suggested readings
3. Operating room fires
Fire triangle
Prevention
Preparation
Management of an operating room fire
Suggested readings
4. Vaporizers
Concentrated-calibrated variable bypass vaporizers
Desflurane vaporizer and electronic temperature-regulated, pressure-controlled vaporizer
Problems with vaporizers
Miscellany
Suggested readings
5. Carbon dioxide absorption
Carbon dioxide absorbers
Absorbent chemistry
Interactions with inhaled anesthetic agents and formation of degradation products
Thermal injury
Carbon dioxide removal capacity
Indication of absorbent exhaustion
Suggested readings
6. Carbon dioxide retention and capnography
Terminology
Retention of carbon dioxide
Capnography
Capnograms
Suggested readings
7. Tracheal tubes
Tracheal tubes
Supraglottic airways
Facemasks
Pharyngeal airways
Suggested readings
8. Complications of tracheal intubation
Complications that occur during intubation
Complications that occur with the tracheal tube in place
Complications that occur immediately after extubation
Delayed complications
Suggested readings
9. Disconnect monitors
Airway pressure monitors
End-tidal carbon dioxide monitoring
Flow monitoring
Empty bellows alarms
Disconnect alarm management
Suggested readings
10. Pulse oximetry
Technology
Accuracy
Other useful data
Complications of pulse oximetry
The future of pulse oximetry
Suggested readings
11. Hemodynamic monitoring
Indications for a pulmonary artery catheter
Insertion and complications of pulmonary artery catheters
Data and interpretation
The pulmonary artery catheter controversy
Arterial catheters
Equipment and cannulation
Waveform interpretation
Dynamic indexes of fluid responsiveness
Cardiac output derived from the arterial pressure waveform
Suggested readings
12. Monitoring integrity of the neuromuscular junction
Neuromuscular physiology
Importance of monitoring neuromuscular blockade
Clinical indicators of neuromuscular blockade
Qualitative monitoring of the neuromuscular junction
Quantitative monitoring of the neuromuscular junction
Suggested readings
13. Evoked potential monitoring and electromyography
Evoked potential monitoring
The evoked potential waveform
Brainstem auditory evoked responses
Somatosensory evoked potentials
Motor evoked potentials
Visual evoked potentials
Intraoperative changes in evoked potential signals
Electromyography
Suggested reading
SECTION II. Physiology
14. Oxygen transport
The oxyhemoglobin dissociation curve
Suggested readings
15. Blood gas temperature correction
α-Stat method
pH-Stat method
pH-Stat versus α-Stat
Suggested readings
16. Central regulation of ventilation
Neural control: Respiratory center
Chemical control
Suggested readings
17. Physiologic effects of hypercarbia
Carbon dioxide transport
Central nervous system
Respiratory system
Cardiovascular system
Gastrointestinal system
Renal system
Metabolic system
Pharmacologic effects of changes in carbon dioxide
Effects of changes in carbon dioxide on minimum alveolar concentration
Signs and symptoms
Suggested readings
18. Factors that affect pulmonary compliance and airway resistance
Compliance of the lung and chest wall
Surface tension at the alveolar gas/liquid interface
Factors that affect respiratory compliance
Effects of decreased compliance
Nonelastic resistance
Principles of gas flow and resistance
Airway resistance
Factors that affect airway resistance
Major effects of increased airway resistance
Suggested readings
19. Pulmonary ventilation and perfusion
Ventilation
Pulmonary blood flow
Ventilation/perfusion ratio
Dead space
Factors that affect dead space and dead space/tidal volume
Shunt
Suggested readings
20. Pulmonary function test interpretation
Tests to measure lung volume
Tests of gas flow
Tests of efficiency of gas exchange
Choosing pulmonary function tests
Suggested readings
21. Chronic obstructive pulmonary disease and restrictive lung disease
Chronic obstructive pulmonary disease
Restrictive lung disease
Suggested readings
22. Measurement and implications of the Q ˙ s/ Q ˙ t
Ventilation/perfusion mismatch
Other causes of shunting
Calculation of shunt fraction
Suggested readings
23. Cardiac cycle: Control and synchronicity
Control
Physiologic effects on cardiac cycle control
Synchronicity
Suggested readings
24. Physiologic determinants of cardiac output
Stroke volume
Heart rate
Suggested readings
25. Myocardial oxygen supply and demand
Coronary perfusion pressure
Vascular resistance
Arterial blood oxygen content
Other factors
Oxygen demand
Summary
Suggested readings
26. Tachyarrhythmias
Narrow complex tachycardia
Treatment
Wide complex tachycardia
Suggested readings
27. Bradyarrhythmias
Heart block or atrioventricular dysfunction
Intraoperative bradycardia
Suggested readings
28. The autonomic nervous system
Anatomy
Functional effects
Suggested readings
29. The sympathetic nervous system: Anatomy and receptor pharmacology
Anatomy
Receptor pharmacology
Agonists
Suggested readings
30. Factors affecting cerebral blood flow
Cerebral metabolic rate
Autoregulation
Carbon dioxide responsiveness
Oxygen responsiveness
Hypothermia
Effects of anesthetic drugs
Intravenously administered anesthetic agents
Inhaled anesthetic agents
Age
Suggested readings
31. Physiology of neuromuscular transmission
Neuromuscular junction
Function of the neuromuscular junction
Upregulation and downregulation
Suggested readings
32. Renal physiology
Renal blood flow
Glomerular filtration rate
Tubular reabsorption
Tubular secretion
Suggested readings
33. Renal function tests
Glomerular filtration rate
Tubular function tests
Other clinical and laboratory assays
Suggested readings
34. Acid-base status
Terminology
Types of acid-base disorders
Compensatory responses
Assessment of acid-base disorders secondary to metabolic disorders
Assessment of acid-base disorders secondary to respiratory mechanics
Suggested readings
35. Electrolyte abnormalities: Potassium, sodium, calcium, and magnesium
Potassium
Sodium
Calcium
Magnesium
Suggested readings
36. Hepatic physiology, preoperative evaluation, and planning
Hepatic physiology
Hepatic blood flow
Preoperative hepatic assessment
