Nurse Anesthesia

Description

Gain a thorough understanding of nursing anesthesia with the most comprehensive text on the market. Written by leading expert, John Nagelhout, CRNA, PhD, FAAN, and new contributing author Sass Elisha, EdD, CRNA, Nurse Anesthesia, 6th Edition features both scientific principles and evidence-based material. Inside you’ll find a solid introduction to the history, education, and legal issues of nurse anesthetist, its scientific foundations, equipment and monitoring, and preoperative evaluation and preparation of the patient. This new edition includes chapters on patient centered care and cultural competence, additional drugs of interest, blood and blood component therapy, anesthesia management for patients with cardiac devices, anesthesia for robotic surgery, anesthesia for transplant surgery and organ procurement, and physiology and management of acute and chronic pain. Not only a key reference for practicing nurse anesthetists, this bestseller prepares you for certification and today's clinical anesthesia practice. Key Features New coverage includes the latest specifics of pharmacokinetics, drug delivery systems, opiate antagonists, and key induction drugs. Updated information on patient safety, monitoring, and pharmacology. Unique! Expert CRNA authors provide the current clinical information that you will use in daily practice. Over 700 tables and boxes highlight the most essential information in a quick, easy-to-reference format. Easy-to-use organization covers basic principles first, and builds on those with individual chapters for each surgical specialty. Updated TJC standards for monitoring and administering moderate sedation/analgesia. Endsheets 2-3......Page 0 Hyperkalemia......Page 419 Disorders of Calcium Balance......Page 420 Hypercalcemia......Page 421 Hypermagnesemia......Page 422 Hyperphosphatemia......Page 423 References......Page 424 References......Page 425 Transfusion Thresholds and Indications......Page 428 Patient Blood Management......Page 429 Preoperative Preparation......Page 430 Transfusion Compatibility......Page 431 Massive Transfusion Protocols......Page 432 Fresh-Frozen Plasma......Page 433 Platelets......Page 434 Cryoprecipitate......Page 435 Complications of Blood Transfusion......Page 436 Viral and Bacterial Risks......Page 437 References......Page 438 References......Page 439 Cardiovascular System......Page 441 Respiratory System......Page 442 Factors Contributing to Nerve Injuries......Page 443 Perioperative Neuropathies......Page 444 Ulnar Neuropathy......Page 445 Brachial Plexus Injuries......Page 447 Postoperative Visual Loss......Page 448 Venous Air Embolism......Page 451 The Lithotomy Position......Page 452 The Lateral Decubitus Position......Page 453 The Prone Position......Page 455 Closed-Claims Studies......Page 456 References......Page 457 References......Page 458 Nose.......Page 461 Larynx.......Page 462 Lower Respiratory Tract......Page 463 Airway Evaluation......Page 464 Bag Mask Ventilation Assessment......Page 465 Mallampati Classification......Page 469 Thyromental Distance......Page 470 Atlanto-Occipital Joint Mobility......Page 471 Supraglottic Airway Assessment......Page 472 Radiologic and Ultrasonographic Imaging......Page 473 Management of the Difficult and Failed Airway......Page 474 Difficult Airway Algorithms......Page 476 DAS Difficult Intubation Guidelines......Page 477 Awake Intubation......Page 479 Patient Preparation......Page 480 Airway Blocks......Page 481 Glossopharyngeal Block......Page 482 Superior Laryngeal Nerve Block......Page 483 Cricoid Pressure......Page 484 Laryngeal Mask Airway......Page 485 Second Generation Supraglottic Devices......Page 486 Intubating Supraglottic Airway Devices......Page 488 Trachlite Lighted Stylet......Page 489 Flexible Bronchoscope......Page 490 Bonfils Retromolar Intubation Fiberscope and RIFL.......Page 492 McGrath Video Laryngoscope......Page 493 Subglottic Interventions and Emergency Front of Neck Access......Page 494 Surgical Cricothyrotomy......Page 495 Retrograde Intubation......Page 497 Tracheal Extubation......Page 