Basics of Anesthesia, 6th Edition

Cover......Page 1
Front matter......Page 2
Copyright......Page 4
Contributors......Page 5
Preface......Page 9
Nitrous Oxide......Page 10
Diethyl Ether......Page 11
Alternatives to Ether......Page 12
Tracheal Intubation......Page 13
Neuromuscular Blocking Drugs......Page 14
Recent Developments......Page 15
Questions of the Day......Page 16
References......Page 17
Definition of Anesthesiology as a Speciality......Page 18
Cardiac Anesthesia (Chapters 25 and 26)......Page 19
Postgraduate (Residency) Training in Anesthesiology......Page 20
Certified Registered Nurse Anesthetists......Page 21
Anesthesia Patient Safety Foundation......Page 22
Professional Liability......Page 23
Risks of Anesthesia......Page 24
References......Page 25
Structured Approach to Anesthesia Care......Page 27
Preoperative Evaluation......Page 28
Managing the Intraoperative Anesthetic......Page 29
Questions of the Day......Page 31
References......Page 32
Purpose of Medical Informatics......Page 33
Standards......Page 34
Security......Page 35
Evidence-Based Medicine......Page 36
Critically Evaluating the Information......Page 37
Perioperative Cardiovascular Evaluation and Testing (Also See Chapter 13)......Page 38
References......Page 39
Pharmacokinetics
......Page 40
Peripheral Volumes of Distribution......Page 41
Metabolism and Clearance......Page 42
First-Order Processes
......Page 45
Compartment Models
......Page 46
The Time Course of Drug Effect
......Page 48
Pharmacodynamics
......Page 49
Receptor Theory
......Page 50
Drug-Drug Interactions
......Page 51
Acknowledgment......Page 52
References......Page 53
Physiologic Approach to Hypotension......Page 55
Frank-Starling Mechanism......Page 56
Afterload
......Page 57
Cardiac Reflexes
......Page 58
Pulmonary Artery Pressure......Page 59
Zones of the Lung......Page 60
Oxyhemoglobin Dissociation Curve......Page 61
Determinants of Alveolar Oxygen Partial Pressure
......Page 62
Intrapulmonary Shunt......Page 63
Hypercapnia
......Page 64
Increased Dead Space......Page 65
Static Properties......Page 66
Central Chemoreceptors......Page 67
Hypercapnic Ventilatory Response......Page 68
Integration of the Heart and Lungs......Page 69
References......Page 70
The Sympathetic Nervous System......Page 71
The Parasympathetic Nervous System......Page 74
Epinephrine
......Page 75
Fenoldopam
......Page 77
Dexmedetomidine
......Page 78
Β-Adrenergic Antagonists
......Page 79
Muscarinic Antagonists......Page 80
Acknowledgment
......Page 81
References
......Page 82
Nitrous Oxide......Page 83
Inhaled Anesthetics Between 1920 And 1940
......Page 84
Isoflurane......Page 85
Central Nervous System Depression and Ion Channels
......Page 86
Variable-Bypass Vaporizers (Also See Chapter 15)
......Page 87
Relative Potency of Inhaled Anesthetics
......Page 88
Inspired Anesthetic Partial Pressure
......Page 89
Solubility
......Page 90
Nitrous Oxide and Methionine Synthase Inactivation......Page 91
Alveolar-To-Venous Partial Pressure Differences
......Page 92
Tissue Concentrations......Page 93
Context-Sensitive Half-Time
......Page 94
Heart Rate......Page 95
Administration with Nitrous Oxide and Oxygen versus 100% Oxygen......Page 97
Ventilation Effects......Page 98
Hypoxic Pulmonary Vasoconstriction
......Page 99
Intracranial Pressure (Also See Chapter 30)
......Page 100
Questions of the Day
......Page 101
References
......Page 102
Propofol
......Page 104
Pharmacokinetics......Page 105
Central Nervous System
......Page 106
Fospropofol
......Page 107
Pharmacokinetics......Page 108
Pharmacodynamics......Page 109
Clinical Uses......Page 110
Physicochemical Characteristics......Page 111