Regional anesthesia and multimodal pain management
Suggested readings
37. Mechanisms of hepatic drug metabolism and excretion
Hepatic clearance
Hepatic metabolic reactions
Extrahepatic metabolic reactions
Suggested readings
SECTION III. Pharmacology
38. Molecular, cellular, and neural mechanisms of general anesthesia
Lipid-based hypotheses
Molecular sites of anesthetic action
Cellular effects
Central nervous system effects
Suggested readings
39. Factors that affect anesthetic gas uptake
Solubility
Cardiac output
Ventilation
Concentration effect
Second gas effect
V˙/Q˙ mismatch
Suggested readings
40. Minimum alveolar concentration
Important concepts related to minimum alveolar concentration
Determination of minimum alveolar concentration
Dose-response relationship
Factors that affect minimum alveolar concentration
Derivatives of minimum alveolar concentration
Clinical relevance
Suggested readings
41. The effect of intracardiac shunts on inhalation induction
Right-to-left shunt
Left-to-right shunt
Mixed shunt (right-to-left and left-to-right)
Clinical practice
Suggested readings
42. Inhalation anesthetic agents
Pharmacokinetics
Uptake
Excretion
Distribution
Minimum alveolar concentration
Blood-gas partition coefficient
Concentration effect and second gas effect
Shunts
Alveolar-mixed venous partial pressure difference
Effect of cardiac output on induction of inhaled anesthetic
Effects of inhaled anesthetic agents on the circulatory and pulmonary systems
Suggested readings
43. Nitrous oxide
Systemic effects
Metabolism
Postoperative nausea and vomiting
Toxicity
Nitrous oxide and closed air spaces
Environmental impact
Suggested readings
44. Cardiovascular effects of the inhalation agents
Systemic vascular resistance
Heart rate
Cardiac output and myocardial contractility
Arrhythmogenicity
Coronary vasodilation
Anesthetic effect on diastolic filling
Right ventricular function
Electrocardiogram
Cardioprotection
Nitrous oxide
Xenon
Suggested readings
45. Effects of inhalation agents on the central nervous system
Effect on central nervous system monitors
Neuroprotection versus neurotoxicity
Nitrous oxide
Isoflurane
Desflurane
Sevoflurane
Suggested readings
46. Hepatic effects of the inhalation agents
Hepatic blood supply
Inhaled anesthetic-induced changes in hepatic blood flow
Hepatic metabolism of inhaled anesthetic agents
Extrahepatic degradation of inhaled anesthetic agents
Suggested readings
47. Propofol
Effects on major organ systems
Pharmacokinetics and pharmacodynamics
Suggested readings
48. Etomidate
Pharmacokinetics
Pharmacodynamics
Effects on major organ systems
Adverse drug effects
Suggested readings
49. Ketamine
Structure
Mechanisms of action
Pharmacokinetics, pharmacodynamics, and routes of administration
Systemic effects
Other side effects, toxicities, and abuse
Clinical use
Suggested readings
50. Opioid pharmacology
Effects
Histamine release
Opioid-induced hyperalgesia
Dependence, tolerance, and addiction
Suggested readings
51. Succinylcholine
Clinical use
Pharmacology
Phase II blockade
Succinylcholine-associated apnea
Variances in butyrylcholinesterase activity
Undesirable effects
Suggested readings
52. Nondepolarizing neuromuscular blocking agents
Mechanism of action
Characteristics of neuromuscular nondepolarizing blockade
Alterations in sensitivity
Chemical structure and pharmacokinetics
Nonrelaxant side effects
Commonly used nondepolarizing neuromuscular blocking agents
Suggested readings
53. Nonrelaxant side effects of nondepolarizing neuromuscular blocking agents
Interference with autonomic function
Histamine release
Respiratory effects
Allergic reactions
Other nonrelaxant side effects of nondepolarizing neuromuscular blocking agents
Suggested readings
54. Antagonism of neuromuscular block
Acetylcholinesterase inhibitors
Sugammadex
Suggested readings
55. Pharmacology of atropine, scopolamine, and glycopyrrolate
Atropine
Scopolamine
Glycopyrrolate
Suggested readings
56. Benzodiazepines
Organ effects outside of the central nervous system
Tolerance, dependence, and withdrawal
Neonatal and fetal exposure
Midazolam
Effects on organ systems
Diazepam
Effects on organ systems
Lorazepam
Remimazolam
Other benzodiazepines and related agents
Benzodiazepine antagonist
Benzodiazepines and SARS-CoV-2 (COVID-19) pandemic
Suggested readings
57. Dexmedetomidine
Pharmacokinetics
Systemic effects
Suggested readings
58. Inotropes
Physiology
Clinical implications
Classification
Specific agents
Suggested readings
59. Vasopressors
Physiology
Clinical implications
Classification
Specific agents
Suggested readings
60. Vasodilators
Introduction
Sodium nitroprusside
Organ system effects
Nicardipine
Clevidipine
Suggested readings
61. Nitroglycerin
Mechanism of action of vasodilation
Metabolism
Cardiovascular effects
Therapeutic uses
Adverse effects
Contraindications
Suggested readings
62. β-adrenergic receptor blo cking agents
Indications for β-adrenergic receptor blockade
Pharmacology of β-adrenergic receptor blocking agents
Side effects
Suggested readings
63. Calcium channel blockers
Mechanism of action
Classes of drugs
General indications
Anesthetic considerations in patients taking calcium channel blockers
Suggested readings
64. Renin-angiotensin receptor inhibition
Physiology
Angiotensin-converting enzyme inhibitors
Aldosterone antagonists
Direct renin inhibitors
Anesthetic considerations for patients receiving renin-angiotensin-aldosterone system inhibitors
Suggested readings
65. Bronchodilators
β-Adrenergic receptor agonists
Methylxanthines
Anticholinergic agents
Antiinflammatory agents
Adjunctive medication
Suggested readings
66. Antiemetics
5-Hydroxytryptamine (Serotonin, 5-HT3) receptor antagonists
Antidopaminergic drugs
Anticholinergic agents
Steroids
Neurokinin-1 receptor antagonists
Other antiemetics
Nonpharmacological prophylaxis
Suggested readings
SECTION IV. Colloids and Blood Products
67. Albumin, hetastarch, and pentastarch
The colloid controversy
Albumin
Hetastarch and pentastarch
Clinical usefulness of colloids
Contraindications to the use of colloid solutions
Acknowledgment
Suggested readings
