Miller’s Basics of Anesthesia

8th Edition - July 5, 2022
Editor: Manuel Pardo
Language: English
Hardback ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 6 7 7 - 4
eBook ISBN:
9 7 8 - 0 - 3 2 3 - 7 9 6 7 8 - 1

Long regarded as the undisputed leading text of its kind, Miller’s Basics of Anesthesia provides comprehensive yet concise coverage of both basic science and clinical topics in… Read more

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Long regarded as the undisputed leading text of its kind, Miller’s Basics of Anesthesia provides comprehensive yet concise coverage of both basic science and clinical topics in anesthesiology. Under the experienced editorial leadership of Dr. Manuel C. Pardo, Jr., the 8th Edition has been meticulously updated to reflect the latest advances in practice and important aspects of contemporary anesthesia care, including pathophysiology, pharmacology, regional anesthesia, anesthetic management, and special problems and patient groups. It remains the first learning resource of choice for anesthesia providers, including anesthesia residents and fellows, medical students, and student registered nurse anesthetists, and is also a valuable review tool for practitioners undergoing maintenance of certification or recertification.

Cover Image
Title Page
Copyright
Dedication
Contributors
Preface
Foreword
Table of Contents
Section I Introduction
Chapter 1 Scope of Anesthesia Practice
ANESTHESIOLOGY AS A MULTIDISCIPLINARY SPECIALTY
PERIOPERATIVE PATIENT CARE
ANESTHESIA WORKFORCE
TRAINING AND CERTIFICATION IN ANESTHESIOLOGY
QUALITY AND SAFETY
VALUE-BASED CARE
FUTURE OF ANESTHESIA CARE
ACKNOWLEDGMENT
REFERENCES
Chapter 2 Learning Anesthesia
COMPETENCIES, MILESTONES, AND ENTRUSTABLE PROFESSIONAL ACTIVITIES
STRUCTURED APPROACH TO ANESTHESIA CARE
LEARNING STRATEGIES
REFERENCES
Chapter 3 Clinician Well-Being
DEFINING TERMS
WHY WELL-BEING IS IMPORTANT
FACTORS AFFECTING CLINICIAN WELL-BEING
MENTAL HEALTH
INTERVENTIONS TO IMPROVE WELL-BEING
REFERENCES
Section II Pharmacology and Physiology
Chapter 4 Basic Pharmacologic Principles
PHARMACOKINETIC PRINCIPLES
PHARMACODYNAMIC PRINCIPLES
SPECIAL POPULATIONS
SUMMARY
REFERENCES
Chapter 5 Clinical Cardiac and Pulmonary Physiology
HEMODYNAMICS
CARDIAC REFLEXES
CORONARY BLOOD FLOW
PULMONARY CIRCULATION
PULMONARY GAS EXCHANGE
PULMONARY MECHANICS
CONTROL OF BREATHING
INTEGRATION OF THE HEART AND LUNGS
REFERENCES
Chapter 6 Autonomic Nervous System
ANATOMY OF THE AUTONOMIC NERVOUS SYSTEM
ADRENERGIC PHARMACOLOGY
SELECTIVE α-ADRENERGIC RECEPTOR AGONISTS
β2-ADRENERGIC RECEPTOR AGONISTS
α-ADRENERGIC RECEPTOR ANTAGONISTS
β-ADRENERGIC ANTAGONISTS
CHOLINERGIC PHARMACOLOGY
REFERENCES
Chapter 7 Inhaled Anesthetics
HISTORY
CHEMICAL AND PHYSICAL PROPERTIES
UPTAKE AND DISTRIBUTION IN THE BODY
MINIMUM ALVEOLAR CONCENTRATION
MECHANISMS
ORGAN SYSTEM EFFECTS
UNIQUE ISSUES WITH NITROUS OXIDE
TOXICITY AND ADVERSE EVENTS
METABOLISM, ELIMINATION, AND RECOVERY
ENVIRONMENTAL CONSIDERATIONS (ALSO SEE CHAPTER 49)
REFERENCES
Chapter 8 Intravenous Anesthetics
WHY INTRAVENOUS ANESTHETICS?