Central Nervous System (Also See Chapter 30)
......Page 112
Respiratory System
......Page 113
Physicochemical Characteristics......Page 114
Induction and Maintenance of Anesthesia
......Page 115
Endocrine System
......Page 116
Pharmacokinetics......Page 117
References
......Page 118
Structure-Activity......Page 120
Mechanism......Page 121
Pharmacokinetics......Page 123
Pharmacodynamics......Page 124
Adverse Effects
......Page 125
Hepatic Failure
......Page 127
Age (Also See Chapter 35)
......Page 128
Morphine
......Page 129
Remifentanil
......Page 130
Rational Drug Selection and Administration......Page 131
References
......Page 132
History
......Page 135
Anesthetic Effect and the Active Form of the Local Anesthetic......Page 136
Sodium Ion Channel State, Anesthetic Binding, and Use-Dependent Block......Page 137
Differential Local Anesthetic Blockade......Page 138
Spread of Local Anesthesia after Injection......Page 140
Systemic Toxicity......Page 141
Central Nervous System Toxicity
......Page 142
Procaine
......Page 143
Mepivacaine
......Page 144
Ropivacaine
......Page 145
References
......Page 146
Neuromuscular Blocking Drugs......Page 148
Neuromuscular Junction
......Page 149
Prejunctional Receptors and Release of Acetylcholine......Page 150
Structure-Activity Relationships
......Page 151
Metabolism......Page 153
Cardiac Dysrhythmias
......Page 154
Increased Intraocular Pressure
......Page 155
Pharmacokinetics......Page 156
Pancuronium......Page 157
Rocuronium......Page 158
Monitoring The Effects Of Nondepolarizing Neuromuscular Blocking Drugs
......Page 159
Patterns of Stimulation......Page 160
Train-Of-Four Stimulation
......Page 161
Tetanus
......Page 162
Anticholinesterase Drugs (Neostigmine)......Page 163
A New Antagonist of Neuromuscular Blocking Drugs30......Page 164
References
......Page 165
History and Physical Examination......Page 167
Co-Morbidities Impacting Administration of Anesthesia......Page 168
Testing
......Page 178
Medications
......Page 180
Fasting
......Page 186
Conclusion
......Page 187
References
......Page 188
Basic Standards for Preanesthesiacare
......Page 191
Anesthetic Technique
......Page 192
Intravenous Induction Of Anesthesia
......Page 193
Characteristics of Inhaled Induction of Anesthesia with Sevoflurane......Page 194
Regional Anesthetic......Page 195
Monitored Anesthesia Care......Page 196
Preparation For Anesthesia
......Page 197
References
......Page 198
Anesthesia Workstation
......Page 200
Compressed Gases......Page 201
Flowmeters......Page 203
Vaporizer Classification and Design......Page 204
Mapleson F (Jackson-Rees) System......Page 206
Flow Characteristics
......Page 207
Bain System......Page 208
Components
......Page 209
Unknown Concentrations of Potent Anesthetic Gases......Page 210
Humidity and Heat Exchange in the Breathing Circuit......Page 211
Humidification......Page 212
Scavenging Systems......Page 213
Soda Lime
......Page 214
Indicators
......Page 215
Checking Anesthesia Machine And Circle System Function
......Page 216
Leak check of the machine´s low-pressure system
......Page 217
Acknowledgment
......Page 218
References
......Page 219
Airway Management......Page 221
History and Anatomic Examination......Page 222
Oropharyngeal Space
......Page 225
Atlanto-Occipital Extension/Neck Mobility
......Page 227
Cricothyroid Membrane and Cricothyrotomy......Page 228
Technique
......Page 229
Cricoid Pressure
......Page 230
Choice of Laryngoscope Blade......Page 231
Endotracheal Tube Sizes
......Page 232
Lighted Stylets......Page 233
Confirmation Of Endotracheal Intubation
......Page 234
Tongue and Oropharynx......Page 235
Nasal Fiberoptic Intubation of the Trachea......Page 236