68. Type, screen, and crossmatch of red blood cells
Type
Screen
Crossmatch
Incompatibility risk and emergency transfusion
Suggested readings
69. Red blood cell and platelet transfusion
Red blood cells: Collection, storage, and administration
Red cell transfusion in practice
Autologous blood transfusion and directed transfusion
Synthetic hemoglobins
Moving from evidence to action: Thresholds for transfusion of red blood cells
Platelet transfusions: Platelet preparation and storage
Platelet matching
Indications for platelet transfusion
Platelet alloimmunization and platelet refractoriness
Other risks of platelet transfusion
Suggested readings
ICU and cardiac surgical studies
TRACS
TRICS III
Titer 2
70. Massive transfusions
Intraoperative complications
Postoperative complications
Treatment of coagulopathy
Suggested readings
71. Hemolytic transfusion reactions
Introduction
Pathophysiology
Signs and symptoms
Complications
Prevention
Treatment
Suggested readings
72. Nonhemolytic transfusion reactions
Febrile nonhemolytic transfusion reaction
Mild allergic reactions
Anaphylactic reactions
Hypotensive transfusion reactions
Transfusion-related acute lung injury
Transfusion-associated circulatory overload
Transfusion-associated dyspnea
Posttransfusion purpura
Transfusion-associated graft-versus-host disease
Transfusion-transmitted infection
Bacterial contamination
Immunomodulation
Suggested readings
73. Blood product conservation
Questions
Background
Transfusion threshold and strategies
Preoperative assessment
Intraoperative considerations
Suggested readings
SECTION V. Preoperative and Postoperative
74. Principles of preoperative evaluation
Preoperative evaluation and risk assessment
Surgical urgency and risk
Patient-specific risk assessment
Medical comorbidities
Bleeding/thrombotic risk assessment
Psychosocial history
Preoperative functional capacity assessment
Sleep apnea screening
Focused physical examination
Ancillary testing
Preoperative medication management
Anemia and nutrition
Special populations—geriatrics
Risk stratification and mitigation
Suggested readings
75. Preoperative evaluation of the patient with cardiac disease for noncardiac operations
Defining comorbid conditions
Assessing surgical risk
Evaluating functional status
Applying the Revised American College of Cardiology/American Heart Association Guidelines
Perioperative β-adrenergic receptor blockade
Patients with prior percutaneous coronary interventions
Patients with cardiac-rhythm management devices
Suggested readings
76. Tobacco use in surgical patients
Smoking abstinence and perioperative outcomes
Surgery represents an excellent opportunity for smoking cessation
Helping patients quit smoking
E-cigarettes
Summary
Suggested readings
77. Obstructive sleep apnea
Introduction
Epidemiology
Pathophysiology
Anesthetic management of patients with obstructive sleep apnea
Summary
Suggested readings
78. Postoperative nausea and vomiting
Introduction
Physiology
Conclusion
Suggested readings
79. Anesthesia for patients who are lactating
Preoperative
Intraoperative
Postoperative
Suggested readings
80. Acute and chronic alcoholism and anesthesia
Metabolism
Acute central nervous system effects
Chronic alcoholism
Anesthetic management of patients with alcohol use disorders
Liver disease and cirrhosis
Acetaminophen
Nonsteroidal antiinflammatory drugs
Delirium tremens
Alcoholic abstinence
Selective serotonin reuptake inhibitors
Suggested readings
81. The evaluation and management of prolonged emergence from anesthesia
Pharmacologic causes of delayed emergence
Pharmacokinetic and pharmacodynamic factors
Metabolic disturbances of delayed emergence
Suggested readings
82. Delirium in the postanesthesia care unit
Predisposing and perioperative risk factors
Diagnosis
Prevention
Treatment
Outcomes and long-term consequences
Suggested readings
SECTION VIA. Specialty Anesthesia: Regional Anesthesia
83. Local anesthetic agents: Mechanism of action and pharmacology
Anatomy of a nerve cell
Nerve cell membrane and depolarization
Structure of local anesthetic agents
Action of local anesthetic agents
Suggested readings
84. Toxicity of local anesthetic agents
Introduction
Factors influencing blood levels of local anesthetic agents
Clinical presentation of systemic toxicity (Box 84.1)
Central nervous system toxicity
Peripheral nervous system toxicity
Cauda equina syndrome
Transient neurologic symptoms
Methemoglobinemia
Diagnosis, prevention, and treatment of toxic reactions
Special populations
Suggested readings
85. Regional analgesia adjuvants, liposomal bupivacaine
Regional anesthesia adjuvants
Liposomal bupivacaine
Suggested readings
86. Multimodal analgesia
Multimodal analgesia
NSAIDs
Acetaminophen
Steroids
Local anesthetics and regional anesthesia
α2-Receptor agonists
α2δ Ligands
Ketamine
Opioids
Conclusion
Appendix
Suggested readings
87. Needle blocks of the eye
Anatomy
Terminology
Local anesthetic agents
Types of eye blocks
Contraindications
Complications
Suggested readings
88. Spinal cord anatomy and blood supply
Anatomy
Vertebrae
Blood supply
Suggested readings
89. Spinal anesthesia
Introduction
Anatomy
Factors affecting block level
Spinal anesthetic agents
Cardiovascular effects
Pulmonary effects
Gastrointestinal effects
Genitourinary effects
Cerebral blood flow
Contraindications to spinal anesthesia
Emerging concerns in neuraxial anesthesia
Suggested readings
90. Epidural anesthesia
Applied anatomy of the epidural space
Identification of the epidural space
Selection and dose of local anesthetic agent
Complications
Suggested readings
91. Combined spinal-epidural blockade
Applied anatomy
Indications
Contraindications
Advantages
Disadvantages
Equipment and technique
Epidural test doses
Complications
Dural puncture epidural
Suggested readings
92. Neuraxial anesthesia and anticoagulation
Vitamin K antagonists (warfarin)
Intravenous and subcutaneous standard (unfractionated) heparin
Low-molecular-weight heparin
New oral anticoagulants
Reversal of direct oral anticoagulants
Antiplatelet medications
The anticoagulated parturient
Anesthetic management of the anticoagulated patient
Suggested readings
