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ویرایش: نویسندگان: C. Ronald MacKenzie (editor), Charles N. Cornell (editor), Stavros G. Memtsoudis (editor) سری: ISBN (شابک) : 3030355691, 9783030355692 ناشر: Springer سال نشر: 2020 تعداد صفحات: 473 زبان: English فرمت فایل : PDF (درصورت درخواست کاربر به PDF، EPUB یا AZW3 تبدیل می شود) حجم فایل: 11 مگابایت
در صورت تبدیل فایل کتاب Perioperative Care of the Orthopedic Patient به فرمت های PDF، EPUB، AZW3، MOBI و یا DJVU می توانید به پشتیبان اطلاع دهید تا فایل مورد نظر را تبدیل نمایند.
توجه داشته باشید کتاب مراقبت های حین عمل از بیمار ارتوپدی نسخه زبان اصلی می باشد و کتاب ترجمه شده به فارسی نمی باشد. وبسایت اینترنشنال لایبرری ارائه دهنده کتاب های زبان اصلی می باشد و هیچ گونه کتاب ترجمه شده یا نوشته شده به فارسی را ارائه نمی دهد.
اگرچه تعدادی از متون جامع مربوط به پزشکی بعد از عمل در دسترس است، اما این تنها متنی است که به طور خاص بر روی بیمار تحت عمل جراحی ارتوپدی تمرکز دارد، اکنون در ویرایش دوم بازبینی شده و توسعه یافته است. این کتاب با شروع فصلهایی که ارزیابیهای قبل از عمل و اصول کلی و شیوههای پزشکی بعد از عمل را پوشش میدهد، سپس مدیریت بیهوشی در جراحی ارتوپدی و نقش مدیریت درد پس از عمل را در نظر میگیرد. پس از آن، بخشی در مورد مدیریت پزشکی در تنظیمات بالینی خاص ارائه می شود که در مورد بیماران مبتلا به بیماری بافت همبند، بیماری قلبی، بیماری های مزمن ریوی و کلیوی، دیابت و بیماری های عصبی و غیره بحث می کند. بخش چهارم مشکلات خاص بعد از عمل جراحی ارتوپدی مانند مراقبت از بیمار مسن، ترومبوآمبولی وریدی، عفونت، تغذیه، سندرم کمپارتمان و سلامت استخوان را پوشش میدهد. در نهایت، نقش خدمات متحد، بهبود کیفیت و اخلاق برجسته می شود. مطالعات موردی منتخب برای نشان دادن مسائل واقعی بعد از عمل و استراتژیهای مدیریت در جراحی ارتوپدی گنجانده شدهاند که اکنون برای سهولت استفاده و مرجع به فصلهای مربوطه منتقل شدهاند. کادرهای سایهدار نکات کلیدی و اهداف فصل در ابتدای هر فصل، و نکات خلاصه در پایان هر فصل، در یک فضای داخلی تمام رنگی حفظ و بهروزرسانی شدهاند.
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نوشته شده توسط کارشناسان در بیمارستان برتر جراحی ویژه در نیویورک، مراقبت های بیمار ارتوپدی پس از عمل، 2e یک کتابچه راهنمای جامع و چند رشته ای خواهد بود که ملاحظات قبل از عمل، عوارض بعد از عمل و دستورالعمل هایی را برای مدیریت بیهوشی و پزشکی بیماران تحت جراحی ارتوپدی ارائه می دهد. این منبع ارزشمندی برای جراحان ارتوپد، متخصصان پزشکی ورزشی و متخصصان مرتبط درگیر در جراحی ارتوپدی خواهد بود.
Although a number of comprehensive texts pertaining to perioperative medicine are available, this remains the only one that focuses specifically on the patient undergoing orthopedic surgery, now in a revised and expanded second edition. Beginning with chapters covering preoperative evaluations and general principles and practices of perioperative medicine, the book then considers anesthesiologic management in orthopedic surgery and the role of postoperative pain management. This is followed by a section on medical management in specific clinical settings, discussing patients with connective tissue disease, cardiac disease, chronic pulmonary and renal diseases, diabetes and neurological diseases, among others. A fourth section covers specific perioperative problems in orthopedic surgery, such as care of the elderly patient, venous thromboembolism, infection, nutrition, compartment syndrome and bone health. Finally, the role of allied services, quality improvement and ethics are highlighted. Selected case studies are included to illustrate real-world perioperative issues and management strategies in orthopedic surgery, now moved to their respective chapters for ease of use and reference. The shaded key points and chapter objectives boxes at the beginning of each chapter, and the summary points at the end of each chapter, have been retained and updated within a full-color interior.
