Pocket Anesthesia (Pocket Notebook)

 

Description:

 

Providing fast access to the most relevant, evidence-based information in all areas of anesthesiology, Pocket Anesthesia, Fourth Edition, is a practical, up-to-date resource for residents, anesthesiologists, CRNAs, and medical students—both on the wards and in the operating room. This concise handbook, now spiral-bound, is designed for portability and quick reference, with information presented in a bulleted, outline format throughout. The Pocket Notebook Series format is ideal for today's fast-paced health care environment. Information is presented in a schematic, outline format, with diagrams and tables for quick, easy reference.

 

 

Table of Contents:

 

CONTENTS

PREOPERATIVE PATIENT EVALUATION

INTRODUCTION

PREOPERATIVE PHYSICAL EXAMINATION

PREOPERATIVE LABORATORY TESTING

ELECTROCARDIOGRAM (ECG) TESTING

CARDIAC RISK STRATIFICATION

INFECTIVE ENDOCARDITIS (IE) ANTIBIOTIC PROPHYLAXIS

PERIOPERATIVE β-BLOCKER THERAPY

STATINS

STENTS & ANTIPLATELET AGENTS

CONDITIONS WHICH MAY REQUIRE DELAY OF SURGERY FOR OPTIMIZATION

MEDICATIONS REQUIRING SPECIAL CONSIDERATIONS IN THE PERIOPERATIVE PERIOD

INHALED ANESTHETICS

INTRODUCTION

INHALED ANESTHETIC UPTAKE

MAJOR FACTORS AFFECTING UPTAKE

Solubility

Cardiac Output

Alveolar–Venous Concentration Gradient

OTHER FACTORS INFLUENCING UPTAKE

Factors That Speed Rate of Induction (↑ Fa/Fi)

ELIMINATION/RECOVERY

DIFFUSION HYPOXIA

MINIMUM ALVEOLAR CONCENTRATION (MAC)

CLINICAL CONSIDERATIONS OF INHALED ANESTHETICS

SYSTEMIC EFFECTS OF INHALED AGENTS

INHALATIONAL ANESTHETICS, SPECIFIC COMMENTS

Nitrous Oxide (N2O)

Isoflurane

Desflurane

Sevoflurane

Halothane

Heliox (Helium–Oxygen Combination)

INTRAVENOUS ANESTHETICS

INTRODUCTION

GENERAL PRINCIPLES

PROPOFOL (DIPRIVAN)

ETOMIDATE (AMIDATE)

SODIUM THIOPENTAL (PENTOTHAL)

METHOHEXITAL (BREVITAL)

KETAMINE (KETALAR)

DEXMEDETOMIDINE

BENZODIAZEPINES (SEE TABLE—PHARMACOLOGY OF COMMONLY ENCOUNTERED BENZODIAZEPINES)

ANALGESICS

OPIOIDS (SEE ALSO CHAPTER 13, ACUTE PAIN MANAGEMENT)

General Comments

Fentanyl (Sublimaze IV, Fentora Buccal, Actiq Lozenge, Duragesic Transdermal)

Remifentanil (Ultiva)

Sufentanil (Sufenta)

Alfentanil (Alfenta)

Morphine (Astramorph, Duramorph, MS Contin, Others)

Hydromorphone (Dilaudid)

Meperidine (Demerol)

Methadone (Dolophine)

Oxycodone

Codeine

NMDA RECEPTOR ANTAGONIST & OPIATE AGONISTS

Ketamine (Ketalar)

Tramadol (Ultram)

OPIATE ANTAGONISTS (SEE CHAPTER 2H)

TRANSDERMAL/TOPICAL MEDICATIONS

Fentanyl Transdermal (Duragesic)

Lidocaine Patch, 5% (Lidoderm)

NONSTEROIDAL ANTI-INFLAMMATORY DRUGS (NSAIDS)

NONSELECTIVE COX INHIBITORS

Acetaminophen (Tylenol, Paracetamol, Ofirmev)

Propionic Acid Derivatives: Ibuprofen, Naproxen, Ketoprofen, Diclofenac

Ketorolac (Toradol)

Aspirin, Acetylsalicylic Acid

SELECTIVE COX-2 INHIBITORS

Celecoxib (Celebrex)

LOCAL ANESTHETICS

MECHANISM OF ACTION

STRUCTURE & CLASSIFICATION

PHARMACODYNAMICS

SPECIFIC CONSIDERATIONS

Chloroprocaine

Lidocaine

Bupivacaine

Liposomal Bupivacaine (Exparel®)

Ropivacaine

Tetracaine

Cocaine

Topical Anesthesia for Minor Procedures (Pediatric IV Placement)

ADDITIVES TO ENHANCE LOCAL ANESTHETICS

LOCAL ANESTHETIC SYSTEMIC TOXICITY (LAST)

LA Toxicity Treatment

Methemoglobinemia (Normal Hemoglobin Oxidized to Methemoglobin)

NEUROMUSCULAR BLOCKING DRUGS AND REVERSAL AGENTS

MECHANISM

Nondepolarizing: Aminosteroids

Nondepolarizing: Benzylisoquinolines

Depolarizing: Succinylcholine

ANTAGONISM OF NONDEPOLARIZING NEUROMUSCULAR BLOCKADE

Cholinesterase Inhibitors

Physostigmine

Sugammadex (Bridion®)

VASOACTIVE, AUTONOMIC, AND CARDIOVASCULAR DRUGS

INTRODUCTION

ADRENERGIC AGONISTS AND VASOPRESSORS

Dobutamine (Dobutrex)

Dopamine (Intropin)

Ephedrine (Generic)

Epinephrine (Adrenaline)

Isoproterenol (Isuprel)

Phenylephrine (Neosynephrine)

Norepinephrine (Levarterenol, Levophed)

Vasopressin (Antidiuretic Hormone [ADH], Pitressin)

Angiotensin II (Giapreza)

PHOSPHODIESTERASE INHIBITORS

Amrinone (Inocor, Inamrinone)

Milrinone (Primacor)

