MORGAN AND MIKHAIL'S CLINICAL ANESTHESIOLOGY CASES Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher oft his work have checked with sources believed to be reli able in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the pos sibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publica tion of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the n:sults obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administra tion. This recommendation is of particular importance in connection with new or infrequently used drugs. a LANGE medical book MORGAN AND MIKHAILS CLINICAL AN ESTH ESIOLOGY CASES EDITED BY JOHN F. BUTTERWORTH IV, MD Professor and Chairman, Department of Anesthesiology, Virginia Commonwealth University School of Medicine VCU Health System, Richmond, Virginia DAVID C. MACKEY, MD Professor, Department of Anesthesiology and Perioperative Medicine, University ofTexas MD Anderson Cancer Center, Houston, Texas JOHN D. WASNICK, MD, MPH Steven L. 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This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. lcoNTENTS Contributors ix Preface xix CHAPTER 1 The Practice of Anesthesiology 1 SECTION 1 ANESTHETIC EQUIPMENT & MONITORS CHAPTER2 The Operating Room Environment 7 CHAPTER3 Breathing Systems 13 CHAPTER4 The Anesthesia Workstation 21 CHAPTERS Cardiovascular Monitoring 27 CHAPTER6 Noncardiovascular Monitoring 39 SECTION 2 CLINICAL PHARMACOLOGY CHAPTER7 Pharmacological Principles 51 CHAPTERS Inhalation Anesthetics 55 CHAPTER9 Neuromuscular Blocking Agents 65 CHAPTER 10 Cholinesterase Inhibitors & Other Pharmacological Antagonists to Neuromuscular Blocking Agents 69 CHAPTER 11 Hypotensive Agents 73 CHAPTER 12 Local Anesthetics 77 CHAPTER 13 Adjuncts to Anesthesia 83 SECTION 3 ANESTHETIC MANAGEMENT CHAPTER 14 Preoperative Assessment, Premedication, & Perioperative Documentation 93 CHAPTER 15 Airway Management 101 v CHAPTER 16 Cardiovascular Physiology & Anesthesia 109 CHAPTER 17 Anesthesia for Patients with Cardiovascular Disease 119 CHAPTER 18 Anesthesia for Cardiovascular Surgery 153 CHAPTER 19 Respiratory Physiology & Anesthesia 161 CHAPTER20 Anesthesia for Patients with Respiratory Disease 171 CHAPTER21 Anesthesia for Thoracic Surgery 177 CHAPTER22 Anesthesia for Neurosurgery 183 CHAPTER23 Anesthesia for Patients with Neurological & Psychiatric Diseases 195 CHAPTER24 Anesthesia for Patients with Neuromuscular Disease 203 CHAPTER25 Kidney Physiology & Anesthesia 207 CHAPTER26 Anesthesia for Patients with Kidney Disease 211 CHAPTER27 Anesthesia for Genitourinary Surgery 217 CHAPTER28 Hepatic Physiology & Anesthesia 223 CHAPTER29 Anesthesia for Patients with Liver Disease 227 CHAPTER30 Anesthesia for Patients with Endocrine Disease 239 CHAPTER31 Anesthesia for Ophthalmic Surgery 245 CHAPTER32 Anesthesia for Otolaryngology- Head & Neck Surgery 249 CHAPTER33 Anesthesia for Orthopedic Surgery 255 CHAPTER34 Obstetric Anesthesia 273 CHAPTER35 Pediatric Anesthesia 303 CHAPTER36 Geriatric Anesthesia 317 vi SECTION 4 REGIONAL ANESTHESIA & PAIN MANAGEMENT CHAPTER37 Peripheral Nerve Blocks 325 CHAPTER38 Chronic Pain Management 349 CHAPTER39 Enhanced Recovery Protocols & Optimization of Perioperative Outcomes 369 SECTION 5 PERIOPERATIVE & CRITICAL CARE MEDICINE CHAPTER40 Management of Patients with Fluid & Electrolyte Disturbances 375 CHAPTER41 Fluid Management & Blood Component Therapy 385 CHAPTER42 Nutrition in Perioperative & Critical Care 393 CHAPTER43 Postanesthesia Care 397 CHAPTER44 Common Clinical Concerns in Critical Care Medicine 405 CHAPTER45 Inhalation Therapy & Mechanical Ventilation in the PACU & ICU 409 CHAPTER46 Safety, Quality, & Performance Improvement 413 Index 417 vii This page intentionally left blank