GABAA RECEPTOR AGONISM
PROPOFOL
BARBITURATES
BENZODIAZEPINES
KETAMINE
ETOMIDATE
DEXMEDETOMIDINE
ACKNOWLEDGMENTS
REFERENCES
Chapter 9 Opioids
BASIC PHARMACOLOGY
CLINICAL PHARMACOLOGY
CLINICAL APPLICATION
EMERGING DEVELOPMENTS
ACKNOWLEDGMENT
REFERENCES
Chapter 10 Local Anesthetics
HISTORY
NERVE CONDUCTION
LOCAL ANESTHETIC ACTIONS ON SODIUM CHANNELS
DIFFERENTIAL LOCAL ANESTHETIC BLOCKADE
SPREAD OF LOCAL ANESTHESIA AFTER INJECTION
PHARMACOKINETICS
ADVERSE EFFECTS
SPECIFIC LOCAL ANESTHETICS
WHEN LOCAL ANESTHESIA FAILS
FUTURE LOCAL ANESTHETICS
CONCLUSIONS
ACKNOWLEDGMENTS
REFERENCES
Chapter 11 Neuromuscular Blocking and Reversal Agents
INTRODUCTION
THE NEUROMUSCULAR JUNCTION
STRUCTURE–ACTIVITY RELATIONSHIPS
DEPOLARIZING NEUROMUSCULAR BLOCKING AGENTS: SUCCINYLCHOLINE
NONDEPOLARIZING NEUROMUSCULAR BLOCKING AGENTS
MONITORING THE EFFECTS OF NONDEPOLARIZING NEUROMUSCULAR BLOCKING AGENTS
ANTAGONISM OF RESIDUAL NEUROMUSCULAR BLOCK
SUMMARY
ACKNOWLEDGMENT
REFERENCES
Chapter 12 Anesthetic Neurotoxicity
ANESTHETIC DRUGS AS A CAUSE FOR NEURODEGENERATION AND LONG-TERM NEUROCOGNITIVE DEFICITS
CLINICAL EVIDENCE FOR NEUROTOXICITY
INTRAOPERATIVE COURSE AND NEUROCOGNITIVE OUTCOMES
CONCLUSION
REFERENCES
Section III Preoperative Preparation and Intraoperative Management
Chapter 13 Preoperative Evaluation
HISTORY AND PHYSICAL EXAMINATION
PREOPERATIVE EVALUATION OF COMMON COEXISTING DISEASES
PREOPERATIVE TESTING
RISK ASSESSMENT
MEDICATION MANAGEMENT
NPO GUIDELINES
INFORMED CONSENT FOR ANESTHESIA
PREOPERATIVE EVALUATION CLINICS
ACKNOWLEDGMENT
REFERENCES
Chapter 14 Choice of Anesthetic Technique
TYPES OF ANESTHESIA
CHOOSING AN APPROPRIATE ANESTHETIC TECHNIQUE
PRACTICAL ASPECTS OF ANESTHESIA CHOICE
ACKNOWLEDGMENT
REFERENCES
Chapter 15 Anesthesia Delivery Systems
THE ANESTHESIA WORKSTATION
FUNCTIONAL ANATOMY OF THE ANESTHESIA WORKSTATION
ANESTHETIC BREATHING CIRCUITS
ANESTHESIA VENTILATORS
SCAVENGING SYSTEMS
CHECKING YOUR ANESTHESIA WORKSTATION
ACKNOWLEDGMENT
REFERENCES
Chapter 16 Airway Management
ANATOMY AND PHYSIOLOGY OF THE UPPER AIRWAY
AIRWAY ASSESSMENT
AIRWAY MANAGEMENT TECHNIQUES
INVASIVE AIRWAY ACCESS
COMPLICATIONS
AIRWAY MANAGEMENT IN INFANTS AND CHILDREN (ALSO SEE CHAPTER 34)
ACKNOWLEDGMENT
REFERENCES
Chapter 17 Spinal, Epidural, and Caudal Anesthesia
PRINCIPLES