ADRENERGIC ANTAGONISTS

α-Blockers

Phenoxybenzamine (Dibenzyline)

Phentolamine (Regitine, OraVerse)

β-Blockers

Labetalol (Normodyne, Trandate)

Metoprolol (Lopressor, Toprol XL extended release)

Esmolol (Brevibloc)

Propranolol (Inderal)

α-AGONISTS

Clonidine (Catapres)

Methyldopa (Aldomet)

CALCIUM CHANNEL BLOCKERS (CCB)

Diltiazem (Cardizem)

Verapamil (Isoptin, Calan)

Nicardipine (Cardene)

Nifedipine (Procardia)

Clevidipine (Cleviprex)

VASODILATORS

Fenoldopam (Corlopam)

Hydralazine (Apresoline)

Isosorbide Dinitrate (Isordil)

Nitroglycerin (Tridil, Glycerol Trinitrate, Nitrostat, Nitrol, Nitro-Bid, Nitrolingual)

Nitroprusside Sodium (Nipride, Nitropress)

ANTIARRHYTHMICS

Adenosine (Adenocard)

Amiodarone (Cordarone)

Lidocaine (Xylocaine)

Procainamide (Pronestyl)

HEART FAILURE

Digoxin (Lanoxin)

Nesiritide (B-Type Natriuretic Peptide, BNP, Natrecor)

PHARMACOLOGY: ANTIBIOTICS AND HERBAL MEDICINES

KEY POINTS

ANTIBIOTICS FOR SURGICAL SITE INFECTION PROPHYLAXIS (PREINCISION DOSING)

PROCEDURE-SPECIFIC SURGICAL PROPHYLACTIC ANTIBIOTIC RECOMMENDATIONS

HERBAL MEDICINES AND SIDE EFFECTS

OTHER DRUGS RELEVANT TO PRACTICE OF ANESTHESIA

5HT3 ANTAGONISTS (ONDANSETRON, GRANISETRON, DOLASETRON)

AMISULPRIDE

ABCIXIMAB (REOPRO)

ACARBOSE (PRECOSE)

ACETAZOLAMIDE (DIAMOX)

ALBUTEROL (PROVENTIL, VENTOLIN)

ALVIMOPAN (ENTEREG)

AMINOCAPROIC ACID (AMICAR)

ANDEXANET ALFA (ANDEXXA; RECOMBINANT FACTOR XA)

APIXABAN (ELIQUIS)

ARGATROBAN (ACOVA)

ATROPINE SULFATE

BICARBONATE (SODIUM BICARBONATE)

BICITRA (SODIUM CITRATE/CITRIC ACID)

BIVALIRUDIN (ANGIOMAX)

BOSENTAN (TRACLEER)

BUMETANIDE (BUMEX)

BUPRENORPHINE + NALOXONE (SUBOXONE)

CALCIUM CHLORIDE (CaCl2); CALCIUM GLUCONATE (KALCINATE)

CANAGLIFLOZIN (INVOKANA)

CARBOPROST TROMETHAMINE (HEMABATE, 15-METHYL PROSTAGLANDIN F2α)

CLOPIDOGREL (PLAVIX)

CHLORAL HYDRATE (SOMNOTE)

CHLOROTHIAZIDE (DIURIL)

DABIGATRAN (PRADAXA)

DALTEPARIN (FRAGMIN)

DANTROLENE (DANTRIUM)

DESMOPRESSIN ACETATE (DDAVP)

DEXAMETHASONE (DECADRON)

DIPHENHYDRAMINE (BENADRYL)

DOLASETRON (ANZEMET)

DROPERIDOL (INAPSINE)

ENOXAPARIN (LOVENOX, LMWH)

EPINEPHRINE, RACEMIC (VAPONEFRIN)

EPOPROSTENOL (FLOLAN, PROSTACYCLIN, PROSTAGLANDIN I2 [PGI2])

EPTIFIBATIDE (INTEGRILIN)

ETHACRYNIC ACID (EDECRIN)

EXENATIDE (BYETTA)

FACTOR VIIA (NOVOSEVEN)

FAMOTIDINE (PEPCID)

FLUMAZENIL (MAZICON)

FUROSEMIDE (LASIX)

GLIPIZIDE (GLUCOTROL)

GLUCAGON (GLUCAGEN)

GLYBURIDE (DIABETA)

GLYCOPYRROLATE (ROBINUL)

GRANISETRON (GRANISOL, KYTRIL)

HALOPERIDOL (HALDOL)

HEPARIN, UNFRACTIONATED (UFH)

HIGHLY ACTIVE ANTIRETROVIRAL THERAPY (HAART)

HYDROCHLOROTHIAZIDE (HCTZ, MICROZIDE)

HYDROCORTISONE (SOLU-CORTEF)

HYDROXYZINE (VISTARIL, ATARAX)

IDARUCIZUMAB (PRAXBIND)

INDIGO CARMINE

INDOCYANINE GREEN (CARDIO-GREEN)

INSULIN, REGULAR

IPRATROPIUM BROMIDE (ATROVENT)

LEVETIRACETAM (KEPPRA)

LEVOTHYROXINE (SYNTHROID, T4)

LIRAGLUTIDE (VICTOZA)

MAGNESIUM SULFATE (MgSO4)

MANNITOL (OSMITROL)

METFORMIN (GLUCOPHAGE)

METHYLERGONOVINE (METHERGINE)

METHYLENE BLUE (METHYLTHIONINE CHLORIDE, UROLENE BLUE)

METHYLPREDNISOLONE (SOLU-MEDROL)

METHYLNALTREXONE (RELISTOR)

METOCLOPRAMIDE (REGLAN)

Naloxone (Narcan)

NITRIC OXIDE, INHALED (NO, iNO, INOMAX)

OCTREOTIDE (SANDOSTATIN)

OMEPRAZOLE (PRILOSEC)

ONDANSETRON (ZOFRAN)

ANTIDIABETICS

OXYTOCIN (PITOCIN)

PHENYTOIN (DILANTIN)

PHOSPHORUS (PHOSPHO-SODA, NEUTRA-PHOS)

