Non–Operating Room Anesthesia Mark S. Weiss, MD Assistant Professor of Anesthesiology and Critical Care Director of Inpatient Anesthesia Endoscopy Services Perelman School of Medicine Hospital of the University of Pennsylvania Philadelphia, Pennsylvania Lee A. Fleisher, MD Robert D. Dripps Professor and Chair of Anesthesiology and Critical Care Professor of Medicine Perelman School of Medicine Senior Fellow, Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia, Pennsylvania 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 NON–OPERATING ROOM ANESTHESIA ISBN: 978-1-4557-5415-1 Copyright © 2015 by Saunders, an imprint of Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. 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Library of Congress Cataloging-in-Publication Data Non–operating room anesthesia / [edited by] Mark S. Weiss, Lee A. Fleisher. p. ; cm. Includes bibliographical references and index. ISBN 978-1-4557-5415-1 (hardcover) I. Weiss, Mark S. (Mark Steven), editor. II. Fleisher, Lee A., editor. [DNLM: 1. Anesthesia--standards. 2. Process Assessment (Health Care)--methods. WO 200] RD81 617.9’6--dc23 2014014682 Executive Content Strategist: William Schmitt Content Development Specialist: Lisa Barnes Publishing Services Manager: Jeff Patterson Project Manager: Clay S. Broeker Design Direction: Louis Forgione Cover Designer: Elaine Kurie Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 This book is dedicated: to Lee Fleisher for his trust and friendship. to my aunt, Lillian Brick, who is my sunshine. to my mother, Minnette Weiss, who has always been so supportive. to my father, Frederick Weiss, who was always there to guide me. to my sons, Isaac, Noah, and Henry David. And this book is dedicated to the love of my life, Paulette Marie Lambert. MSW This book is dedicated to my wife, Renee, and my children, Jessica and Matthew, for supporting me in my career while ensuring that I understand what is truly important. LAF This page intentionally left blank About the Authors Mark S. Weiss, MD, is an Assistant Professor of Anesthe- Lee A. Fleisher, MD, is the Robert D. Dripps Professor and siology and Critical Care at the University of Pennsylva- Chair of Anesthesiology and Critical Care and a Professor nia’s Perelman School of Medicine. He received his medical of Medicine at the University of Pennsylvania’s Perelman degree from the University of Cincinnati and completed School of Medicine. He received his medical degree from the his residency training at Yale University. His focus is on State University of New York at Stony Brook, from which perioperative management of high-risk patients, with an he received the Distinguished Alumni Award in 2011. emphasis on non–operating room anesthesia (NORA). He is His research focuses on perioperative cardiovascular risk currently the director of Inpatient Endoscopy Services at the assessment and reduction and the measurement of qual- University of Pennsylvania. ity of care, and he has received numerous federal, industry, and foundation grants related to these subjects. He is Presi- dent of the Association of University Anesthesiologists. He is a member of the Consensus Standards Advisory Commit- tee of the National Quality Forum and of the Administrative Board of the Council of Faculty and Academic Specialties of the Association of American Medical Colleges. In 2007, he was elected to membership of the Institute of Medicine of the National Academy of Sciences. v This page intentionally left blank Contributors Rose Campise-Luther, MD, FAAP Anil Gupta, MD, FRCA, PhD Assistant Professor Associate Professor Pediatric Anesthesiology Department of Anesthesiology and Intensive Care Medical College of Wisconsin Institution for Medicine and Health Milwaukee, Wisconsin Örebro, Sweden Thomas Cutter, MD, MAEd Manon Hache, MD Professor Assistant Professor Department of Anesthesia and Critical Care Department of Anesthesiology University of Chicago Columbia University Medical Center Chicago, Illinois New York, New York Christina D. Diaz, MD Eric A. Harris, MD, MBA Assistant Professor Associate Professor of Clinical Anesthesiology Pediatric Anesthesiology Department of Anesthesiology, Perioperative Medicine, Medical College of Wisconsin and Pain Management Milwaukee, Wisconsin University of Miami, Miller School of Medicine Miami, Florida Karen B. Domino, MD, MPH Professor Jennifer E. Hofer, MD Department of Anesthesiology and