93. Brachial plexus anatomy
Anatomy of the brachial plexus
Anatomy of the brachial plexus with clinical correlations
Suggested readings
94. Upper extremity blocks
Interscalene brachial plexus block
Supraclavicular brachial plexus block
Infraclavicular brachial plexus block
Axillary brachial plexus block
Suggested readings
95. Peripheral nerve blocks of the posterior trunk
Introduction
Paravertebral block
Quadratus lumborum block
Erector spinae block
Suggested readings
96. Peripheral nerve blocks of the anterior trunk
Introduction
Interpectoral, pectoserratus, and serratus anterior plane blocks
Parasternal intercostal plane block
Rectus sheath block
Transversus abdominis plane block
Ilioinguinal/Iliohypogastric nerve block
Suggested readings
97. Lower extremity peripheral nerve blocks
Clinical applications
Complications
Posterior lumbar plexus block (psoas compartment block)
Technique
Femoral nerve block
Fascia iliaca nerve block
Obturator nerve block
Pericapsular nerve group block
Adductor canal block
Sciatic nerve block
Popliteal block
Suggested readings
98. Peripheral nerve blocks at the ankle
Technique
Suggested readings
99. Perioperative antifibrinolytic medication use
Introduction
Routes, dosage, and side effects
Usage and efficacy
Complications and safety
Summary
Suggested readings
100. Basics of ultrasound-guided regional anesthesia
Introduction
Ultrasound imaging physics
Ultrasound safety
Suggested readings
SECTION VIB. Speciality Anesthesia: Neuroanesthesia
101. Cerebral protection
Regulation of physiologic parameters
Anesthetic agents
Conclusion
Suggested readings
102. Increased intracranial pressure
Brain
Cerebrospinal fluid
Blood
Intracranial elastance
Anesthetic considerations
Metabolic considerations
Postoperative care
Suggested readings
103. Functional neurosurgery
Deep brain stimulation
Cervical denervation for dystonia
Epilepsy surgery
Focused ultrasound
Suggested readings
104. Anesthesia for awake intracranial surgery
Introduction
Indications for awake craniotomy
Awake craniotomy versus general anesthesia
Preoperative assessment and patient selection
Anesthetic management
Monitored anesthesia care
Asleep-awake-asleep method
Asleep-awake method
Intraoperative complications
Summary
Suggested readings
105. Cerebral circulation
Anterior circulation
Posterior circulation
Meningeal arteries
Venous drainage of the head
Clinical considerations
Suggested readings
106. Management of cerebral aneurysms
Epidemiology and risk factors
Aneurysm rupture
Surgical treatment versus endovascular interventions
Anesthetic management
Recovery
Suggested readings
107. Anesthesia for pituitary surgery
Adenohypophysis
Cushing disease
Acromegaly
Hyperprolactinemia
Pituitary hyperthyroidism
Hypopituitarism
Neurohypophysis
Management of patients having pituitary surgery
Suggested readings
108. Anesthesia for the sitting position
Advantages of the sitting position
Complications of the sitting position (Box 108.3)
Suggested readings
109. Physiology and treatment of venous air embolism
Etiology
Prevalence
Pathophysiology
Morbidity and mortality
Diagnosis
Treatment
Anesthetic considerations
Suggested readings
110. Perioperative implications of caring for patients with epilepsy
Perioperative seizure frequency
Effect of anesthetics on epilepsy
Effect of antiepileptic drugs on perioperative patient care
Suggested readings
111. Effects of anesthetic agents and sedation medications on electroencephalograms
Normal electroencephalogram
Inhalation anesthetic agents
Suggested readings
112. Carotid endarterectomy
Preoperative evaluation
Carotid endarterectomy procedure
Techniques for cerebral monitoring
Other considerations
Suggested readings
113. Management of acute spinal cord injury
Pathophysiologic factors
Respiratory considerations
Gastrointestinal considerations
Cardiovascular considerations
Metabolic considerations
Anesthetic management
Suggested readings
114. Anesthesia for adult complex spine surgery
Epidemiology
Preoperative evaluation
Surgery
Blood loss and management strategies
Intraoperative neuromonitoring
Anesthesia
Positioning
Suggested readings
SECTION VIC. Specialty Anesthesia: Cardiac
115. Coronary circulation and the myocardial conduction system
Coronary circulation
Myocardial conduction system
Suggested readings
116. Transesophageal echocardiography: Anatomic considerations
Transesophageal echocardiography safety
Anatomic correlations
Standard views
Suggested readings
117. Detection and treatment of perioperative acute coronary syndromes
Monitoring for myocardial injury and infarction
Treatment of acute coronary syndrome
ST-Segment elevation myocardial infarction
Non–ST-Segment elevation acute coronary syndrome
Special situations
Suggested readings
118. Heart failure: Classification, compensation, and treatment
Types of heart failure
Classification of heart failure
Compensatory mechanisms in heart failure
Biomarkers in heart failure
Treatment of heart failure
Suggested readings
119. Right heart failure, tricuspid and pulmonary valve pathology
The right ventricle
Anatomy
Electrocardiography of the right ventricle
Coronary perfusion
Design and function
Preload
Afterload
Evaluation of the right ventricle
Management of right ventricular dysfunction
Tricuspid valve
Tricuspid regurgitation
Tricuspid stenosis
Pulmonic valve
Pulmonic regurgitation
Pulmonic stenosis
Suggested readings
120. Management of end-stage heart failure: Heart transplantation versus ventricular assist device
Ventricular assist devices
Total artificial heart
Anesthetic considerations for patients with end-stage heart failure who require implantation of a ventricular assist device or total artificial heart
Intraoperative management
Postoperative management
Considerations for patients for heart transplantation
Conclusion
Suggested readings
121. Coronary artery stents
Recommendations
Suggested readings
122. Cardiopulmonary bypass
Basic cardiopulmonary bypass structure
Control of systemic oxygenation during cardiopulmonary bypass
Basic relationships
General practice of cardiopulmonary bypass
Cardiopulmonary bypass hemodynamics and hemodilution