PHYSOSTIGMINE (ANTILIRIUM)

PIOGLITAZONE (ACTOS)

POTASSIUM CHLORIDE (KCl, KDUR)

PRASUGREL (EFFIENT)

PROCHLORPERAZINE (COMPAZINE)

PROMETHAZINE (PHENERGAN)

PROSTAGLANDIN E1 (ALPROSTADIL, PROSTIN VR)

PROTAMINE SULFATE

RECOMBINANT FACTOR VIIA (NOVOSEVEN)

REPAGLINIDE (PRANDIN)

RIVAROXABAN (XARELTO)

ROSIGLITAZONE (AVANDIA)

SCOPOLAMINE PATCH (TRANSDERM SCÓP)

SCOPOLAMINE INJECTION (HYOSCINE)

SILDENAFIL (VIAGRA, REVATIO)

SITAGLIPTIN (JANUVIA)

SPIRONOLACTONE (ALDACTONE)

THAM

TISSUE PLASMINOGEN ACTIVATOR (ALTEPLASE, ACTIVASE, TPA)

TRANEXAMIC ACID/TXA (CYKLOKAPRON)

TROMETHAMINE (THAM ACETATE)

VITAMIN K (PHYTONADIONE, AQUAMEPHYTON)

WARFARIN (COUMADIN)

ANESTHESIA EQUIPMENT

GAS SUPPLY

Oxygen: Path of Hospital Supply to Patient

ANESTHESIA MACHINE (1SEE APPENDIX B FOR CHECKOUT RECOMMENDATIONS)

BREATHING CIRCUIT: CONNECTS ANESTHESIA MACHINE TO PATIENT

Closed-Circuit Anesthesia

Airway Pressures

Management of Increased Airway Pressures

Open Breathing Systems (Historical, Not Typically Used in Modern Medicine)

Mapleson Breathing Circuits A to E: Five Systems Described in 1950s

Bain Circuit: Modification of Mapleson D

ELECTRICAL SAFETY IN THE OR

Electrosurgery

Risk of Electrocution

Ungrounded Power & Protection from Electric Shock

AIRWAY MANAGEMENT

INTRODUCTION

AIRWAY ASSESSMENT

AIRWAY DEVICES

AIRWAY MANAGEMENT: OROTRACHEAL INTUBATION

AIRWAY MANAGEMENT: NASOTRACHEAL INTUBATION

AIRWAY MANAGEMENT: AWAKE FLEXIBLE FIBEROPTIC INTUBATION

TRANSTRACHEAL PROCEDURES

TECHNIQUES OF EXTUBATION

DIFFICULT AIRWAY ALGORITHM

ANESTHESIA TECHNIQUES

INTRODUCTION

PATIENT INTERVIEW AND EVALUATION

PREMEDICATION

ANESTHESIA TECHNIQUES: (GOALS)

MONITORED ANESTHESIA CARE VS. GENERAL ANESTHESIA: ASA DEFINITIONS

FLUMAZENIL (FOR ANTAGONISM OF BENZODIAZEPINE EFFECTS)

INHALATIONAL INDUCTION

Pediatric Technique

Adult Inhalational Induction

INTRAMUSCULAR INDUCTION

RECTAL INDUCTION

Characteristics

Technique

COMPONENTS OF ANESTHESIA

“BALANCED ANESTHETIC” TECHNIQUE

MONITORING OF NEUROMUSCULAR BLOCKADE/PARALYSIS

Technique

Train of Four

Tetanic Stimulation

Double-Burst Stimulation

Post-tetanic Count

Phase II Blockade with Succinylcholine

AWARENESS

Frequency of Awareness (from Prospective Study of 11,785 General Anesthetics)

BRAIN FUNCTION MONITORING, DEPTH OF ANESTHESIA, AND AWARENESS

BRAIN FUNCTION MONITORING & ANALGESIA

TOTAL INTRAVENOUS ANESTHESIA (TIVA)

GUIDELINES FOR USING PROPOFOL

Induction of General Anesthesia

Maintenance of General Anesthesia

Sedation

EXTUBATION & EMERGENCE

Deep Extubation

REGIONAL ANESTHESIA

PERIPHERAL NERVE BLOCKS

Introduction

Preparation and Materials

Contraindications—Similar to Those for Neuraxial Blockade

Complications—Common to All Nerve Blocks

General Considerations for Quality Improvement and Safety without US

Ultrasound Basics

Transducer Selection

Imaging Plane

Sonographic Appearance of Nerves

General Considerations for Quality Improvement and Safety

SUPERFICIAL CERVICAL PLEXUS (SCP) AND DEEP CERVICAL PLEXUS (DCP) BLOCKS

BRACHIAL PLEXUS BLOCKS

Interscalene Brachial Plexus Block

Indications

Supraclavicular Brachial Plexus Block

Infraclavicular Brachial Plexus Block

Axillary Brachial Plexus Block

Distal Blocks of Peripheral Nerves of Upper Extremity (see Figure 6-2 for anatomy)

DIGITAL NERVE BLOCK (UPPER EXTREMITY)

LOWER-EXTREMITY BLOCKS

Lumbar Plexus Block

Femoral Nerve Block

Obturator Nerve Block

Lateral Femoral Cutaneous Block

Adductor Canal Block

Sciatic Nerve Block (Classic, Anterior, Subgluteal)

Popliteal Block of Sciatic Nerve

Saphenous Nerve Block

Ankle Block (Fig. 6-4)

INTRAVENOUS REGIONAL ANESTHESIA (BIER BLOCK)

TRUNCAL BLOCKS OF PERIPHERAL NERVES

Intercostal Nerve Blocks

Transversus Abdominis Plane Block (TAP Block)

Thoracic Paravertebral Block (PVB)

SPINAL/EPIDURAL ANESTHESIA

Neuraxial Anatomy (also see Figure 6-5)

Physiologic Effects

Contraindications to Placing a Neuraxial Block

Patient Positioning for Block Placement

SPINAL ANESTHESIA

Continuous Spinal Anesthesia (CSA)