Written by experts at the top-ranked Hospital for Special Surgery in New York, Perioperative Care of the Orthopedic Patient, 2e will be a comprehensive, multidisciplinary manual providing preoperative considerations, postoperative complications, and guidelines for the anesthetic and medical management of patients undergoing orthopedic surgery. It will be an valuable resource for orthopedic surgeons, sports medicine specialists and allied professionals involved in orthopedic surgery.
Foreword to the Second Edition Preface to the Second Edition Preface to the First Edition Contents Contributors Part I: Preoperative Considerations 1: General Principles and Practices of Perioperative Medicine Introduction Preoperative Consultation Goals of the Preoperative Medical Consultation Identification of Conditions that Affect Postoperative Outcome Optimization of Conditions that May Affect Postoperative Outcome The Assessment of Perioperative Risk Patient Education and Preventive Practices Efficacy of Preoperative Consultation Summary References 2: Perioperative Risk Models Introduction General Risk Assessment Models Cardiac Risk Assessment Tools Pulmonary Risk Assessment Tools Hepatic Risk Assessment Tools Venous Thromboembolism Risk Assessment Tools Renal/Genitourinary Risk Assessment Tools Additional Models Discussion and Summary Case Study How Does One Approach the Perioperative Risk Assessment of Such a Patient? References 3: The Prevalence of Disabling Musculoskeletal Conditions and the Demand for Orthopedic Surgery in the Twenty-First Century Introduction Incidence of Degenerative Disorders of the Spine Incidence of Spine Procedures Incidence of Complications After Spine Surgery Definition and Classification of Complications Study Methodology Surgeon-Related Factors Procedure-Related Factors Patient-Related Factors Prevalence of Osteoarthritis and Related Reconstructive Surgeries of the Hip and Knee The Incidence of Complications After Total Knee and Total Hip Arthroplasty General Trends Specific Complications: Medical Infection Dislocation Venous Thromboembolism Periprosthetic Fractures Summary References 4: The Rheumatic Diseases: A Primer Introduction Pathological Considerations Laboratory Considerations The Rheumatic Diseases Osteoarthritis (OA) Disorders of the Synovium Connective Tissue Diseases Spondyloarthritis Vasculitides Metabolic Bone Disease Crystal-Induced Arthropathies Infectious Arthritis Sarcoidosis Summary References 5: The Pathophysiologic Events of Total Joint Replacement Surgery Introduction Pathophysiology of the Bone Cement Syndrome Physiologic Effects on Various Organ Systems Cardiopulmonary Effects Effects in Other Organ Systems The Role of Embolic Load The Role of Cement The Role of Fat Embolization: The Fat Embolism Syndrome The Pathophysiology of Spine Fusion Surgery Timing of Complications Interventions Summary Case Study References Part II: Anesthesiologic Management 6: Anesthesia in the Orthopedic Patient Introduction The Orthopedic Population Advanced Age Rheumatoid Arthritis Osteoarthritis Positioning Regional Anesthesia Mortality Postoperative Analgesia and Rehabilitation Respiratory Complications Postoperative Confusion Deep Vein Thrombosis Pulmonary Embolism Drawbacks to Regional Anesthetics Anticoagulation Ultrasound-Guided Regional Anesthesia Blood Conservation Strategies Controlled Hypotension Pneumatic Tourniquet Cell Salvaging Tranexamic Acid Enhanced Recovery After Surgery Summary Case Study References 7: Pediatric Anesthesia for Orthopedic Surgery Introduction Regional Anesthesia The Impact of Regional Anesthesia in the Pediatric Patient Safety in Pediatric Regional Anesthesia Ultrasound Neuraxial Anesthesia Neuraxial Anesthesia in Children Caudal Epidurals Perioperative Care Perioperative Blocks and Postoperative Pain Management Complications Neurological Injury Neuraxial Complications Pediatrics and Local Anesthesia Special Patient Groups and Considerations Cerebral Palsy Surgery for Scoliosis Correction Allergic Reactions Summary Case Study References 8: Anesthetic Techniques and Their Clinical Application for Specific Orthopedic Procedures Introduction