Effect of temperature change on systemic oxygenation
Effect of anesthetic depth on systemic oxygenation
Monitoring the adequacy of perfusion during cardiopulmonary bypass
Difficulties in maintaining systemic oxygenation during cardiopulmonary bypass
Cardioplegia
Suggested readings
123. Evaluation of the coagulation system
Preoperative assessment
Common point-of-care tests of coagulation
Functional measurement of anticoagulation
Suggested readings
124. Anticoagulation and reversal for cardiopulmonary bypass
Heparin
Administration and monitoring of heparin during cardiopulmonary bypass
Problems associated with the use of heparin
Problems associated with heparin manufacture
Heparin alternatives for cardiopulmonary bypass
Reversal of heparin after cardiopulmonary bypass
Suggested readings
125. Aortic stenosis
Clinical features
Natural history
Anatomic considerations
Valve replacement
Concomitant diseases
Anesthetic considerations for aortic valve replacement
Anesthesia for patients with aortic stenosis undergoing noncardiac surgery
Suggested readings
126. Mitral regurgitation
Anatomy of the mitral valve
Classification mitral regurgitation
Natural history of mitral regurgitation
Concomitant disease
Surgical correction of mitral regurgitation
Anesthetic considerations in the patient with mitral regurgitation
Suggested readings
127. Percutaneous approaches to valvular disease: Transcatheter aortic valve replacement and transcatheter mitral valve repair
Treatment options for aortic stenosis and mitral regurgitation
Patient selection
Devices and insertion techniques
Anesthetic management
Suggested readings
128. Pacemakers
Overview
Generic codes of pacemakers
Preoperative evaluation/preparation
Effect of a magnet on pacemaker function
Intraoperative management
Electromagnetic interference
Magnetic resonance imaging
Special situations
Summary
Acknowledgement
Suggested readings
129. Implantable cardioverter-defibrillators
Overview
The implantable cardioverter defibrillator system
Implantable cardioverter defibrillator placement
Implantable cardioverter defibrillator functioning as a pacemaker
Electromagnetic interference and implantable cardioverter defibrillators
Inappropriate implantable cardioverter defibrillator shocks
Implantable cardioverter defibrillator magnets
Preoperative evaluation
Intraoperative management
Complications
Acknowledgement
Suggested readings
130. Intra-aortic balloon pump
Equipment
Hemodynamic effects
Counterpulsation adjustment
Indications
Contraindications
Weaning from intra-aortic balloon pump support
Complications
Outcome
Suggested readings
131. Extracorporeal membrane oxygenation
Basic principles of extracorporeal membrane oxygenation
Practical considerations among extracorporeal membrane oxygenation patients
Indications
Outcomes
Contraindications
Complications
Challenges and future directions
Conclusions
Suggested readings
SECTION VID. Specialty Anesthesia: Thoracic
132. Intraoperative bronchospasm: Etiology and treatment
Introduction
Differential diagnosis for bronchospasm
Perioperative evaluation, planning, and bronchospasm management
Suggested readings
133. Anesthesia for bronchoscopy
Clinical aspects of bronchoscopy
Aims of anesthesia for bronchoscopy
Preoperative preparation
Fiber-optic bronchoscopy
Sedation
Upper airway anesthesia for bronchoscopy
Artificial airways and fiber-optic bronchoscope
Treatment of hypoxemia for bronchoscopy
Rigid bronchoscopy
Removal of a foreign body
Management of massive hemoptysis
Bronchoscopy management of central airway obstruction
Complications associated with bronchoscopy
Summary
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134. Double-lumen tracheal tubes
Tube selection
Double-lumen tube placement technique
Suggested readings
135. One-lung ventilation and methods of improving oxygenation
Mechanism of hypoxemia
Factors affecting oxygenation during one-lung ventilation
Preoperative and intraoperative condition of the dependent lung
Methods to attenuate hypoxemia during one-lung ventilation
Miscellaneous causes of hypoxemia
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136. Bronchopleural fistula
Etiology
Treatment
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137. High-frequency ventilation: Physics, physiology, and clinical applications
Background
Physics and physiology
Clinical applications
Potential risks and benefits
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138. Thoracotomy pain management
Mechanism of postthoracotomy pain
Thoracic epidural analgesia
Medication choice
Risks of thoracic epidural analgesia
Other analgesic techniques
Multimodal analgesia
Suggested readings
139. Lung transplantation
Indications
Preoperative management and preparation
Intraoperative anesthetic management
Postoperative management
Suggested readings
SECTION VII. Multispecialty Anesthesia; General Urologic ENT
140. Thermoregulation and perioperative hypothermia
Heat balance and thermoregulation
Measuring temperature intraoperatively
Systemic side effects of perioperative hypothermia
Mechanisms and prevention of perioperative hypothermia
Suggested readings
141. The role of the anesthesia provider in wound infection
Preoperative optimization
Hand hygiene
Hyperglycemia
Nutritional status
Intraoperative factors
Conclusion
Suggested readings
142. Anesthesia in the patient with extreme obesity
General
Physiology and pathophysiology of morbid obesity
Anesthesia for the morbidly obese patient
Suggested readings
143. Weight loss procedures
Surgical procedures for weight loss
Summary
Suggested readings
144. Complications of transurethral resection of the prostate
Introduction
Treatment
Specific complications
Prevention of complications
Suggested readings
145. Extracorporeal shock wave lithotripsy
Technical aspects
Patient selection
Complications
Anesthetic considerations
Suggested readings
146. Anatomy of the larynx
Description
Laryngeal skeleton
Joints, ligaments, and membranes of the larynx
Interior of the larynx
Innervation
Muscles
Blood supply
Considerations with the infant larynx
Suggested readings
147. Anesthesia for laryngeal surgery
Airway anatomy and physiology