EPIDURAL ANESTHESIA

COMBINED SPINAL–EPIDURAL (CSE) TECHNIQUE

CAUDAL ANESTHESIA

POINT-OF-CARE ULTRASOUND (POCUS)

POINT-OF-CARE ULTRASOUND (POCUS)

FOCUSED CARDIAC ULTRASOUND

Parasternal Long Axis (Fig. 7-1)

Parasternal Short Axis (Fig. 7-2)

Apical Four Chamber (Fig. 7-3)

Subcostal Views (2)

LUNG ULTRASOUND

Ultrasound Artifact Analysis (and Pathology)

Interstitial or Alveolar Disease (e.g., Pulmonary Edema, Consolidation, Contusion)

Pneumothorax

Pleural Effusion

FOCUSED ASSESSMENT WITH SONOGRAPHY IN TRAUMA (FAST)

ULTRASOUND-GUIDED VASCULAR ACCESS

Indications

Ultrasound Views

AIRWAY ULTRASOUND (SEE Fig. 7-7)

PERIOPERATIVE MONITORING

PULSE OXIMETRY

Information in Pulse Oximeter Waveform

NONINVASIVE SPECTROPHOTOMETRIC HEMOGLOBIN MONITORING (e.g., MASIMO® RADICAL-7®)

NEAR-INFRARED CORTICAL SPECTROPHOTOMETRY (e.g., MEDTRONIC INVOSTM, CASMED FORE-SIGHT ELITE®, MASIMO-O3®)

NONINVASIVE BLOOD PRESSURE MONITORING (OSCILLOMETRIC SPHYGMOMANOMETRY)

Causes of Artifacts in NIBP Monitoring

Complications

NONINVASIVE CONTINUOUS BLOOD PRESSURE, SV, SVV, SVR, AND CARDIAC OUTPUT MONITORING (EDWARDS CLEARSIGHT™)

Potential Causes of Artifacts in Noninvasive Continuous Monitoring

Complications

TEMPERATURE MONITORING

Complications of Hyperthermia

Complications of Hypothermia (below 36°C)

Artifacts

Hazards

Placement

Malignant Hyperthermia

ARTERIAL BLOOD PRESSURE (ABP) MONITORING

SAFELY FLUSHING AN ARTERIAL LINE

HAZARDS OF ARTERIAL LINE MONITORING

CENTRAL VENOUS LINES & CENTRAL VENOUS PRESSURE (CVP) MONITORING

Hazards of Central Line Placement

Artifacts

NORMAL CVP & CORRESPONDING ECG WAVEFORM (Fig. 8.2)

INTRAVASCULAR VOLUME MONITORING BY DYNAMIC RESPONSE OF PULSE PRESSURE VARIATION (PPV): PULSION™ PICCO®; AND STROKE VOLUME VARIATION (SVV): EDWARDS™ VIGILEO®, FLO-TRAC® (USING PERIPHERAL ARTERIAL CATHETER, OPTIONAL CENTRAL VENOUS CATHETER)

MEASUREMENT OF CARDIAC OUTPUT (ALSO SEE APPENDIX A)

CONSIDERATIONS FOR PA THERMODILUTION CATHETER INSERTION & MONITORING

NORMAL PA WAVEFORMS AS CATHETER IS PASSED FROM CVP (RA) TO RV TO PA TO PCWP

“V” WAVES IN A WEDGE TRACING

VENTILATION TECHNIQUES

INTRODUCTION AND OVERVIEW

Common Ventilation Modes: Continuous Mandatory Ventilation

MANY ADVANTAGES OF SPONTANEOUS BREATHING VS. POSITIVE-PRESSURE VENTILATION WHILE INTUBATED

CAPNOGRAPHY

Hazards of Capnography

CAPNOGRAPHS (FIG. 9-2)

FLOW–VOLUME LOOPS (FIG. 9-3)

MECHANICAL VENTILATION: PROTECTIVE STRATEGIES

Current Strategies to Prevent Volutrauma, Barotrauma, Atelectrauma, Tracheal Ischemia, & O2 Toxicity

Specific Settings

PRONE VENTILATION FOR SEVERE ARDS

NONINVASIVE VENTILATION (NIV): CPAP VS. BIPAP VS. HIGH-FLOW NASAL CANNULA

DISCONTINUING MECHANICAL VENTILATION (ALSO CALLED WEANING OR LIBERATING FROM MV)

SIMV Plus PS is a Common Weaning Mode in Many ICUs

FLUIDS, ELECTROLYTES, & TRANSFUSION THERAPY

FLUID MANAGEMENT

Fluid Compartments

Assessing Volume Status

Volume Deficits

Volume Replacement

Crystalloids & Colloids

Notes on Specific Fluids

APPROACH TO ACID–BASE ANALYSIS

Strong Ion Difference (Stewart Acid/Base)

ELECTROLYTES

Hyponatremia (Na+ <135 mEq/L)

Hypernatremia (Na+ >145 mEq/L)

Hypokalemia (K <3.5 mEq/L)

Hyperkalemia (K+ >5.5 mEq/L)

Hypocalcemia (Ca2+ <8.4 mg/dL)

Hypercalcemia (Ca2+ >10.3 mg/dL)

Hypomagnesemia (Mg2+ <1.3 mEq/L)

Hypermagnesemia (Mg2+ >2.5 mEq/L)

Hypophosphatemia (PO43- 2.8 mg/dL)

Hyperphosphatemia (PO43- >4.5 mg/dL)

TRANSFUSION THERAPY

Blood Typing Tests

Emergency Transfusion

COMMON BLOOD PRODUCTS

Red Blood Cells (RBC)

Packed Red Blood Cells (PRBC)

Equation for Arterial O2 Content in Blood

Calculating Allowable Blood Loss

Whole Blood

Platelets

Fresh Frozen Plasma (FFP)

Cryoprecipitate

Factor VII (NovoSeven, eptacog alfa)