Local Anesthetics Choice of Local Anesthetic Drug Dosage Latency Adjuvants Contraindications for the Use of Regional Anesthesia Infection Coagulation Disorders Preexisting Neurological Deficits Complications and Side Effects Associated with Regional Anesthesia Local Anesthetic Systemic Toxicity Neuropathy/Neurological Injury Regional Anesthesia Techniques Anatomical Landmarks Paresthesia Techniques Nerve Stimulator Ultrasound Guidance Catheter Techniques Upper Extremity Nerve Blocks The Brachial Plexus Review of Anatomy Interscalene Nerve Block Supraclavicular Nerve Block Infraclavicular Nerve (Coracoid) Block Axillary Nerve Block Extremity Nerve Blocks The Lumbosacral Plexus Review of Anatomy Lumbar Plexus Block Saphenous Nerve Block IPACK Block Femoral Nerve Block Popliteal Nerve Block Ankle Block Neuraxial Anesthesia Regional Anesthesia for Specific Procedures Anesthetic Techniques: Upper Extremity Total Shoulder Arthroplasty Shoulder Arthroscopy Elbow, Forearm, and Hand Surgery Anesthetic Techniques: Lower Extremity Total Hip Arthroplasty Total Knee Arthroplasty Knee Arthroscopy Foot and Ankle Surgery Spine Surgery Summary Case Study References 9: The Role of the Postanesthesia Care Unit in the Perioperative Care of the Orthopedic Patient Introduction Recovery from Anesthesia and Fluid/Blood Management Pain Management Common Complications Cardiac Complications Respiratory Complications Renal Complications Obstructive Sleep Apnea Patients After Bilateral Joint Arthroplasty and Revision Arthroplasty Postoperative Delirium Readmission to the PACU Summary Case Study References 10: Postoperative Pain Management in the Orthopedic Setting Introduction General Principles of Pain Management Pathophysiology of Pain Chronic Postoperative Pain Variation of Perioperative Pain for Orthopedic Procedures Preemptive and Preventive Analgesia Multimodal Analgesia Systemic Analgesic Techniques Opioids Intravenous Patient-Controlled Analgesia (PCA) Nonsteroidal Anti-inflammatory Drugs (NSAIDs) Acetaminophen Tramadol and Tapentadol Gabapentinoids Steroids Muscle Relaxants Dexmedetomidine Ketamine Local Anesthesia Infiltration/ Periarticular Injection Periarticular Injection Liposomal Bupivacaine Regional Anesthesia Techniques Peripheral Nerve Blockade Neuraxial Anesthesia and Analgesia Ambulatory Lower Extremity Procedures Total Hip and Knee Arthroplasty Peripheral Nerve Catheters HSS Pain Management for Specific Procedures Total Joint Replacement Total Hip Arthroplasty Quadratus Lumborum Block (QLB) Suprainguinal Fascia Iliaca Block (SIFI) Total Knee Arthroplasty Shoulder Surgery Total Shoulder Arthroplasty Shoulder Arthroscopies Elbow Surgery Foot and Ankle Surgery Spine Surgery Recuperative Pain Model Orthopedic Patients with Chronic Pain Transitional Pain Service Summary Case Study References 11: Enhanced Recovery After Surgery (ERAS) Protocols in Orthopedic Patients Introduction What Is Enhanced Recovery After Surgery? Enhanced Recovery After Surgery for Orthopedic Surgery Elective Total Hip and Knee Arthroplasty Fractured Neck of Femur Revision Joint Arthroplasty Total Shoulder Arthroplasty Spine Limitations of ERAS Research Methodology Conclusions and Summary Case Study References Part III: Medical Management in Specific Clinical Settings 12: Perioperative Care of the Orthopedic Patient with Connective Tissue Disease Introduction Rheumatoid Arthritis Systemic Lupus Erythematosus Spondyloarthropathy Ankylosing Spondylitis Psoriatic Arthritis Medications Corticosteroid Synthetic DMARDS Biologic Agents Tofacitinib Summary Case Study References 13: Perioperative Care of the Orthopedic Patient with Cardiac Disease Introduction The Identification of Cardiac Conditions Affecting Postoperative Outcome The Optimization of Cardiac Conditions Affecting Postoperative Outcome Pharmacologic Therapy Interventional Therapy Postoperative Considerations and Conditions Orthopedic Surgery After Coronary Revascularization Devices Valvular Heart Disease Atrial Fibrillation Myocardial Ischemia Summary Case Study References 14: Perioperative Care of the Orthopedic Patient with Chronic Pulmonary Disease Introduction The