PRACTICE
EVIDENCE
ANATOMY
MECHANISM OF ACTION
PHYSIOLOGIC EFFECTS
INDICATIONS
CONTRAINDICATIONS
SPINAL ANESTHESIA
EPIDURAL ANESTHESIA
COMBINED SPINAL-EPIDURAL ANESTHESIA
CAUDAL ANESTHESIA
COMPLICATIONS
REFERENCES
Chapter 18 Peripheral Nerve Blocks
INTRODUCTION
ULTRASOUND BASICS
CERVICAL PLEXUS BLOCK
UPPER EXTREMITY BLOCKS
LOWER EXTREMITY BLOCKS
CHEST AND ABDOMEN BLOCKS
INTRAVENOUS REGIONAL ANESTHESIA (BIER BLOCK)
REFERENCES
Chapter 19 Patient Positioning and Associated Risks
PHYSIOLOGIC ASPECTS OF POSITIONING
GENERAL POSITIONING PRINCIPLES
POSITIONING FOR ROBOTIC-ASSISTED SURGERY
PRESSURE INJURIES
BITE INJURIES
PERIPHERAL NERVE INJURIES
EVALUATION AND TREATMENT OF PERIOPERATIVE NEUROPATHIES
PERIOPERATIVE EYE INJURY AND VISUAL LOSS
ANESTHESIA OUTSIDE THE OPERATING ROOM
CONCLUSION
REFERENCES
Chapter 20 Anesthetic Monitoring
INTRODUCTION
RESPIRATORY SYSTEM
CIRCULATORY SYSTEM
CENTRAL NERVOUS SYSTEM
PERIPHERAL NERVOUS SYSTEM
TEMPERATURE
MAGNETIC RESONANCE IMAGING AND ADVERSE CONDITIONS
MULTIFUNCTION DISPLAYS AND DECISION SUPPORT
REFERENCES
Chapter 21 Point-of-Care Ultrasound
REVIEW OF ULTRASOUND PHYSICS
ULTRASOUND TRANSDUCERS
PREPARING FOR THE EXAMINATION
BASIC CARDIAC ULTRASOUND
PULMONARY ULTRASOUND
ABDOMINAL ULTRASOUND
CONCLUSIONS AND FUTURE DIRECTIONS
REFERENCES
Chapter 22 Acid–Base Balance and Blood Gas Analysis
DEFINITIONS
REGULATION OF THE HYDROGEN ION CONCENTRATION
ANALYSIS OF ARTERIAL BLOOD GASES
DIFFERENTIAL DIAGNOSIS OF ACID–BASE DISTURBANCES
OTHER INFORMATION PROVIDED BY ANALYSIS OF ARTERIAL BLOOD GASES AND pH
REFERENCES
Chapter 23 Hemostasis
INTRODUCTION
NORMAL HEMOSTASIS
BLEEDING DISORDERS
PROTHROMBOTIC STATES
LABORATORY EVALUATION OF HEMOSTASIS
ANTITHROMBOTIC AND PROCOAGULANT DRUGS
PERIOPERATIVE MANAGEMENT OF ANTITHROMBOTIC THERAPY
CONCLUSION
ACKNOWLEDGMENT
REFERENCES
Chapter 24 Fluid Management
INTRODUCTION
PHYSIOLOGY OF FLUID BALANCE
FLUID REPLACEMENT SOLUTIONS
HEMODYNAMIC MONITORING FOR FLUID RESPONSIVENESS
PERIOPERATIVE FLUID STRATEGIES FOR OPTIMAL VOLUME STATUS
CONCLUSIONS
ACKNOWLEDGMENT
REFERENCES
Chapter 25 Blood Therapy
BLOOD BANKING ESSENTIALS
BLOOD COMPONENTS
PATIENT BLOOD MANAGEMENT AND THE DECISION TO TRANSFUSE RED BLOOD CELLS
COMPLICATIONS OF BLOOD THERAPY
AUTOLOGOUS BLOOD TRANSFUSIONS
CONCLUSIONS AND FUTURE DIRECTIONS