DDAVP

4-Factor Prothrombin Complex Concentrates

TRANSFUSION COMPLICATIONS

Infectious Complications

Coagulopathic Complications

Transfusion Reactions

Metabolic Complications

Immune Complications—Transfusion-Related Immunomodulation (TRIM)

COAGULATION

Disorders of Coagulation

Coagulation Studies

Platelet Inhibitors

Bleeding Disorders (Coagulopathies)

Hyperfibrinolysis

Heparin-Induced Thrombocytopenia (HIT)

Disseminated Intravascular Coagulation (DIC)

Vitamin K Deficiency

COMMON INTRAOPERATIVE PROBLEMS

HYPOXIA

Actions (Fig. 11-1)

Additional Diagnostic Tests

BRONCHOSPASM

Causes

Investigations

Management

HYPOTENSION

Differential Diagnosis

Investigations

Treatment Options

HYPERTENSION

Differential Diagnosis

Investigations/Treatment Options

HYPERCARBIA

Differential Diagnosis

Investigations/Treatment Options

HYPOCARBIA

Differential Diagnosis

Investigations/Treatment Options

↑ PEAK AIRWAY PRESSURES

Differential Diagnosis

Treatment

OLIGURIA

Differential Diagnosis

Investigations/Treatment Options

MYOCARDIAL ISCHEMIA/INFARCTION

Etiology

Investigations

Treatment Options

MALIGNANT HYPERTHERMIA

BRADYCARDIA

Differential Diagnosis

Investigations/Treatment

TACHYCARDIA

Differential Diagnosis

Treatment Options

DELAYED EMERGENCE

Differential Diagnosis

Investigations/Treatment Options

ANAPHYLAXIS

Differential Diagnosis

Clinical Manifestations

Treatment Options

Prevention

LATEX ALLERGY

Incidence/Risk Factors

Mechanism

Preoperative Evaluation

Equipment/Drug Considerations

Anesthetic Considerations

Treatment

GASTRIC ACID ASPIRATION OR VOMITING UPON INDUCTION OF ANESTHESIA

Clinical Manifestations

Management

COMPLICATIONS OF LARYNGOSCOPY AND INTUBATION

Causes

General Complications

Specific Complications

PROCEDURES IN ANESTHESIA

PERIPHERAL VENOUS ACCESS

Indications

Technique

Complications

RAPID INFUSION CATHETER (RIC LINE)

Indications

Technique

ARTERIAL ACCESS (ALSO SEE CHAPTER 8, ON PERIOPERATIVE MONITORING)

Indications

Technique: Radial Artery

Technique: Brachial Artery

Technique: Axillary Artery

Contraindications

Complications

CENTRAL VENOUS ACCESS (ALSO SEE CHAPTER 8, ON PERIOPERATIVE MONITORING)

Indications

Contraindications

Technique: Internal Jugular Vein (IJ)

Technique: Subclavian Vein (SC)

Technique: Femoral Vein (Fem)

Complications

Ultrasound-Guided Central Line Placement

One-look technique

Real-Time Visualization of IJ

Real-Time Visualization of SC

INSERTION OF A PULMONARY ARTERY CATHETER (PAC) (ALSO SEE CHAPTER 8, ON PERIOPERATIVE MONITORING)

Indications

Contraindications

Technique

Complication: PA Perforation

DECOMPRESSION OF A PNEUMOTHORAX (NEEDLE THORACOSTOMY)

Indication

Technique (Fig. 12-3)

Complications

INSERTION OF A NASOGASTRIC TUBE (NGT)

Indication

Contraindications

Technique

Complications

ACUTE PAIN MANAGEMENT

INTRODUCTION

DEFINITIONS

NORMAL PAIN MECHANISMS & PAIN PATHWAYS

Pain Pathways

PAIN ASSESSMENT & MEASUREMENT

History & Physical Exam (see also Fig. 32-1)

Pain Measurement

ACUTE PAIN MANAGEMENT

Treatment

ANALGESIC DELIVERY SYSTEMS

PO

SC/IM

IV

Patient-Controlled Analgesia (PCA)

Neuraxial Analgesia

Epidural Opioids

Troubleshooting Epidural Catheter Infusions

Intrathecal Opioids

MANAGING SIDE EFFECTS

ACUTE ON CHRONIC PAIN

Opioid Receptor Mixed Agonists/Antagonists

Definitions

PACU MANAGEMENT AND DISCHARGE

HYPOTENSION

Initial Diagnosis & Management

Management of Specific Conditions

Bleeding

HYPERTENSION

Diagnosis and Management

RESPIRATORY AND AIRWAY PROBLEMS

Respiratory Insufficiency: Diagnosis & Management

Respiratory Insufficiency: Management of Specific Conditions

NEUROLOGIC PROBLEMS

Common Problems

POSTOPERATIVE NAUSEA AND VOMITING (PONV)

PACU DISCHARGE CRITERIA

Guidelines for Discharge from Phase 2

Common Discharge Issues

COMPLICATIONS OF ANESTHESIA

INTRODUCTION

PERIPHERAL NERVE INJURY

Classification of Peripheral Nerve Lesions

Anesthesia-related Causes

Duration of Ischemia

Other Factors Impacting Peripheral Nerves

AIRWAY/DENTAL COMPLICATIONS

Airway Complications

Dental Injuries

Burns

Electrocautery/Electrosurgical Unit

Magnetic Resonance Imaging

Perioperative Blindness

ENHANCED RECOVERY AFTER SURGERY (ERAS)

TRAUMA, BURN, AND CRITICAL CARE MANAGEMENT

INTRODUCTION

AIRWAY MANAGEMENT FOR TRAUMA

Intubation Indications

Intubation Considerations

Induction Considerations

Acute Spinal Cord Injury (ASCI)

Intraoperative Trauma Management

Emergence/Transport

Fluid Resuscitation

Nutrition

Total Parenteral Nutrition (TPN)