Bullard Laryngoscope......Page 237
GlideScope......Page 238
Classic Laryngeal Mask Airway......Page 239
LMA CTrach......Page 240
Technique
......Page 241
Cuffed Oropharyngeal Airway......Page 242
Complications......Page 243
Immediate And Delayed Complications After Tracheal Extubation
......Page 244
Airway Differences between Infants and Adults......Page 245
Direct Laryngoscopy and Tracheal Intubation......Page 246
Intubating Laryngeal Airways
......Page 247
Laryngoscopes......Page 248
Lighted Stylets
......Page 249
Croup Or Stridor
......Page 250
Obstructive Sleep Apnea
......Page 251
References
......Page 252
Spinal and Epidural Anesthesia......Page 254
Nomenclature And Features
......Page 255
Surface Landmarks
......Page 257
Dura Mater
......Page 258
Spinal Nerves......Page 259
Subarachnoid Space......Page 260
Epidural Space......Page 261
Artery of Adamkiewicz......Page 262
Venous
......Page 263
Abnormal Coagulation
......Page 264
Spinal Needles......Page 265
Midline Technique
......Page 266
Anesthetic Injection......Page 267
Hypobaric Solutions......Page 268
Neurotoxicity......Page 269
Documentation of Anesthesia......Page 270
Failed Spinal Anesthesia and Repetitive Subarachnoid Injections......Page 271
Treatment......Page 272
Manifestations......Page 273
High Spinal Anesthesia
......Page 274
Epidural Needles......Page 275
Thoracic Epidural
......Page 276
Hanging-Drop Technique
......Page 277
Caudal Anesthesia
......Page 278
Epinephrine
......Page 279
Sympathetic Nervous System Block
......Page 280
Accidental Dural Puncture (``Wet Tap´´) And Headache
......Page 281
Technique......Page 282
Questions of the day
......Page 283
References
......Page 284
Preparation For Nerve Blocks
......Page 286
Ultrasound......Page 287
Nerve Stimulation......Page 288
Brachial Plexus Anatomy
......Page 289
Complications......Page 290
Supraclavicular Block
......Page 291
Axillary Block
......Page 292
Radial Nerve Block......Page 294
Femoral Nerve Block......Page 295
Sciatic Nerve Block (Classic Approach of Labat)......Page 296
Ankle Block......Page 298
Selection of Local Anesthetic......Page 299
Acknowledgment
......Page 300
References
......Page 301
Cardiovascular Concerns
......Page 302
Pulmonary Concerns
......Page 303
Associated Arm Position
......Page 304
Complications
......Page 305
Lithotomy......Page 306
Lateral Decubitus......Page 307
Prone......Page 309
Sitting......Page 311
Peripheral Nerve Injury
......Page 312
Ulnar Nerve......Page 313
Lower Extremity Nerves......Page 315
Perioperative Eye Injury And Visual Loss
......Page 316
Anesthesia Outside The Operating Room
......Page 317
References
......Page 318
Anesthetic Monitoring......Page 321
Normal Electrocardiogram......Page 322
Korotkoff Method......Page 323
Cannulation Site
......Page 324
Technique Of Measurement
......Page 325
Pulmonary Artery Occlusive Pressure......Page 326
Echocardiography
......Page 327
Color Doppler Imaging......Page 328
Evoked Potentials (Also See Chapter 30)
......Page 329
Capnography
......Page 330
Clinical Uses
......Page 331
Raman Scattering Spectrometry......Page 332
References
......Page 333
Methods......Page 334
Methods......Page 335
Acidemia and Acidosis......Page 336
Hemoglobin Buffer System......Page 337
Renal Response......Page 338
pH Electrode......Page 339
Oxygenation......Page 340
Compensatory Responses and Treatment......Page 341
Metabolic Acidosis......Page 342
Compensatory Responses and Treatment......Page 343
Diagnosis......Page 344
Ventilation......Page 345
Alveolar-Arterial Gradient......Page 346
Fick Equation......Page 347
Arteriovenous Difference......Page 348
References......Page 349
Hemostasis......Page 350