498 Tracheal Extubation of the Difficult Airway......Page 499 Laryngospasm......Page 500 Airway Trauma......Page 502 Aspiration......Page 503 References......Page 504 References......Page 505 Cardiac Skeleton......Page 508 Right Ventricle.......Page 509 Coronary Circulation......Page 510 Cardiac Innervation......Page 511 Atrioventricular Node.......Page 512 Structural and Regulatory Proteins.......Page 513 Resting Membrane Potentials.......Page 514 Phases of the Action Potential.......Page 515 Diastole.......Page 516 Control of Coronary Circulation and Oxygen Supply and Demand.......Page 517 Autoregulation.......Page 518 Cardiac Output.......Page 519 Oculocardiac Reflex.......Page 521 Arteries.......Page 522 Veins.......Page 523 Upper Extremity Arteries.......Page 524 Lower Extremities.......Page 525 Angiogenesis-Growth of Collateral Circulation......Page 526 Short-Term Regulation.......Page 527 Physiology of the Venous System......Page 528 Preoperative Evaluation......Page 529 Induction of Anesthesia......Page 530 Acute Pericarditis......Page 531 Clinical Presentation.......Page 532 Anesthetic Management.......Page 533 Pathophysiology......Page 534 Pathophysiology......Page 535 Effects of Afterload Reductions......Page 536 Left Ventricular Function......Page 537 Monitoring and Premedication......Page 538 Pathophysiology......Page 539 Pathophysiology and Unique Problems......Page 540 Pathophysiology......Page 541 Anesthetic Considerations......Page 542 Anesthetic Considerations......Page 543 Takotsubo Cardiomyopathy (TCM)......Page 544 References......Page 545 References......Page 546 Myocardial Oxygen Supply and Demand......Page 548 Ischemia Cascade......Page 549 Left Ventricular Failure and Remodeling.......Page 550 Diastolic Dysfunction.......Page 551 Right Ventricular Failure.......Page 552 Cannulae.......Page 553 Oxygenator.......Page 554 Anticoagulation......Page 555 Antifibrinolytics.......Page 556 Brain.......Page 557 Comorbidities.......Page 558 Management of Preoperative Medications.......Page 559 Arterial Line (A-Line).......Page 560 Central Venous Access.......Page 561 Transesophageal Echocardiography.......Page 562 Precardiopulmonary Bypass Period.......Page 563 Preincision Period.......Page 564 Cannulation.......Page 565 Maintenance.......Page 566 Preparation for Separation From CPB.......Page 567 Hemodynamic Management.......Page 568 Transport.......Page 569 Anesthetic Considerations and Surgical Options for On-Pump CABG......Page 570 Anesthetic Considerations and Surgical Options for Off-Pump CABG......Page 572 Anesthetic Considerations and Surgical Options.......Page 573 Pathophysiology.......Page 574 Anesthetic Considerations and Surgical Options.......Page 576 Mitral Regurgitation or Insufficiency......Page 577 Anesthetic Considerations and Surgical Options.......Page 578 Surgical Approaches.......Page 579 Anesthetic Considerations.......Page 580 CPB Cannulation and Cardioplegia.......Page 581 Minimally Invasive Myocardial Revascularization......Page 582 Surgical Approach.......Page 583 Anesthetic Considerations.......Page 584 Extracorporeal Membrane Oxygenation.......Page 585 Components, Types, and Heart Mate II.......Page 587 Anesthetic Management.......Page 588 Anesthetic Management.......Page 589 Ascending Aortic Aneurysms......Page 590 Aortic Arch Aneurysms......Page 591 Deep Hypothermic Circulatory Arrest......Page 592 References......Page 593 References......Page 594 Types of Pacemakers......Page 600 Pacemaker Codes......Page 603 Indications and Terminology......Page 604 Preoperative......Page 605 Electromagnetic Interference......Page 606 Electromagnetic Interference and Cardiac Implantable Electronic Devices.......Page 607 Reprogramming and Magnet Application......Page 608 References......Page 609 References......Page 610 Antiplatelet Medications.......Page 611 Postoperative Considerations......Page 612 Mortality......Page 613 Patient Selection......Page 614 Hemodynamic Alterations......Page 615 Spinal Cord Ischemia.......Page 616 Surgical Approach......Page 617 Management of Fluid and Blood