Glycemic Control in ICU Patients

BURN MANAGEMENT

Pathophysiology

INTRAOPERATIVE MANAGEMENT: GENERAL CONSIDERATIONS

Anesthesia for Burn Surgery

SEPSIS AND SEPTIC SHOCK

Screening for Early Sepsis

Acute Physiology and Chronic Health Evaluation (APACHE) II Score

Associated Problems in Sepsis

Early Quantitative Fluid Resuscitation

Markers of Resuscitation in Sepsis

MANAGEMENT OF SEPSIS

An Approach to Sedation of ICU Patients

Transfusion of Red Blood Cells (RBCs) in the Critically-Ill Patient

CARDIAC SURGERY

NORMAL CARDIOVASCULAR PHYSIOLOGY

Cardiac Cycle: Definitions & Equations

COMMON DISEASE STATES AFFECTING THE HEART

Determinants of Myocardial Perfusion

Hypertension (HTN)

Valvular Disease

HEART BLOCKS/ARRHYTHMIAS (SEE CHAPTER 35, ELECTROCARDIOGRAM [ECG] INTERPRETATION)

Bradyarrhythmias—HR <60 bpm

Tachyarrhythmias—HR >100 bpm

Intra-aortic Balloon Pump

CARDIOVASCULAR IMPLANTABLE ELECTRONIC DEVICE (CIED)

Anesthetic Considerations for Pacemakers

Implantable Cardiac Defibrillator (ICD)

CARDIOPULMONARY BYPASS MACHINE

Cardiopulmonary Bypass Preanesthetic Management

Potential Catastrophes During Bypass

Alpha Stat Vs. pH Stat

Postop Complications

TRANSESOPHAGEAL ECHOCARDIOGRAPHY (TEE)

CARDIAC PHARMACOLOGY (SEE CHAPTER 2F, VASOACTIVE, AUTONOMIC, AND CARDIOVASCULAR DRUGS)

TRANSCATHETER AORTIC VALVE IMPLANTATION (TAVI)/ REPLACEMENT (TAVR)

THORACIC SURGERY

PREOPERATIVE EVALUATION FOR THORACIC SURGERY

COMMON DISEASE STATES OF THE LUNG

COPD

Asthma

Pulmonary Edema

ARDS (see also Chapter 17, Trauma, Burn, and Critical Care Management)

Restrictive Lung Disease

Pulmonary Hypertension Management

LUNG ISOLATION AND ONE-LUNG VENTILATION (OLV)

Double-Lumen Tubes (DLTs)

Bronchial Blockers

Physiology of 1-Lung Ventilation

Anesthesia for 1-Lung Ventilation

Anesthetic Techniques—Specific Surgical Procedures

GENERAL SURGERY

INTRODUCTION

ANESTHETIC CONSIDERATIONS IN ABDOMINAL SURGERY

Preoperative Evaluation

Anesthetic Management

ALCOHOL ABUSE

Preop Evaluation

Anesthetic Considerations

Postop Considerations

ANESTHETIC MANAGEMENT: LIVER SURGERY

General Considerations

Management of Portal Hypertension

Monitoring

Anesthetic Technique

Postop Care

ANESTHETIC MANAGEMENT: LAPAROSCOPIC SURGERY

General Considerations

Anesthetic Technique: Laparoscopic Surgery

Monitoring

Postop Care

LARGE INTESTINAL SURGERY

Indications

Preop Evaluation

Anesthetic Management: Large Intestinal Surgery

Postop Complications

SMALL INTESTINAL SURGERY

Indications

Carcinoid Tumors/Carcinoid Syndrome

Monitoring

Anesthetic Management

Postop Care

PANCREATIC SURGERY

Indications

Monitoring

Anesthetic Management

Postop Care

SPLENIC SURGERY

Indications

Preop Preparation

Anesthetic Management

Postop Care

HEMORRHOIDECTOMY & DRAINAGE OF PERIRECTAL ABSCESS

Anesthetic Management

Postop Care

INGUINAL HERNIORRHAPHY

Anesthetic Management

VENTRAL HERNIORRHAPHY

Preop Considerations

Monitoring

Anesthetic Management

APPENDECTOMY

Preop Evaluation

Anesthetic Management

Postop Care

CHOLECYSTECTOMY

Anesthetic Management

Postop Care

Anesthesia for Aesthetic Surgery

Practice Advisory on Liposuction

BARIATRIC SURGERY

ANESTHETIC MANAGEMENT: BARIATRIC SURGERY

Types of Bariatric Surgery

Preanesthetic Considerations

Anesthetic Technique

Airway Management

Monitoring

Postop Complications

VASCULAR SURGERY

OPEN VASCULAR PROCEDURES

Abdominal Aortic Aneurysm (AAA) Repair

Thoracoabdominal Aortic Aneurysm (TAAA) Repair

Carotid Endarterectomy

ENDOVASCULAR PROCEDURES

Endovascular AAA Repair (EVAR)

Carotid Stent Placement

Distal Angioplasty/Thrombectomy

PERIPHERAL VASCULAR SURGERY

NEUROSURGERY AND ECT

BASIC PRINCIPLES OF NEUROPHYSIOLOGY

Cerebral Metabolic Rate (CMR), Cerebral Blood Flow (CBF), and Autoregulation (Fig. 23-1)

Intracranial Pressure (ICP)

CRANIOTOMY

Anesthetic Management

Awake Craniotomy

INTRACRANIAL VASCULAR SURGERY: ANEURYSM CLIPPING & RESECTION OF ARTERIOVENOUS MALFORMATIONS (AVMS)

Preoperative Evaluation

Induction & Pinning

Maintenance

VENTRICULOPERITONEAL SHUNT PLACEMENT/OMMAYA RESERVOIR

EPIDURAL, SUBDURAL, & INTRACEREBRAL HEMORRHAGE (ICH)

TRAUMATIC BRAIN INJURY

ELECTROCONVULSIVE THERAPY (ECT)

Goals

Agents

Management

INTERVENTIONAL RADIOLOGY

Central Intra-arterial Thrombolysis/Thrombectomy

SPECIFIC NEUROLOGIC DISORDERS

Myasthenia Gravis (MG)

Multiple Sclerosis

Guillain–Barré Syndrome

Parkinson Disease

OTOLARYNGOLOGY (ENT) AND OPHTHALMOLOGY

PROCEDURES IN OTOLARYNGOLOGY

Functional Endoscopic Sinus Surgery (FESS)