Direct laryngoscopy
Vocal cord surgery
Laryngectomy
Laryngeal and tracheal trauma
Suggested readings
148. Management of the difficult airway
Defining the difficult airway
Preoperative evaluation
Preparation for management of the difficult airway
Management of the difficult airway
Specific patient populations
Suggested readings
149. Enhanced recovery pathways (ERPS)
History and development
Preoperative considerations
Intraoperative interventions
Postoperative management
Suggested readings
SECTION VIII. Anesthesia for Unique Situations
150. Anesthesia during a pandemic
Introduction
Supply chain
COVID-19 testing
Personal protective equipment
Managing the surgical schedule
The next pandemic
Suggested readings
151. Monitored anesthesia care
Suggested readings
152. Anesthesia for patients undergoing magnetic resonance imaging
Magnetic resonance imaging basics
Magnetic resonance imaging safety
Monitors and equipment compatibility
Anesthetic management
Unique considerations
Suggested readings
153. Anesthesia for robotic surgery
Introduction
Technique
Physiology
Anesthetic considerations
Other adverse effects/risks
Summary
Suggested readings
154. Anesthesia for electroconvulsive therapy
Mechanism of action
Physiology
Morbidity and mortality rates
Anesthetic management
Suggested readings
155. Myasthenia gravis and Lambert-Eaton myasthenic syndrome
Myasthenia gravis
Lambert-Eaton myasthenic syndrome
Suggested readings
156. Anesthesia for endoscopic procedures
Introduction
Operational considerations
Monitoring
Patient safety
Anesthetic management
Procedures
Suggested readings
157. Anesthesia outside of the operating room
Introduction
Monitoring, equipment, and patient evaluation
Spectrum of sedation and anesthesia
Providers
Complications
Nonoperating room locations
Suggested readings
158. Anesthesia for interventional neuroradiology
Neurologic interventional radiologic imaging exposure and considerations
Contrast drugs
Ischemic stroke
Carotid artery stenting
Cerebral aneurysms
Brain arteriovenous malformations
Suggested readings
159. Anesthesia for patients with diabetes mellitus
Introduction
Complications of diabetes
Preoperative assessment
Hyperglycemia
Management of anesthesia
Summary
Suggested readings
160. Anesthesia for thyroid surgery
General considerations
The patient with known thyroid disease
The patient with occult thyroid disease
Thyroid storm
Suggested readings
161. Anesthesia for patients with carcinoid syndrome
Small bowel neuroendocrine tumors
Anesthetic management
Suggested readings
162. Anesthesia for patients with hepatocellular disease
Chronic hepatic disease
Acute hepatic failure
Anesthesia considerations
Suggested readings
163. Anesthesia for the patient undergoing liver transplantation
Preoperative evaluation
Intraoperative management
Postoperative management
Acute liver failure
Suggested readings
164. Autonomic dysreflexia
Pathophysiology of autonomic dysreflexia
Clinical features
Prevention
Treatment
Suggested readings
SECTION IX. Obstetric Anesthesia
165. Maternal physiologic changes in pregnancy
Respiratory system
Cardiovascular system
Gastrointestinal system
Renal function
Hepatic function
Hematologic system
Neurologic system
Uterine physiology
Fetal oxygenation
Conclusion
Acknowledgment
Suggested readings
166. Fetal assessment and intrapartum fetal monitoring
Overview
Antepartum fetal assessment
Intrapartum fetal monitoring
Suggested readings
167. Analgesia for labor
Labor pain
Preanesthesia evaluation and monitoring
Analgesia options for parturients during labor
Systemically administered medication
Suggested readings
168. Opioid dependence in the parturient
Pharmacology
Maternal and fetal outcomes
Pregnancy management for the opioid-addicted parturient
Labor analgesia
Anesthetic management for cesarean delivery
Suggested readings
169. Preterm labor: Tocolytics and anesthetic management
Epidemiology
Tocolytic agents
Magnesium sulfate for neuroprotection
Corticosteroids for fetal lung maturity
Anesthesia management of parturients with preterm labor
Suggested readings
170. Hypertensive disorders of pregnancy
Definitions
Etiology and pathophysiology
Treatment
Anesthetic management
Suggested readings
171. Anesthesia for cesarean delivery
Preoperative evaluation and preparation
Regional anesthesia
Emergent or urgent cesarean delivery
Suggested readings
172. Nonobstetric surgery in pregnancy
Physiology of pregnancy
Teratogenicity of anesthetic agents
Preoperative preparation
Fetal monitoring
Anesthetic technique
Suggested readings
173. Anesthesia for fetal surgery
Anesthesia for open fetal surgery
Anesthesia for minimally invasive fetal surgery
Anesthesia for ex utero intrapartum treatment procedures
Suggested readings
174. Peripartum hemorrhage
Antepartum hemorrhage
Postpartum hemorrhage
Suggested readings
175. Anesthesia for tubal ligation
Interval tubal ligations
Postpartum tubal ligation
Suggested readings
176. Maternal diabetes: Neonatal effects
Suggested readings
SECTION X. Pediatric Anesthesia
177. Impact of anesthesia on neural development
Relevance
U.S. food and drug administration statement
Data: Nonclinical studies
Data: Clinical studies
What to tell parents and caregivers
Suggested readings
178. Anesthetic risks associated with prematurity
Respiratory distress syndrome
Bronchopulmonary dysplasia
Apnea
Patent ductus arteriosus
Necrotizing enterocolitis
Intracranial hemorrhage
Infection
Retinopathy of prematurity
Temperature instability
Pharmacologic concerns
Acknowledgment
Suggested readings
179. Meconium aspiration and meconium aspiration syndrome
Pathophysiology of meconium passage in utero
Consequences of meconium passage or aspiration
Treatment
Diagnosis after delivery
Management
Outcomes
Suggested readings
180. Risks of general anesthesia and sedation drugs in pediatric patients
Introduction
Development neuroscience
Description of anesthetic-induced developmental neurotoxicity
Anesthetic and sedative drugs
Clinical evidence for anesthesia-induced developmental neurotoxicity
Conclusion
Suggested readings
181. Neonatal cardiovascular physiology
Fetal circulation
Transition to neonatal circulation