Preoperative Evaluation Identification of Conditions That Affect Postoperative Pulmonary Outcome Chronic Pulmonary Disease Pulmonary Arterial Hypertension Obesity Congestive Heart Failure Impairment in Cognitive and Functional Capacity The Optimization of Conditions Relevant to Postoperative Pulmonary Outcome The Assessment of Perioperative Risk Pulmonary Hypertension Anesthesia Technique Postoperative Considerations Summary Case Study References 15: Perioperative Care of the Orthopedic Patient with Renal Disease Introduction Chronic Kidney Disease The Preoperative Renal Evaluation Renal Function and Postoperative Risk Medication Management Blood Pressure, Fluid, and Volume Management Electrolyte Disturbances Hematologic Issues: Anemia Hematologic Issues: Uremic Bleeding Renal Replacement Therapy: Dialysis and Transplantation Hemodialysis Patients Peritoneal Dialysis Patients Renal Transplant Patients Postoperative Renal Considerations Acute Kidney Injury Hyponatremia Hyperkalemia Medications and Nephrotoxins The Use of Contrast When Imaging Patients with Renal Disease Analgesia in Patients with Renal Disease Anesthesia in Patients with Renal Disease Miscellaneous Summary Case Studies Case 1 Case 2 References 16: Perioperative Care of the Orthopedic Patient with Diabetes Mellitus Introduction Preoperative Evaluation of the Patient with Diabetes Optimization of the Diabetic Patient Perioperative Care Non-insulin Hypoglycemic Agents Insulin The Assessment of Perioperative Risk in the Diabetic Patient Patient Education and Preventive Practices Postoperative Management Postoperative Insulin Management Summary Case Study References 17: Perioperative Care of the Orthopedic Patient with Gastrointestinal and Liver Issues Introduction Preoperative Evaluation Identification of Conditions That Affect Postoperative Gastroenterological Outcome Elevated Transaminases Without Cirrhosis Cirrhosis and Chronic Liver Disease Optimization of Gastroenterological and Hepatic Conditions That May Affect Postoperative Outcome The Assessment of Postoperative Risk Elevated Liver Function Tests without Cirrhosis The Postoperative Period Postoperative Nausea and Vomiting Postoperative Abdominal Distention Clostridium difficile Colitis and Postoperative Diarrhea Postoperative Gastrointestinal Bleeding Summary Case Studies Case 1 Case 2 Case 3 Case 4 References 18: Perioperative Care of the Orthopedic Patient with Neurological Disease Introduction The Preoperative Evaluation Assessment of Perioperative Risk Cerebrovascular Diseases Neurodegenerative and Neuromuscular Diseases Epileptogenic Disorders Cerebral Aneurysms and Arteriovenous Malformations Optimization of the Patient with Neurological Disease Cerebrovascular Disease Epileptogenic Disorders Cerebral Aneurysms and Arteriovenous Malformations Neurodegenerative and Neuromuscular Diseases Postoperative Complications Stroke Managing Patients with Parkinson Disease in the Hospital Setting Peripheral Nerve Injury Postoperative Delirium Causes Presentation Evaluation Treatment Summary Case Studies Case 1 Case 2 References 19: Perioperative Care of the Orthopedic Patient with Sleep-Disordered Breathing: Obstructive Sleep Apnea Introduction Obesity Hypoventilation Syndrome Perioperative Implications Preoperative Evaluation, Risk Assessment, and Clinical Management Intraoperative Considerations Airway Management Complications Medications Inhalational Agents and Propofol Neuromuscular Blocking Agents Opioids Benzodiazepines Anesthesia Technique OSA in the Postoperative Setting Patient Extubation Patient Positioning Patient Monitoring Oximetry Supplemental Oxygen CPAP Pain Management Healthcare Challenges Summary Case Report References 20: Perioperative Care of the Patient with Psychiatric Disease Introduction Preoperative Assessment Preoperative Assessment of Psychiatric Medications Preoperative Assessment of Substances of Abuse Preoperative Assessment of Capacity Preoperative Prevention of Delirium Postoperative Psychiatric Issues Postoperative Delirium Postoperative Withdrawal and Intoxication Psychiatrically Difficult Patients Summary Case Studies Case 1 Case 2 References 21: Perioperative Care of the Orthopedic Patient with Chronic Pain Introduction Chronic Pain Strategies for Perioperative Pain Control Substance Use Disorder Mental Health Problems Summary Case Studies Case 1 Case 2 Case 3 References 22: Perioperative Care of the Orthopedic Patient with Gout Introduction Gout in the Perioperative Context General Principles of Gout Management Approach to Preoperative Management of Gout Approach to Postoperative Gout Flares Using Discharge Planning to Improve Long-Term Gout Management Summary Case Study References Part IV: Specific Perioperative Problems in Orthopedic Surgery 23: Perioperative Care of the Elderly Orthopedic Patient Introduction Age-Related Perioperative Risk Factors Cognitive Impairment Frailty Immobility and Functional Dependency Poor Nutrition Transitions Specific Clinical Problems Postoperative Delirium Hip Fracture Surgical Management Postoperative Pain Management in Elderly Patients Physical Therapy and Rehabilitation of the Elderly Summary References 24: Venous Thromboembolism and Orthopedic Surgery Introduction Diagnosis of Venous Thromboembolism Subsegmental Pulmonary Embolism Screening for Venous Thromboembolism in Asymptomatic Patients Prevention of Venous Thromboembolism Nonpharmacological Approaches Inferior Vena Cava Filters Pharmacological Options Venous Thromboembolism Prophylaxis in Orthopedic Patients Hip and Knee Arthroplasty Hip Fracture Surgery Spine Surgery Knee Arthroscopy Shoulder Arthroplasty Foot and Ankle Procedures Conclusions and Summary References 25: Coagulation Disorders and Orthopedic Surgery Introduction The Preoperative Evaluation Hemostasis Evaluation and Approach of Primary Hemostasis: Platelet Deficiency Evaluation and Approach to Secondary Hemostasis: Clotting Factor Deficiency Specific Chronic Diseases Summary Case Study References 26: Perioperative Nutrition in the Orthopedic Surgical Patient Introduction Preoperative Nutrition Enhanced Recovery after Surgery (ERAS) Early Feeding Postoperatively Minimizing NPO Status Diet Progression Adequate Postoperative Nutrition Undernutrition and Malnutrition Identifying Malnutrition Obesity Weight Loss Intervention Diabetes Mellitus Nutrition-Related Complications Postoperative Ileus Skin Integrity Enteral Nutrition Support Parenteral Nutrition Support Conclusion and Summary Case Study Inpatient Registered Dietitian Initial Assessment Note Assessment Diagnosis Intervention Monitoring and Evaluation References 27: Infection and Perioperative Orthopedic Care Introduction Preoperative Risk Assessment and Risk Reduction Non- modifiable Risk Factors Modifiable Risk Factors Metabolic Disease Diabetes/Hyperglycemia Obesity Malnutrition Smoking Inflammatory Arthritis Corticosteroids Human Immunodeficiency Virus (HIV) Chronic Illness Preoperative Screening Dental S. aureus Colonization UTI/Bacteriuria Infections at Other Sites Infection at the Operative Site Dermatologic Disease Perioperative Management of Infection Risk Skin Preparation Antibiotic Prophylaxis Postoperative Management Postoperative Fever Postoperative Wound Issues Early Postoperative Period Surgical Site Infections Orthopedic Surgery in the Patient with Known Orthopedic Infection Surface Cultures Synovial Fluid Other Collections Wound Cultures Blood Cultures Late Considerations in Arthroplasty Patients Summary Case Study References 28: Risks and Benefits of Bilateral Total Knee Replacement Surgery Introduction Epidemiology and Trends Benefits of Single-Stage Bilateral Total Knee Arthroplasty Clinical Results of Bilateral Total Knee Arthroplasty Number of Anesthetic Sessions Surgical Time Use of Pain Medication Patient Satisfaction Cost Drawbacks of Single-Stage Bilateral Total Knee Arthroplasty Mortality Cardiac Complications Complications Including Thromboembolism Postoperative Confusion Potential Increase in Wound Infection Rate Use of Allogenic Blood Transfusions Use of Tertiary Rehabilitation Centers Timing of Surgery for BTKA Recommendations for Patient Selection Summary Case Study References 29: Compartment Syndrome and Orthopedic Surgery: Diagnosis and Management Introduction Perioperative Considerations