Physiologic Control of Coagulation......Page 351
Fibrin Clot Dissolution (Fibrinolysis)......Page 352
Platelet Aggregation Studies......Page 353
Disorders Favoring Bleeding......Page 354
Treatment......Page 355
Phenotypes......Page 356
Thrombocytopenia......Page 357
Diagnosis......Page 358
Clinical Uses......Page 359
Direct Thrombin Inhibitors......Page 360
Preoperative Heparinization......Page 361
An Approach to Patients Receiving Antiplatelet Therapy......Page 362
Coagulation Factor Deficiency......Page 363
References......Page 365
Overview of Fluid and Electrolyte Physiology......Page 366
Crystalloids......Page 367
Hypertonic Salt Solutions......Page 368
Crystalloids versus Colloids......Page 369
Compensatory Intravascular Volume Expansion......Page 370
Liberal versus Restrictive Fluid Management......Page 371
Monitoring Adequacy of Fluid Replacement......Page 372
References......Page 373
Emergency Transfusion......Page 374
Monitoring for Transfusion Indicators (Especially Hemoglobin Concentration)......Page 375
Acute Blood Loss......Page 376
Cryoprecipitate......Page 377
Metabolic Abnormalities......Page 378
Coagulation......Page 379
Predeposited Autologous Donation......Page 380
References......Page 381
Cardiovascular Disease......Page 383
Angina Pectoris......Page 384
Current Medications......Page 385
Risk Stratification versus Risk Reduction......Page 386
Perioperative Cardiac Risk Reduction Therapy......Page 387
Management of Anesthesia......Page 388
Monitoring......Page 389
Maintenance of Anesthesia......Page 390
Neuromuscular Blocking Drugs......Page 391
Postoperative Care......Page 392
Management of Anesthesia......Page 393
Management of Anesthesia......Page 394
Management of Anesthesia......Page 395
Mitral Valve Prolapse......Page 396
Heart Block......Page 397
Management of Anesthesia......Page 398
Artificial Cardiac Pacemakers......Page 399
Induction of Anesthesia......Page 400
Maintenance of Anesthesia......Page 401
Congestive Heart Failure......Page 402
Management of Anesthesia......Page 403
Cardiac Tamponade......Page 404
Management of Anesthesia......Page 405
Cardiopulmonary Bypass......Page 406
Components of the Cardiopulmonary Bypass Circuit......Page 407
Monitoring During Cardiopulmonary Bypass......Page 408
Myocardial Preservation......Page 409
Discontinuation of Cardiopulmonary Bypass......Page 410
Off-Pump Coronary Artery Bypass Graft Surgery......Page 412
Management of Anesthesia......Page 414
References......Page 415
Left-to-Right Shunts......Page 418
Mixing Lesions......Page 419
Eisenmenger´s Syndrome......Page 420
History and Physical Examination......Page 421
Inhalation Induction of Anesthesia......Page 422
Blood Products......Page 425
Cardiopulmonary Bypass......Page 426
Presence of a Residual Mixing Lesion......Page 427
Blood Component and Intravascular Volume Therapy......Page 428
References......Page 429
Chronic Pulmonary Disease......Page 430
Treatment of Asthma and Bronchospasm......Page 431
Intraoperative Bronchospasm......Page 432
Acute Exacerbation of COPD......Page 433
Pathophysiology......Page 434
Postoperative Management......Page 435
Management of Anesthesia......Page 436
Isolation of the Lungs......Page 437
Left-Sided Double-Lumen Tube......Page 438
Right-Sided Double-Lumen Tube......Page 439
Bronchial Blockers......Page 441
Gas Exchange During One-Lung Ventilation......Page 442
Management of One-Lung Ventilation......Page 444
References......Page 446
Renal Blood Flow......Page 448
Prostaglandins......Page 449
Renal Function Tests......Page 450
Creatinine Clearance......Page 451
Dopamine and Fenoldopam......Page 452
Management of Anesthesia in Patients with End-Stage Renal Disease......Page 453