Neonatal cardiovascular physiology
Acknowledgment
Suggested readings
182. Differences between the infant and adult airway
Anatomy
Intubation
Tracheal tube
Suggested readings
183. Fluid management in infants
Fluid management in infants
Maintenance fluids
Fluid replacement
Blood replacement
Red blood cell products
Glucose management
Suggested readings
184. Neuromuscular blocking agents in infants
Specific agents and unique characteristics in neonates and infants
Reversal of neuromuscular blockade
Suggested readings
185. Congenital diaphragmatic hernia
Incidence and classification
Etiology, embryology, and pathophysiology
Prenatal diagnosis and management
Prenatal management: Fetal endoscopic tracheal occlusion
Postnatal diagnosis and management
The use of extracorporeal membrane oxygenation
Surgery and timing
Anesthetic management
Postoperative care
Outcome
Mortality rate
Suggested readings
186. Congenital pediatric airway problems
Congenital pediatric airway problems
Congenital abnormalities of the airway
Anesthetic management of the difficult pediatric airway
Suggested readings
187. Congenital heart disease: Congestive heart failure
Anesthetic management
Acknowledgment
Suggested readings
188. Other neonatal emergencies: Tracheoesophageal fistula and omphalocele
Tracheoesophageal fistula
Omphalocele
Suggested readings
189. Neonatal resuscitation
Transition from fetal to neonatal circulation
Preparing for a neonatal resuscitation
Neonatal resuscitation program basics
Additional considerations: Meconium
Additional considerations: Prematurity
Unique neonatal assessments: Apgar scores and umbilical cord gases
Conclusions
Suggested readings
190. Pyloric stenosis
Presentation
Management of anesthesia
Suggested readings
191. Pediatric breathing circuits
Mapleson circuits
Circle system
Summary
Suggested readings
192. Croup versus epiglottitis
Management
Suggested readings
193. Sickle cell anemia: Anesthetic implications
Introduction
Anesthetic management
Preoperative
Intraoperative
Postoperative
Suggested readings
194. Anesthetic considerations for the patient with down syndrome
Clinical manifestations
Neurologic manifestations
Cardiac abnormalities
Respiratory manifestations
Gastrointestinal manifestations
Endocrinologic manifestations
Musculoskeletal abnormalities
Head and neck abnormalities
Adults with down syndrome
Perioperative management
Operative management
Suggested readings
195. Pediatric neuromuscular disorders
Pediatric neuromuscular disorders
Cerebral palsy
Muscular dystrophy
Mitochondrial myopathies
Malignant hyperthermia and neuromuscular disorders
Suggested readings
196. Anesthesia for patients with myotonic dystrophy
Introduction
Coexisting organ system dysfunction
Anesthetic considerations
Suggested readings
197. Regional anesthesia and pain relief in children
Topical blocks
Transverse abdominis plane block
Rectus sheath block
Suggested readings
SECTION XI. Pain Medicine
198. Perioperative management of the opioid-tolerant patient
Introduction
Postoperative management
Perioperative multimodal analgesia
Special situations
Suggested readings
199. Patient-controlled analgesia
Evolution and application of patient-controlled analgesia
Intravenous patient-controlled analgesia
Conclusion
Suggested readings
200. Neuraxial opioids
Suggested readings
201. Complex regional pain syndrome
Background
Definitions
Diagnosis
Etiology
Treatment
Suggested readings
202. Postoperative headache
Postdural puncture headache
Prevention
Treatment
Other postoperative headaches
Patient characteristics associated with postoperative headache
Suggested readings
203. Treatment of cancer-related pain
Introduction
Mechanisms of cancer pain
Medical therapy
Adjuvant analgesic agents
Interventional therapy
Neuromodulation
Surgical procedures
Other approaches
Suggested readings
204. Postherpetic neuralgia
Introduction
Description of the syndrome
Pathophysiology
Treatment
Acknowledgment
Suggested readings
205. Common interventions for low back pain
Facet (zygapophysial) joint injections
Medial branch blocks and radiofrequency ablation
Sacroiliac joint injections
Contraindications and adverse effects
Conclusion
Suggested readings
206. Stellate ganglion block
Indications
Anatomy
Technique
Suggested readings
207. Lumbar sympathetic blockade
Relevant anatomy
Indications
Technique
Adverse side effects
Suggested readings
208. Celiac plexus block
Indications
Anatomy
Procedure
Expected side effects
Adverse effects
Suggested readings
209. Neuromodulation techniques in pain medicine
History
Mechanism of action
Patient selection
Contraindications
Types of spinal cord stimulation
Types of peripheral nerve stimulation
Procedural process
Outcome studies
Complications
Future directions
Suggested readings
SECTION XII. Critical Care Medicine
210. Hyperbaric oxygen therapy
Effects of hyperbaric oxygen
Anesthetic management in a hyperbaric oxygen therapy chamber
Suggested readings
211. Perioperative management of blood glucose
Introduction
Preoperative management of glycemic control
Intraoperative management of glycemic control
Postoperative management of glycemic control
Measurement of blood glucose
Summary
Suggested readings
212. Acute respiratory distress syndrome
Introduction
Pathophysiology
Etiology
Clinical presentation
Diagnosis
Management
Refractory hypoxemia
Alternative management strategies
Post-ARDS outcomes
Suggested readings
213. Pulmonary hypertension
Introduction
Pathophysiology
Clinical features
Diagnosis
Treatment of pulmonary hypertension
Anesthetic management of the patient with pulmonary arterial hypertension
Preoperative
Intraoperative
Postoperative
Conclusion
Suggested readings
214. Management of stroke
Initial evaluation of acute stroke patients
Anesthetic management
Suggested readings
215. Acute kidney injury
Incidence, signs, and symptoms
Risk factors
Laboratory analysis
Causes and treatment
Management
Complications
Suggested readings
216. Sepsis and septic shock
Initial resuscitation
Diagnosis
Antimicrobial therapy and source control
Vasopressors and inotropes
Corticosteroids
Recombinant human-activated protein C
Vitamin C