Acute Assessment Anesthetic Considerations Sign-Out/Documentation Informed Consent/Patient Expectations The Spectrum of Compartment Syndrome Special Consideration in the Perioperative Patient Summary Case Studies Case 1 Case 2 References 30: Bone Health and Orthopedic Surgery Introduction Background Vitamin D and Orthopedic Procedures Total Joint Arthroplasty Fracture Bisphosphonate Therapy Denosumab Teriparatide Spinal Fusion The Clinical Assessment of Bone Health Summary Case Studies Case 1 Case 2 References 31: Perioperative Care of the Complex Spine and Scoliosis Surgery Patient Introduction Preoperative Evaluation Cardiac Risk Pulmonary Optimization Perioperative Glycemic Management Intubation and Airway Considerations Preoperative Assessment of Bone Health Anterior Thoracic Spine Surgery Positioning Intraoperative Neurological Evaluation Intraoperative Hemodynamic Management Postoperative Visual Loss Postoperative Ventilation Postoperative Orthoses and Mobilization Postoperative Pain Management Summary References 32: Management of Blood Products in Orthopedic Surgery Introduction Defining Anemia Preoperative Interventions Preoperative Optimization Preoperative Autologous Blood Donation Iron Safety Erythropoietin Safety Intraoperative Interventions Pharmacologic Antifibrinolytics Lysine Analogues: Tranexamic Acid and Epsilon-Aminocaproic Acid Tranexamic Acid Safety Aprotinin DDAVP Safety Recombinant Factor 7 Fibrin Sealants Non-pharmacologic Electrocautery Hypotensive Anesthesia Safety Hemodilution Safety Tourniquet Intraoperative/Postoperative Blood Reinfusion Safety Postoperative Interventions Drains Transfusion Trigger Combination of Techniques/Algorithm Summary Case Study References Part V: Role of Allied Services 33: Professional Nursing Practice in the Orthopedic Care Setting Introduction Magnet Recognition Program Patient Assessment Care Coordination Patient Education Preoperative Education Postoperative Education Follow-Up After Discharge Complex Care and Nurse Specialization Identification and Management of Postoperative Orthopedic Complications Compartment Syndrome Thromboembolism Nosocomial Surgical Site Infection Summary References 34: The Approach to Physical Therapy Following Orthopedic Reconstructive Surgery Introduction Preoperative Education Functional Milestones Postoperative Rehabilitation Following Orthopedic Surgery Postoperative Rehabilitation Following Total Knee Arthroplasty Postoperative Rehabilitation Following Total Hip Arthroplasty Rehabilitation Following Spine Surgery Summary Case Study: Right Total Hip Arthroplasty References 35: Introduction of Clinical Pathways in Orthopedic Surgical Care: The Experience of the Hospital for Special Surgery Introduction The Key Elements of Clinical Pathways Addressing Total Joint Arthroplasty Elements of Pre-Hospital Preparation for Total Joint Replacement Perioperative Pain Management Post-mobilization and Physical Therapy: Fast-Track Rehabilitation Successful Implementation of Clinical Pathways Summary References 36: Achieving Value in Orthopedic Surgery: Clinical Pathways, Bundled Payment Programs, and Proactive Risk Assessment for Elective Orthopedic Procedures Introduction Bundled Payment Models Proactive Risk Assessment Reasons to Assess Risk Surgical Consultation Medical Clearance and Risk Optimization Obesity and Malnutrition Smoking Substance Abuse Ischemic Heart Disease Congestive Heart Failure Stroke High-Risk Surgery Diabetes Mellitus Serum Creatinine >2 or Chronic Kidney Disease Postsurgical Risk Assessment Surgery-Specific Complications Operative Time Blood Loss Pre-Discharge Risk Assessment Post-Discharge Risk Assessment Summary Case Study References 37: Bioethical Considerations in Perioperative Orthopedic Medicine Introduction Basic Concepts of Bioethics Beneficence Nonmaleficence Justice Autonomy Professional Duty Capacity and Competency Vulnerable Populations Common Ethical Problems That Arise in the Perioperative Setting Informed Consent Capacity, Competency, and Advanced Directives Clinical Ethics Consultation Summary Case Study Refusal of Care and “Do Not Resuscitate” Orders Discussion References Index