Prerenal Oliguria......Page 454
Extrinsic Determinants of Hepatic Blood Flow......Page 455
Protein Metabolism......Page 456
Renal Dysfunction and Hepatorenal Syndrome......Page 457
Intraoperative Management......Page 458
Management of Anesthesia in Intoxicated Patients......Page 459
Management of Anesthesia......Page 460
References......Page 461
Morbid Obesity......Page 463
Malnutrition......Page 464
Perioperative Considerations......Page 465
Perioperative Considerations......Page 466
Perioperative Considerations......Page 467
Perioperative Considerations......Page 468
Pheochromocytoma and Paraganglioma......Page 469
MEN I......Page 470
Adrenal Insufficiency and Steroid Replacement......Page 471
Cushing's Syndrome......Page 472
References......Page 473
Neuroanatomy......Page 476
Cerebral Metabolic Rate......Page 477
Intracranial Pressure-Volume Relationship......Page 478
Neuroprotection......Page 479
Positioning (Also See Chapter 19)......Page 480
Maintenance of Anesthesia......Page 481
Venous Air Embolism......Page 482
Intracranial Aneurysms......Page 483
Carotid Disease......Page 484
References......Page 485
Ophthalmology......Page 486
Oculocardiac Reflex......Page 487
Anesthetic Options (Table 31-2)......Page 488
Needle-Based Ophthalmic Regional Anesthesia......Page 489
Retina Surgery......Page 490
Postoperative Visual Loss......Page 491
Obstructive Sleep Apnea......Page 492
Tonsillectomy and Adenoidectomy......Page 493
Foreign Body in Airway......Page 494
Laser Surgery......Page 495
Thyroid and Parathyroid Surgery......Page 496
References......Page 497
Airway and Cervical Spine Changes......Page 499
Atlantoaxial Subluxation......Page 500
Superior Migration of the Odontoid......Page 502
Spine Surgery......Page 503
Positioning (Also See Chapter 19)......Page 504
Intraoperative Spinal Cord Monitoring (Also See Chapter 20)......Page 505
Wake-Up Test......Page 506
Surgery in the Sitting Position (Also See Chapter 19)......Page 507
Fractured Hip......Page 508
Total Hip Replacement......Page 509
Total Knee Replacements and Tourniquets......Page 510
Questions of the day......Page 511
References......Page 512
Obstetrics......Page 514
Systemic Vascular Resistance......Page 515
Compensatory Responses and Risks......Page 516
Gastrointestinal Changes......Page 517
Hepatic Changes......Page 518
Fetal Uptake......Page 519
Anatomy of Labor Pain......Page 520
Opioids......Page 521
Adjuvant Neuraxial Drugs......Page 522
Epidural Technique (Also See Chapter 17)......Page 523
Epidural and Combined Spinal-Epidural Dosing and Delivery Techniques......Page 524
Systemic Toxicity and Excessive Blockade (Also See Chapters 11 and 17)......Page 526
Inhaled Analgesia for Vaginal Delivery......Page 527
Epidural Anesthesia......Page 528
Maintenance of Anesthesia......Page 529
Multiple Gestations......Page 531
Preeclampsia......Page 532
Antihypertensive Drugs......Page 533
Massive Hemorrhage......Page 534
Placenta Accreta......Page 535
Anesthesia for Nonobstetric Surgery During Pregnancy......Page 536
Management of Anesthesia......Page 537
Decelerations......Page 538
Cardiopulmonary Resuscitation......Page 539
Glucose......Page 541
Pulmonary Aspiration of Meconium-Stained Amniotic Fluid......Page 542
References......Page 543
Pediatrics......Page 546
Factors Affecting Respiration......Page 547
Fetal Circulation......Page 548
The Neonatal Myocardium......Page 549
Pharmacokinetics......Page 550
Minimum Alveolar Concentration......Page 551
Glucose Administration......Page 552
Recombinant Factor VIIa......Page 553
Difficult Pediatric Airway......Page 554
PREOPERATIVE FASTING GUIDELINES......Page 555
ROUTES OF INDUCTION OF ANESTHESIA......Page 556