CSF Leak Repair

Microdirect/Suspension Laryngoscopy (MDL) & Transbronchoscope ENT Procedures

Medialization Thyroplasty (Vocal Cord Medialization)

PROCEDURES ON THE INNER EAR AND MASTOID

Indications

Special Considerations

Anesthetic Management

Stapedectomy

Myringotomy Tube Placement (Placement of Ear Tubes)

TONSILLECTOMY/PAROTIDECTOMY/UVULOPALATOPHARYNGOPLASTY

Tonsillectomy and Adenoidectomy

Parotidectomy

Uvulopalatopharyngoplasty (UPPP)

TRACHEOSTOMY

Indications

Special Considerations

Anesthetic Management

Management of Existing Tracheostomy

Management of Mature Tracheostomy (>7 d)

Management of Fresh Tracheostomy

PROCEDURES IN OPHTHALMOLOGY

Special Considerations

Special Medications in Ophthalmologic Population

Cataract Surgery: Clear Corneal Phacoemulsification

Strabismus Surgery

Other Procedures

Peribulbar Block (25G–27G, 25-mm needle)

Retrobulbar Block (25G–27G, 3-cm needle)

Subtenon’s Block (25G needle)

RENAL SYSTEM AND UROLOGIC SURGERY

EVALUATION OF RENAL FUNCTION

Acute Kidney Injury

Chronic Renal Failure

ANESTHESIA FOR PATIENTS WITH RENAL DISEASE

Effects of Anesthesia on Renal Function

Indirect Effects of Anesthesia

Direct Effects of Anesthesia

MEDICATIONS TO AVOID OR USE WITH CAUTION IN RENAL FAILURE

UROLOGIC SURGERY

Cystoscopy/Ureteroscopy/TURBT

ORTHOPEDIC SURGERY

GENERAL VS. REGIONAL ANESTHESIA

POSITIONING

SPINE SURGERY

Cervical Spine Surgery

Thoracic/Lumbar Spine Surgery

NEUROMONITORING (ALSO SEE CHAPTER 23, NEUROSURGERY AND ECT)

Types of Monitoring

Factors Affecting Monitoring

COMPLICATIONS IN ORTHOPEDIC SURGERY

ENDOCRINE SURGERY

THYROID GLAND

Hyperthyroidism

Hypothyroidism

PARATHYROID GLANDS

Hyperparathyroidism

Hypoparathyroidism

Pheochromocytoma

DIABETES MANAGEMENT

ADRENAL INSUFFICIENCY

Anesthesia for Adrenal Insufficiency

Excess of Corticosteroids (Cushing Syndrome)

Hyperaldosteronism (Conn Syndrome)

POSTERIOR PITUITARY GLAND

Diabetes Insipidus (DI)

Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Secretion

OBSTETRIC AND GYNECOLOGIC ANESTHESIA

INTRODUCTION

Labor Analgesia and Anesthesia for Cesarean Delivery

Labor Analgesia

Anesthetic Considerations in Labor

Anesthesia for Cesarean Delivery

APGAR SCORE

POSTDURAL PUNCTURE HEADACHE (PDPH)

ANTEPARTUM HEMORRHAGE

Postpartum Hemorrhage (PPH)

DRUGS USED ON THE LABOR AND DELIVERY UNIT

HYPERTENSIVE DISORDERS OF PREGNANCY

Preeclampsia

Nonobstetric Surgery in Pregnancy

ANESTHESIA FOR GYNECOLOGIC SURGERY

PEDIATRIC ANESTHESIA

ANATOMY

Upper Airway

Vascular Access

PHYSIOLOGY

Transition from Fetal to Neonatal Circulation

Respiratory

Cardiovascular

Renal

Hepatic

Gastrointestinal

Hematopoietic

Neurologic

Temperature Regulation

PHARMACOLOGY

Body Fluid Composition

Organ System Maturity

Protein Binding

Receptors

PREOPERATIVE EVALUATION

Psychological Assessment

Neurotoxicity of Anesthetic Agents

OR EQUIPMENT AND SETUP

Intravenous Fluids

Emergency Drugs

ANESTHESIA TECHNIQUES

Induction

Maintenance

CLINICAL CONDITIONS

Respiratory

Secondary Smoke Exposure

Cardiac

Atrial & Ventricular Septal Defects (ASD/VSD)

Metabolic

Gastrointestinal

Pediatric Congenital Syndromes

NEONATAL & PEDIATRIC RESUSCITATION

Neonatal Resuscitation Algorithm

Pediatric Advanced Cardiac Life Support (Also see Chapter 37, Emergency Algorithms)

POSTOPERATIVE NAUSEA & VOMITING

OUTSIDE OF THE OPERATING ROOM ANESTHESIA

GENERAL CONSIDERATIONS AND SAFETY

CT AND MRI

CT: General Considerations

Special Procedures in the CT Suite

MRI: General Considerations

INTERVENTIONAL NEURORADIOLOGY

General Considerations

ENDOSCOPY AND ERCP

General Considerations

CHRONIC PAIN MANAGEMENT

INTRODUCTION

LOW BACK PAIN (LBP)

Strength Testing

Sensory Testing

Interventional Pain Treatment

LUMBAR SPINAL CANAL STENOSIS

Pathophysiology

Evaluation

Treatment

FAILED BACK SURGERY SYNDROME (FBSS)

Pathophysiology

Evaluation

Treatment

OSTEOARTHRITIS VS. RHEUMATOID ARTHRITIS

PERIPHERAL NEUROPATHIC PAIN

ALGORITHM FOR MANAGEMENT OF NEUROPATHIC PAIN

Peripheral Neuropathy

POSTHERPETIC NEURALGIA (PHN)

Symptoms

Evaluation

Treatment

TRIGEMINAL NEURALGIA

Incidence

Etiology

Symptoms

Evaluation

Treatment

COMPLEX REGIONAL PAIN SYNDROME (CRPS)