Pain Medicine Assistant Professor University of Washington School of Medicine Department of Anesthesia and Critical Care Seattle, Washington University of Chicago Chicago, Illinois Richard E. Galgon, MD, MS Assistant Professor E. Heidi Jerome, MD Department of Anesthesiology Associate Professor University of Wisconsin School of Medicine and Public Department of Anesthesiology and Pediatrics Health Columbia University Medical Center Madison, Wisconsin New York, New York Esther D. Garazi, MD Max Kanevsky, MD, PhD Department of Anesthesia Assistant Professor of Anesthesia Perioperative and Pain Medicine Division of Cardiovascular Anesthesia Stanford University School of Medicine Stanford University School of Medicine Stanford, California Stanford, California Gregory G. Ginsberg Meghan Lane-Fall, MD, MSHP Professor of Medicine Assistant Professor of Anesthesiology and Critical Care Director of Endoscopy Department of Anesthesiology and Critical Care Gastroenterology Division University of Pennsylvania Hospital of the University of Pennsylvania Philadelphia, Pennsylvania Philadelphia, Pennsylvania Kelly Lebak, MD Basavana G. Goudra, MD, FRCA, FCARCSI Anesthesiologist Assistant Professor MetroHealth Medical Center Department of Anesthesiology and Critical Care Medicine University of Wisconsin—Madison Hospital of the University of Pennsylvania Madison, Wisconsin Philadelphia, Pennsylvania Jeffrey Lee, MS, MD Caitlin J. Guo, MD, MBA Assistant Professor Assistant Professor Anesthesiology Department of Anesthesia University of Wisconsin—Madison New York University Medical Center Madison, Wisconsin New York, New York vii viii Contributors Mark A. Leibel, MD Mark C. Phillips, MD Assistant Professor Assistant Professor and Medical Director, Advanced GI Department of Anesthesiology Endoscopy Anesthesia University of Wisconsin School of Medicine and Public Department of Anesthesiology Health University of Alabama at Birmingham School of Medicine Madison, Wisconsin Birmingham, Alabama Larry Lindenbaum, MD Christopher D. Press, MD Assistant Professor Department of Anesthesiology, Perioperative Department of Anesthesiology and Critical Care Medicine and Pain Medicine Medical College of Wisconsin Stanford University School of Medicine Milwaukee, Wisconsin Stanford, California Alex Macario, MD, MBA Johan Raeder, MD, PhD Professor Professor Department of Anesthesiology, Perioperative and Pain Faculty of Medicine Medicine NOR Consultant Vice-Chair for Education Department of Anaesthesiology Program Director, Anesthesia Residency Oslo University Hospital Stanford University School of Medicine Oslo, Norway Stanford, California W. Kirke Rogers, MD Jeff E. Mandel, MD, MS Associate Assistant Professor of Anesthesiology and Critical Care Department of Anesthesiology Perelman School of Medicine The University of Iowa Roy J. and Lucille A. Carver College University of Pennsylvania of Medicine Philadelphia, Pennsylvania Iowa City, Iowa Ramon Martin, MD, PhD Daniel Rubin, MD Staff Anesthesiologist Assistant Professor Department of Anesthesiology, Perioperative and Pain Department of Anesthesia and Critical Care Medicine University of Chicago Brigham and Women’s Hospital Chicago, Illinois Assistant Professor Anesthesia John P. Scott, MD Harvard Medical School Assistant Professor Boston, Massachusetts Department of Anesthesiology and Pediatrics Medical College of Wisconsin Julia I. Metzner, MD Milwaukee, Wisconsin Associate Professor Department of Anesthesiology and Pain Medicine Jack S. Shanewise, MD University of Washington Professor of Anesthesiology Seattle, Washington Columbia University Medical Center New York, New York Roger A. Moore, MD Clinical Associate Professor of Anesthesiology and Critical Preet Mohinder Singh, MD Care Assistant Professor Chair Emeritus, Deborah Heart and Lung Center Department of Anesthesiology and Critical Care Medicine Perelman School of Medicine Postgraduate Institute of Medical Education and Research Hospital of the University of Pennsylvania Chandigarh, India Philadelphia, Pennsylvania Scott Springman, MD Melissa L. Pant, MD Professor Clinical Associate Anesthesiology Department of Anesthesia and Critical Care University of Wisconsin—Madison University of Chicago Madison, Wisconsin Chicago, Illinois Lena S. Sun, MD E.M. Papper Professor of Pediatric Anesthesiology Department of Anesthesiology and Pediatrics Columbia University Medical Center New York, New York