REFERENCES
Section IV Special Anesthetic Considerations
Chapter 26 Cardiovascular Disease
CORONARY ARTERY DISEASE
VALVULAR HEART DISEASE
DISTURBANCES OF CARDIAC CONDUCTION AND RHYTHM
HEART FAILURE
HYPERTROPHIC CARDIOMYOPATHY
PULMONARY HYPERTENSION
CARDIAC TAMPONADE
ANEURYSMS OF THE AORTA
CARDIOPULMONARY BYPASS
ACKNOWLEDGMENTS
REFERENCES
Chapter 27 Chronic Pulmonary Disease
INTRODUCTION
ASTHMA
CHRONIC OBSTRUCTIVE PULMONARY DISEASE
INTERSTITIAL LUNG DISEASE
CYSTIC FIBROSIS
OBSTRUCTIVE SLEEP APNEA (ALSO SEE CHAPTER 48)
PULMONARY HYPERTENSION
ANESTHESIA FOR LUNG RESECTION
MEDIASTINOSCOPY
MEDIASTINAL MASSES
REFERENCES
Chapter 28 Renal, Liver, and Biliary Tract Disease
RENAL DISEASE
LIVER DISEASE
DISEASES OF THE BILIARY TRACT
REFERENCES
Chapter 29 Nutritional, Gastrointestinal, and Endocrine Disease
NUTRITIONAL DISORDERS
GASTROINTESTINAL DISORDERS
ENDOCRINE DISORDERS
REFERENCES
Chapter 30 Central Nervous System Disease
NEUROANATOMY
NEUROPHYSIOLOGY
INTRACRANIAL PRESSURE AND BRAIN RELAXATION
NEUROPROTECTION
NEUROPHYSIOLOGIC MONITORING
ANESTHESIA FOR NEUROSURGERY
COMMON CLINICAL CASES
REFERENCES
Chapter 31 Ophthalmology and Otolaryngology
OPHTHALMOLOGY
OTOLARYNGOLOGY
REFERENCES
Chapter 32 Orthopedic Surgery
RHEUMATOLOGIC DISORDERS
SPINE SURGERY
SURGERY IN THE SITTING POSITION
FRACTURED HIP
TOTAL JOINT REPLACEMENT
REFERENCES
Chapter 33 Obstetrics
PHYSIOLOGIC CHANGES IN PREGNANT WOMEN
PHYSIOLOGY OF THE UTEROPLACENTAL CIRCULATION
STAGES OF LABOR
ANATOMY OF LABOR PAIN
METHODS OF LABOR ANALGESIA
NEURAXIAL TECHNIQUES
CONTRAINDICATIONS OF NEURAXIAL ANESTHESIA
COMPLICATIONS OF NEURAXIAL ANESTHESIA
ANESTHESIA FOR CESAREAN DELIVERY
ABNORMAL PRESENTATIONS AND MULTIPLE BIRTHS
HYPERTENSIVE DISORDERS OF PREGNANCY
HEMORRHAGE IN PREGNANT WOMEN
AMNIOTIC FLUID EMBOLISM
ANESTHESIA FOR NONOBSTETRIC SURGERY DURING PREGNANCY
DIAGNOSIS AND MANAGEMENT OF FETAL DISTRESS
EVALUATION OF THE NEONATE AND NEONATAL RESUSCITATION
REFERENCES
Chapter 34 Pediatrics
DEVELOPMENTAL PHYSIOLOGY
PHARMACOLOGIC DIFFERENCES
FLUIDS AND ELECTROLYTES
TRANSFUSION THERAPY
PEDIATRIC AIRWAY
ANESTHETIC CONSIDERATIONS
MEDICAL AND SURGICAL DISEASES AFFECTING THE NEONATE
CONGENITAL HEART DISEASE
SPECIAL ANESTHETIC CONSIDERATIONS
REFERENCES
Chapter 35 Geriatrics
INTRODUCTION
THE PHYSIOLOGIC CHANGES OF AGING