Signs and Symptoms of CRPS

Treatment

OCCIPITAL NEURALGIA

Etiology

Symptoms

Evaluation

Treatment

HEADACHE

PHANTOM LIMB PAIN

Incidence

Etiology

Treatment

VISCERAL PAIN

Incidence

Symptoms

Evaluation

FIBROMYALGIA

Incidence

Etiology

Symptoms

Evaluation

Treatment

CANCER PAIN

Treatment

ORGAN TRANSPLANTATION

NONLIVING DONORS

Cadaveric Organ Grafts

Non–Heart Beating Organ Donors (NHBD) = Donation after Cardiac Death (DCD)

Organ Preservation Techniques

Intraoperative Management of Procurement

LIVING KIDNEY DONOR

Donor Criteria and Evaluation

Anesthetic Considerations

Surgical Procedure

LIVING LIVER DONOR

Donor Criteria

Pediatric Recipients

Morbidity & Mortality

Surgical Procedure

Anesthetic Considerations

LIVING LUNG DONOR

Morbidity & Mortality

Anesthetic Considerations

Surgical Procedure

ANESTHESIA FOR KIDNEY TRANSPLANTATION

Indications

Preoperative Evaluation

Intraoperative Management

Induction & Maintenance

Surgical Procedure

Specific Intraoperative Considerations

Postoperative Management

ANESTHESIA FOR PANCREAS TRANSPLANTATION

Indications

Preoperative Evaluation

Intraoperative Management

Induction & Maintenance

Specific Intraoperative Considerations

Postoperative Management

ANESTHESIA FOR LIVER TRANSPLANTATION (ALSO SEE CHAPTER 20, GENERAL SURGERY)

General

Preoperative Evaluation

Intraoperative Management

Induction and Maintenance

Postoperative Management

ANESTHESIA FOR LUNG TRANSPLANTATION

Indications

Indications for Heart–Lung Transplantation (HLT)

Bilateral Sequential Lung Transplantation (BSLT)

Living Donor Lung Transplantation (LDLT)

Preoperative Evaluation

Intraoperative Considerations

Induction and Maintenance

Surgical Procedure for Single-Lung Transplantation

Specific Intraoperative Considerations

Postoperative Management

ANESTHESIA FOR HEART TRANSPLANTATION

General Information

Most Common Indications

Preoperative Assessment

Intraoperative Management

Surgical Procedure

Specific Intraoperative Considerations

GERIATRIC ANESTHESIA

GENERAL CONCERNS & CONSIDERATIONS

EFFECTS OF AGING ON PHYSIOLOGY

Cardiovascular System

Pulmonary System

Renal System

Nervous System

Assessing Frailty and Low Physiologic Reserve

PHARMACOLOGY IN THE ELDERLY

Factors Complicating Drug Administration

Anesthetic Agent Selection and Administration

ADDITIONAL PERIOPERATIVE CONSIDERATIONS

Neuraxial/Regional Blocks

Elderly Cognitive Assessment

Postop Delirium (POD) and Periop Neurocognitive Disorder (PND)

ELECTROCARDIOGRAM (ECG) INTERPRETATION

ECG LEAD PLACEMENT & UTILITY

STEPS FOR ECG INTERPRETATION

ATRIOVENTRICULAR CONDUCTION SYSTEM

VENTRICULAR ARRHYTHMIAS

ETHICAL ISSUES & EVENT DISCLOSURE

END-OF-LIFE ISSUES

Pediatric/Minor (<18 y) Patients

JEHOVAH’S WITNESSES (JW)

DISCLOSURE AND APOLOGY—COMMUNICATING ABOUT UNANTICIPATED EVENTS

EMERGENCY ALGORITHMS

ADVANCED CARDIAC LIFE SUPPORT (ACLS)

C-A-B (Chest compressions, Airway, Breathing)

Specific Details (Also see Fig. 37-1)

PEDIATRIC ADVANCED LIFE SUPPORT (PALS) (ALSO SEE CHAPTER 29, PEDIATRIC ANESTHESIA)

RECOGNIZE THE NEED OF CPR

Ventricular Fibrillation/Ventricular Tachycardia (Pulseless)

Asystole and PEA

Bradycardia with Cardiorespiratory Compromise

Tachycardia with Cardiorespiratory Compromise

Acute coronary syndromes: see Figure 37-5

VASCULAR ACCESS/DRUG ADMINISTRATION

COMMON MEDICAL PHRASES IN SPANISH

INTRODUCTION

APPENDIX

APPENDIX A: FORMULAE AND QUICK REFERENCE

CARDIOLOGY

Fick Cardiac Output

Shunts

Valve Area

Coronary Artery Anatomy (see Fig. A-1)

PULMONARY

NEPHROLOGY

HEMATOLOGY

OTHER

SENSITIVITY AND SPECIFICITY CALCULATIONS

Appendix B: ANESTHESIA MACHINE CHECKOUT & SETTING UP THE OR

ANESTHESIA MACHINE CHECKOUT

SETTING UP THE OR FOR A CASE: “SOAP M”

S: Suction

O: Oxygen

A: Airway

P: Pharmacy

M: Machine/Monitors

APPENDIX C: MANAGEMENT OF MALIGNANT HYPERTHERMIA (ALSO SEE CHAPTER 11)

DIAGNOSIS VS. ASSOCIATED PROBLEMS

Signs of MH

Sudden/Unexpected Cardiac Arrest in Young Patients

Trismus or Masseter Spasm with Succinylcholine

ACUTE PHASE TREATMENT

POSTACUTE PHASE

APPENDIX D: COVID-19† CONSIDERATIONS

INTRODUCTION

POOR PROGNOSTIC INDICATORS

PERIOPERATIVE CONSIDERATIONS

AIRWAY RECOMMENDATIONS (OR AND OUT-OF-OR)

INDEX

 

An aparitie	25 July 2020
Autor	Richard D. Urman
Dimensiuni	15.27 x 1.52 x 22.86 cm
Editura	LWW
Format	Paperback
ISBN	9781975136796
Limba	Engleza
Nr pag	415