REGIONAL ANESTHESIA (Also See Chapters 17 and 18Chapters 1718)......Page 557
BEHAVIORAL RECOVERY......Page 558
Management of Anesthesia......Page 559
Management of Anesthesia......Page 560
Surgical Approaches......Page 561
Congenital Diaphragmatic Hernia......Page 562
Management of Anesthesia......Page 563
Pyloric Stenosis......Page 564
Ex Utero Intrapartum Therapy Procedure and Fetal Surgery......Page 565
References......Page 566
Why Geriatric Anesthesiology is Important......Page 568
Medications to Avoid in the Geriatric Population......Page 569
Age-Related Physiologic Changes......Page 570
Pulmonary Changes......Page 571
Perioperative Care in the Elderly......Page 572
Choice of Anesthesia......Page 573
Intravenous Anesthetics (Also See Chapter 9)......Page 574
Monitored Anesthesia Care (Also See Chapters 37 and 38)......Page 575
Postoperative Neurologic Events......Page 576
Questions of the day......Page 577
References......Page 578
Considerations for Organ Transplantation......Page 580
Intraoperative Management......Page 581
Preoperative Assessment (Also See Chapter 13)......Page 582
Intraoperative Management......Page 583
Postoperative Management (Also See Chapter 39)......Page 584
Intraoperative Management (Also See Chapter 25)......Page 585
Pancreas Transplantation......Page 586
References......Page 587
Outpatient Anesthesia......Page 588
Patient Safety Outside the Hospital......Page 589
Preoperative Evaluation and Testing......Page 590
Goals......Page 591
Five Principles of Outpatient Anesthesia......Page 592
Diabetes Mellitus (Also See Chapter 29)......Page 593
Malignant Hyperthermia......Page 594
Obstructive Sleep Apnea in Adults (Also See Chapter 27)......Page 595
Opioids and Pain in the Care of Surgical Outpatients (Also See Chapter 40)......Page 596
Preoperative Medication (Also See Chapter 13)......Page 597
Unique Roles of the Anesthesiologist and Medical Director (Also See Chapter 45)......Page 598
Acknowledgment......Page 599
References......Page 600
Guidelines for Case and patient Selection......Page 606
Medications to be stocked in each OR anesthesia cart (stocked in sufficient quantities to avoid restocking during the day)......Page 607
An Outcomes Management Program......Page 608
Discharge Criteria and Postdischarge Requirements......Page 612
Procedures Performed Outside the Operating Room......Page 617
Characteristics of remote locations......Page 618
Allergic reactions......Page 619
Computed tomography......Page 620
Compatible Equipment......Page 621
Anticoagulation (Also See Chapters 25 and 26)......Page 622
Alternative Radiation Therapy Delivery Devices......Page 623
Delivery of Electroconvulsive Therapy......Page 624
Physiologic responses to the seizure......Page 625
Cardioversion......Page 626
Management of Anesthesia......Page 627
References......Page 628
Postanesthesia Recovery......Page 629
Loss of Pharyngeal Muscle Tone......Page 630
Residual Neuromuscular Blockade (Also See Chapter 12)......Page 631
Management of Airway Obstruction......Page 632
Alveolar Hypoventilation......Page 633
Increased Venous Admixture......Page 634
Oxygen Delivery......Page 635
Hypovolemia (decreased preload)......Page 636
Low-risk patients......Page 637
Ventricular dysrhythmias......Page 638
Emergence Excitement......Page 639
Rhabdomyolysis......Page 640
High-Risk Patients......Page 641
Discharge criteria......Page 642
References......Page 644
Standard iv......Page 646
Standard v......Page 647
Perioperative Pain Management......Page 648
Common terminology (Also See Chapter 43)......Page 649
Modulation of Nociception......Page 650
Multimodal Approach to Perioperative Recovery......Page 651