PHARMACOLOGIC CONSIDERATIONS
PREOPERATIVE ASSESSMENT AND RISK MANAGEMENT
INTRAOPERATIVE CONSIDERATIONS
POSTOPERATIVE MANAGEMENT
CHRONIC PAIN IN THE ELDERLY
PERIOPERATIVE NEUROCOGNITIVE DISORDERS
SUMMARY
ACKNOWLEDGMENT
REFERENCES
Chapter 36 Organ Transplantation
CONSIDERATIONS FOR ORGAN TRANSPLANTATION
KIDNEY TRANSPLANTATION
LIVER TRANSPLANTATION
HEART TRANSPLANTATION
LUNG TRANSPLANTATION
PANCREAS TRANSPLANTATION
CONCLUSION
REFERENCES
Chapter 37 Outpatient Anesthesia
INTRODUCTION
PATIENT SELECTION
SURGERIES AND PROCEDURES
PREOPERATIVE EVALUATION
ANESTHETIC TECHNIQUES
POSTOPERATIVE CARE
QUALITY IMPROVEMENT
ADVANCES AND NEW TRENDS IN OUTPATIENT ANESTHESIA
CONCLUSION
REFERENCES
Chapter 38 Anesthesia for Procedures in NonOperating Room Locations
CHARACTERISTICS OF NORA LOCATIONS
SAFETY AND CONCERNS IN RADIOLOGY SUITES
MAGNETIC RESONANCE IMAGING
ANESTHESIA FOR NONINVASIVE IMAGING PROCEDURES
INTERVENTIONAL RADIOLOGY
ENDOSCOPY AND ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY
CATHETER-BASED CARDIOLOGY PROCEDURES
ELECTROCONVULSIVE THERAPY
REFERENCES
Section V The Recovery Period
Chapter 39 Postanesthesia Recovery
ADMISSION TO THE POSTANESTHESIA CARE UNIT
EARLY POSTOPERATIVE PHYSIOLOGIC CHANGES
UPPER AIRWAY OBSTRUCTION
PULMONARY EDEMA IN THE PACU
MONITORING AND TREATMENT OF HYPOXEMIA
HEMODYNAMIC INSTABILITY
RENAL DYSFUNCTION
POSTOPERATIVE HYPOTHERMIA AND SHIVERING
POSTOPERATIVE NAUSEA AND VOMITING
DELIRIUM
DELAYED AWAKENING
DISCHARGE CRITERIA
POSTANESTHESIA SCORING SYSTEMS
REFERENCES
Chapter 40 Perioperative Pain Management
COMMON TERMINOLOGY
NEUROBIOLOGY OF PAIN
ANALGESIC DELIVERY SYSTEMS
SYSTEMIC THERAPY
NEURAXIAL ANALGESIA (ALSO SEE CHAPTER 17)
SURGICAL SITE (INCISION) INFILTRATION
INTRAARTICULAR ADMINISTRATION
PARAVERTEBRAL BLOCKS
PERIPHERAL NERVE BLOCK
REGIONAL ANALGESIA
TRANSVERSUS ABDOMINIS PLANE BLOCK
REFERENCES
Section VI Consultant Anesthetic Practice
Chapter 41 Critical Care Medicine
ICU DEFINITIONS, INTERPROFESSIONAL CARE, AND PHYSICIAN STAFFING
ORGAN FAILURE AND SUPPORT
A-F BUNDLE
ACKNOWLEDGMENT
REFERENCES
Chapter 42 Perioperative Medicine
INTRODUCTION
THE PERIOPERATIVE MEDICINE CONSULTANT
IMPROVING PERIOPERATIVE OUTCOMES AND OPERATIONALIZING PERIOPERATIVE MEDICINE
VALUE-ADDED PREOPERATIVE SCREENING AND TESTING
