Practical Anesthetic Management

Description:

As Sir William Osler said “The practice of medicine is an art, based on science”. The authors believe that the art of precision medicine is knowing when the science of medicine should not be applied to your patient. This practical guide to managing patient expectations while maintaining a good medical practice presents as one of the only books of its kind. Written for anesthesiology residents in training, as well as practicing physicians, Practical Anesthetic Management focuses on giving clinicians the tools to create safer, more effective and efficient practices while catering to patient satisfaction. Featuring pearls for teaching purposes, Practical Anesthetic Management also covers topics like preoperative evaluation, tips on blood-gas analysis, and essentials of airway management, all complete with accompanying videos. 

Table of Contents:

Chapter 1: Preoperative Evaluation

Telephone Consultation

Preoperative Anesthetic Evaluation

Anesthesia Consent

Business Card

Surgeon Consultation

Outside Consultations

Chapter 2: Induction of General Anesthesia

Summary

References

Chapter 3: Role of the Laryngeal Mask Airway in Airway Management

Uses of an LMA in Airway Management

As a Substitute for Bag-Mask Ventilation

As a Substitute for an Endotracheal Tube

For Airway Management During Nasal Fiberoptic Intubation

As a Conduit for Fiberoptic Intubation

As a Conduit for Plan C

As a Conduit for Inserting an Endotracheal Tube

As an Emergency Airway in the Field

Failures and Complications

Video Laryngoscopy

Summary

References

Chapter 4: Essentials of Airway Management

Evaluation of the Airway (Video 4.1.)

Preoxygenation

Bag-Mask Ventilation

Standard Endotracheal Intubation (Plan A) (Video 4.2)

What to do if Direct Laryngoscopy (Plan A) Fails; (Plan B)

What to do if Both Plan A and Plan B Fail (Plan C) (Video 4.6)

Plan D (Video 4.10)

Other Devices

Cervical Spine Injury

Extubation Strategy

When is Tracheal Intubation Not Indicated for Respiratory Failure?

Fiberoptic Intubation of the Trachea

Videolaryngoscopy

Tying the Tracheal Tube (Video 4.17)

Insertion of Double-Lumen Tubes (Video 4.18)

References

Chapter 5: Laryngospasm: The Silent Menace

Introduction

Case 1

Case 2

Case 3

Case Discussion

Functional Anatomy of the Larynx

Prevention of Laryngospasm

Treatment of Laryngospasm

Summary

References

Chapter 6: Cricothyrotomy: A Lesson to Be Learned

Summary

Chapter 7: Bronchospasm vs. Bronchoconstriction: A Different View

Introduction

Summary

References

Chapter 8: Management of the Full Stomach

Introduction

Incidence of Pulmonary Aspiration

Consequences of Pulmonary Aspiration

Importance of Fasting

Use of Prophylactic Medications

Gastroesophageal Reflux Disease (GERD)

Hiatal Hernia

Categories of Full Stomach

Preoxygenation

Prevention of Pulmonary Aspiration

Rapid Sequence Induction

Summary

References

Chapter 9: Nitrous Oxide: Yea or Nay

Advantages of Nitrous Oxide

Analgesia

Insolubility

Circulatory Support

Cost

Disadvantages of Nitrous Oxide

Transition States

Presence of Air Cavities

Pulmonary Hypertension

Prolonged Exposure

Laser Surgery

Special Issues

Nausea/Vomiting

Diffusion Hypoxia

Malignant Hyperthermia

ENIGMA Trials

GALA Trial

Greenhouse Gas

Summary

References

Chapter 10: Meperidine: A Forgotten Jewel

History

Pharmacology

Clinical Use

Summary

Addendum

Case 1

Case 2

References

Chapter 11: Sevoflurane: The Best Volatile Anesthetic Ever Developed

Introduction

Historical Development

Pharmacological Properties of Sevoflurane

Solubility

Potency

Optimum Airway Properties

Circulatory Effects

Respiratory Effects

Neuroanesthesia Effects

Renal Effects

Hepatic Effects

Adverse Effects of Sevoflurane

Malignant Hyperthermia

Emergence Dysphoria

Nausea/Vomiting

Seizures

Carbon Monoxide Production

Fire in the Anesthesia Circuit

Summary

References

Chapter 12: The Bariatric Challenge

Introduction

Etiology of Obesity

Classification of Obesity

Medical Management of Obesity

Surgical Management of Obesity

Anesthetic Management

Preoperative Preparation

Intraoperative Management

Positioning

Airway Management

General vs. Regional Anesthesia

Drug Choice and Dosing

Monitoring

Fluid Therapy

Extubation Strategy

Postoperative

Summary

References

Chapter 13: Preventing Ischemic Optic Neuropathy during Posterior Spine Surgery

Incidence

Etiology

Prevention of CRAO

Prevention of ION

Positioning

Management of Blood Pressure

Fluid Therapy

Monitoring for Anemia

Role of Research

The Future

References

Chapter 14: Continuous Spinal Anesthesia: A Lost Art

Patient Selection

Continuous Spinal Technique

Choice of Local Anesthetic

Complications of Continuous Spinal Anesthesia

Summary

References

Chapter 15: Epidural Anesthesia: The Best Technique

Performing an Epidural

Summary

Chapter 16: An Incendiary Issue: Avoiding Operating Room Fires

Introduction

Case One

Case Two

Hospital and Operating Room (OR) Fires

Case Analysis

ASA Advisories

Summary

Reference

Chapter 17: Tension Pneumothorax

Case One

Case Two

Analysis

Chapter 18: Tips on Blood-Gas Analysis

Chapter 19: Preoxygenation

Reference

Chapter 20: Diffusion Hypoxia

Reference

Index