Supportive therapy
Suggested readings
217. Anesthesia for burn-injured patients
Acute injury
Excision and grafting
Operating room setup
Preoperative phase
Intra- and postoperative phases
Outfield procedures
Electrical injuries
Nonthermal skin diseases
Conclusion
Suggested readings
SECTION XIII. Risk Management
218. Medical ethics
Principles of medical ethics
A method of resolving ethical challenges in clinical care
When patients lack capacity
Patient refusal of blood products
Do not resuscitate in the operating room
Conclusion
Suggested readings
219. Medicolegal principles: Informed consent
The informed-consent process
Obtaining informed consent when treating the incompetent or minor patient
Obtaining informed consent in emergent circumstances
Suggested reading
220. Medicolegal principles: Medical negligence
Elements of malpractice actions
Types of claims against anesthesia personnel
Lack of informed consent
The process
Managing legal risk
Suggested readings
221. Anesthesia quality registries
Genesis of anesthesia quality registries
The anesthesia closed claims program
Anesthesia incident reporting system
National anesthesia clinical outcomes registry
Future of anesthesia quality registries
Suggested readings
222. Depth of anesthesia
Incidence and experience of intraoperative awareness
Risk factors for intraoperative awareness
Prevention of awareness
Summary
Suggested readings
223. Patient safety and quality improvement
Quality improvement
Medication errors, assessment, and prevention
Programs to improve outcome
Disclosure of errors to patients
Suggested readings
224. Perioperative pulmonary aspiration
Importance of pulmonary aspiration
Pulmonary aspiration in children
Use of medications and preoperative fasting
Occurrence of aspiration in the perioperative period
Management of perioperative pulmonary aspiration
Conclusion
Suggested readings
225. Eye and dental complications
Eye injury
Dental injury
Suggested readings
226. Intraoperative patient positioning and positioning complications
Commonly used positions
Recommendations for correct positioning
Complications resulting from incorrect positioning
Complications related to hyperlordosis
Complications of upper extremity positioning
Complications of lower extremity positioning
Complications of steep trendelenburg position
Complications related to the sitting position
Complications related to head positioning
Practical considerations for preventing positioning-related injury
What to do when injury occurs
Acknowledgment
Suggested readings
227. Malignant hyperthermia
Introduction
History
Incidence and mortality
Genetics of malignant hyperthermia
Clinical presentation
Anesthesia for malignant hyperthermia-susceptible patients
Evaluation of susceptibility
Dantrolene availability and patient safety
Acknowledgment
Suggested readings
228. Anaphylactic and anaphylactoid reactions in anesthesia
Pathophysiology
Clinical features
Causative agents
Diagnosis
Treatment
Suggested readings
229. Central line safety
Introduction
Indications
Complications
Insertion procedure
Insertion procedure safety steps
Safe central line use, maintenance, and removal
Suggested readings
SECTION XIV. Practice Management
230. American Society of Anesthesiologists evidence-based practice parameters
Practice parameters and their influence on clinical practice
Practice guideline and practice advisory methodology
Discussion
Suggested readings
231. Value-based payment models
The medicare access and CHIP reauthorization act of 2015
Anesthesia considerations
Suggested readings
232. Perioperative surgical home
What is the perioperative surgical home model?
Why was the perioperative surgical home model created?
What are the components and principles of the perioperative surgical home model?
Who are the stakeholders in the perioperative surgical home model?
How is the perioperative surgical home implemented?
What organizational capabilities are associated with a successful perioperative surgical home pilot?
What types of institutions are piloting the perioperative surgical home model?
What are some of the outcomes of the perioperative surgical home pilots?
What are examples of institutions that have implemented a PSH pilot?
Conclusion
References
Suggested readings
233. Licensure, credentialing, and privileging
How health care organizations credential and privilege physicians
License renewal, reappointment, and continuation of clinical privileges
Delegated credentialing
Suggested readings
234. Board certification and maintenance of certification
Primary certification examination process
Continuum of education in anesthesiology
ABA staged examinations
Maintenance of certification
Maintenance of certification in anesthesiology 2.0
Subspecialty certification
Summary
Suggested readings
235. Professional liability insurance
Scope of coverage—what is covered?
Exclusions—what is not covered?
Limits of liability—how much is covered?
Duties of the insurance company and the insured
Consent-to-settle clauses
Coverage forms
Suggested readings
236. Anesthesia information management systems
Architecture and configuration
Prevalence and utilization
Benefits/disadvantages
Summary
Suggested readings
237. Medical coding and payment systems
Medical diagnosis and procedure codes
Current procedural terminology code development and valuation process
Anesthesia coding
Payment methodology illustrations—anesthesia
Payment methodology illustrations—resource-based relative value system
Conclusion
Suggested readings
238. Chemical dependence in anesthesia personnel
Suggested readings
239. Sustainability in anesthesiology and the operating room
Inhaled anesthetic gases
Intravenous anesthetic agents
Mitigation efforts for environmental effects of anesthetic agents
Reusable, reprocessed, or disposable
Solid waste
Putting it into practice
Summary
Suggested readings
Index

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Terence L. Trentman

Brantley D. Gaitan

Bhargavi Gali

Rebecca L. Johnson

Jeffrey T. Mueller

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Toby N. Weingarten

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