MEDICAL MANAGEMENT OF THE MOST COMMON COMORBIDITIES
PSYCHOLOGICAL STATE: ASSESSMENT AND INTERVENTIONS
COGNITIVE SCREENING AND INTERVENTIONS (ALSO SEE CHAPTER 35)
HEALTH LITERACY AND SHARED DECISION MAKING
OTHER OPPORTUNITIES TO IMPROVE PERIOPERATIVE OUTCOMES
FUTURE DIRECTIONS IN PERIOPERATIVE MEDICINE: SOCIAL DETERMINANTS OF HEALTH
REFERENCES
Chapter 43 Anesthesia for Trauma
INTRODUCTION
INITIAL MANAGEMENT
INTRAOPERATIVE MANAGEMENT
SPECIAL CONSIDERATIONS
ACKNOWLEDGMENT
REFERENCES
Chapter 44 Chronic Pain Management
INTRODUCTION
CHRONIC PAIN FOUNDATIONS
PAINFUL CONDITIONS: SPINE
PAINFUL CONDITIONS: NEUROPATHIC PAIN
PAINFUL CONDITIONS: CHRONIC POSTSURGICAL PAIN
PAIN CONDITIONS: ADDITIONAL GENERATORS
PSYCHOLOGICAL TREATMENT PILLAR: CATASTROPHIZING
PHYSICAL MEDICINE TREATMENT PILLAR
PHARMACOLOGIC TREATMENT PILLAR
PROCEDURAL TREATMENT PILLAR
NEUROMODULATION: ADVANCED INTERVENTIONAL PAIN MEDICINE
SUMMARY
ACKNOWLEDGMENT
REFERENCES
Chapter 45 Cardiopulmonary Resuscitation
INTRODUCTION
EVIDENCE BASED
PRINCIPLES OF MANAGEMENT
REFERENCES
Chapter 46 Quality and Patient Safety in Anesthesia Care
INTRODUCTION
DEFINITIONS: QUALITY VERSUS SAFETY
SPECIFIC APPROACHES TO ANESTHESIA SAFETY
FROM SAFETY TO QUALITY: MAKING ANESTHESIA BOTH SAFER AND BETTER
TOOLS FOR IMPROVING LOCAL OUTCOMES
SUMMARY
REFERENCES
Chapter 47 Palliative Care
INTRODUCTION
WHAT DO PALLIATIVE CARE TEAMS DO?
PALLIATIVE CARE AND PAIN
CHALLENGES IN THE PALLIATIVE CARE PATIENT
PERIOPERATIVE MANAGEMENT OF THE PALLIATIVE CARE PATIENT
CONCLUSION
REFERENCES
Chapter 48 Sleep Medicine and Anesthesia
INTRODUCTION
BASIC SLEEP PHYSIOLOGY
GENERAL ANESTHESIA
OTHER AROUSAL STATES
SLEEP AND ANESTHESIA STATES
FUNCTIONAL NEUROANATOMY OF SLEEP AND AROUSAL PATHWAYS
SLEEP-DISORDERED BREATHING OR SLEEP-RELATED BREATHING DISORDERS
OBSTRUCTIVE SLEEP APNEA
CONCLUSION
REFERENCES
Chapter 49 Anesthesia and Environmental Health
HEALTH, HEALTH CARE, AND CLIMATE CHANGE
ENVIRONMENTAL IMPACT OF ANESTHESIA GASES
OCCUPATIONAL HAZARDS OF INHALED ANESTHETICS
LOW-FLOW ANESTHESIA
CLOSED-CIRCUIT ANESTHESIA
CO2 ABSORBENTS
WASTE ANESTHETIC GAS SCAVENGING SYSTEMS
ENVIRONMENTAL IMPACT OF PROPOFOL
DRUG WASTE
ENVIRONMENTAL IMPACT OF OPERATING ROOM PRACTICES
SUMMARY
REFERENCES
Index

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Manuel Pardo