Patient-Controlled Analgesia......Page 652
Oral Administration......Page 653
Transmucosal Administration......Page 654
Side Effects of Neuraxial Analgesic Drugs......Page 655
Infection......Page 656
Regional analgesia (Also See Chapter 18)......Page 657
References......Page 658
Critical Care Medicine......Page 661
Pressure support ventilation......Page 662
Evidence-based weaning strategies......Page 663
Disadvantages......Page 664
Sedation and analgesia in the intensive care unit......Page 665
Side effects......Page 666
Ketamine (Also See Chapter 9)......Page 667
Sedative Titration and Weaning from Mechanical Ventilation......Page 668
Treatment......Page 669
Treatment......Page 670
Epinephrine (Also See Chapter 7)......Page 671
Acute renal failure......Page 672
Nutritional support......Page 673
End-of-life issues......Page 674
References......Page 675
Basic principles of trauma care......Page 677
Airway and Breathing (Also See Chapter 16)......Page 678
Circulation and Shock......Page 679
Disability (Neurologic Injury)......Page 680
Preoperative Preparation......Page 681
Abdominal Injuries......Page 682
Community Preparedness......Page 683
Triage of Victims......Page 684
Anesthetic techniques......Page 685
Chemical and biologic terrorism......Page 686
Anthrax......Page 687
Plague......Page 688
Botulism......Page 689
Nerve Agents......Page 691
Questions of the day......Page 692
References......Page 693
Classification of chronic pain......Page 694
Epidemiology......Page 695
Chronic radicular pain......Page 696
Chronic lumbosacral pain......Page 697
Complex regional pain syndrome......Page 698
Acetaminophen and Nonsteroidal Anti-inflammatory Drugs......Page 699
Chronic Opioid Therapy......Page 700
Epidural Injection of Steroids......Page 701
Lumbar Diskography and Intradiscal Treatments......Page 702
Stellate ganglion block......Page 703
Celiac plexus block......Page 706
Lumbar sympathetic block......Page 707
Intrathecal Drug Delivery......Page 708
References......Page 709
Basic life support......Page 711
Airway......Page 712
Breathing......Page 713
Airway management......Page 714
Medications......Page 716
Asystole and pulseless electrical activity......Page 717
Vasopressin......Page 719
Defibrillation......Page 720
Postresuscitation care......Page 721
Mild Hypothermia......Page 722
Local Anesthetic Toxicity (Also See Chapter 11)......Page 723
References......Page 724
Operating Room Management......Page 725
Anesthesiology staffing......Page 726
Operating room efficiency......Page 727
Operating Room Utilization......Page 728
Turnover time......Page 729
Parallel Processing......Page 730
Questions of the day......Page 731
References......Page 732
Incidence......Page 733
Etiology and risk factors for intraoperative awareness......Page 734
Prevention of awareness......Page 735
Brain Function Monitoring......Page 736
The asa's practice advisory on intraoperative awareness and brain function monitors......Page 737
Data from the ASA Closed Claims Project......Page 738
Summary......Page 739
References......Page 740
Quality of Care and Patient Safety......Page 742
ASA Closed Claims Database......Page 743
Root Cause Analysis......Page 744
Preventing Wrong-Site Surgery......Page 745
Labeling syringes......Page 746
Surgical care improvement project......Page 747
Culture of Safety......Page 748
References......Page 749
A......Page 751
B......Page 757
C......Page 760
D......Page 767
E......Page 770
F......Page 773
G......Page 775
H......Page 776
I......Page 778
L......Page 782
M......Page 786
N......Page 789
O......Page 792
P......Page 794
R......Page 801
S......Page 803
T......Page 808
U......Page 810
V......Page 811
W......Page 812
Y......Page 813