Loss......Page 618 Anesthetic Selection......Page 619 Juxtarenal and Suprarenal Aortic Aneurysms......Page 620 Thoracic Aortic Aneurysms......Page 621 Treatment......Page 622 Preoperative Assessment......Page 623 Postoperative Considerations......Page 624 Procedure......Page 625 Indications......Page 627 Preoperative Assessment......Page 629 Cerebral Physiology......Page 630 Blood Pressure Control......Page 631 Regional Anesthesia.......Page 632 General Anesthesia.......Page 633 Postoperative Considerations......Page 634 Anesthetic Considerations......Page 635 References......Page 638 References......Page 639 Nose......Page 643 Laryngeal Cartilages......Page 644 Bronchi......Page 645 Respiratory Zone......Page 646 Mechanics of Breathing......Page 647 Lung Compliance......Page 648 Transpulmonary Pressure......Page 649 Lung Volumes......Page 650 Dead Space......Page 651 Pulmonary Blood Flow......Page 652 Relationship of Pulmonary Blood Flow and Ventilation......Page 653 Ventilation-Perfusion Relationships in the Lung......Page 654 Oxyhemoglobin Dissociation Curve......Page 655 Oxygen Content Calculations......Page 656 Acid-Base Balance......Page 657 Compensatory Mechanisms......Page 658 Chemical Control of Breathing......Page 659 Etiology and Pathophysiology......Page 660 Clinical Features and Diagnosis......Page 661 Pulmonary Function Testing......Page 662 Chronic Obstructive Pulmonary Disease......Page 663 Definition......Page 664 General Gas Exchange Characteristics......Page 665 Pulmonary Function Tests.......Page 666 Treatment......Page 667 Preoperative Evaluation......Page 668 General Anesthesia......Page 669 Ventilation Management......Page 670 Pathogenesis and Pathophysiology......Page 671 Clinical Features and Diagnosis......Page 672 Preoperative Evaluation......Page 674 Asthma and the Pregnant Surgical Patient......Page 675 Anesthetic Management......Page 677 Etiology......Page 678 General Anesthesia......Page 679 Etiology......Page 680 Clinical Features and Diagnosis......Page 681 Prevention......Page 682 Detection of Pulmonary Embolism During Anesthesia......Page 683 Definition......Page 684 Pulmonary Edema......Page 685 Pulmonary Edema Due to Upper Airway Obstruction......Page 686 Incidence and Outcome......Page 687 Pathophysiology......Page 688 Preoperative Management......Page 689 Intraoperative Management......Page 690 Clinical Features and Diagnosis......Page 691 Etiology......Page 692 Clinical Features and Diagnosis......Page 693 Amiodarone......Page 694 Etiology......Page 695 Sarcoidosis......Page 696 Flail Chest......Page 697 Tension Pneumothorax......Page 698 Etiology and Pathophysiology......Page 699 Incidence and Outcome......Page 700 Preoperative Evaluation.......Page 701 Anesthetic Management......Page 702 References......Page 703 References......Page 704 History and Physical Examination......Page 710 Chest Radiograph......Page 711 Pulmonary Function Tests......Page 712 Patient Optimization......Page 713 Lateral Decubitus Position......Page 714 Awake Lateral Position......Page 715 Anesthetized, Paralyzed, Mechanically Ventilated......Page 716 Indications for Lung Separation......Page 717 Advantages and Disadvantages......Page 718 Insertion of Double-Lumen Endotracheal Tubes......Page 719 Features......Page 720 Advantages and Disadvantages......Page 721 Physiology of One-Lung Ventilation......Page 723 Ventilation Modes......Page 724 Hypoxemia During One-Lung Ventilation......Page 725 Mediastinal Masses......Page 727 Thoracoscopy......Page 728 Complications After Thoracotomy......Page 729 References......Page 730 References......Page 731 Cells of the Central and Peripheral Nervous Systems......Page 735 Cerebral Structures......Page 736 Spinal Cord......Page 738 Sympathetic Nervous System......Page 739 Vasculature of the Central Nervous System......Page 741 Electrophysiology......Page 742 Biogenic Amines......Page 743 Neuropeptides......Page 744 Pain and Temperature Pathways......Page 745 Vibratory Sense, Proprioception, and Discriminatory Touch......Page 746 Corticospinal Tract......Page 747 Neuroanesthesia......Page 748 Inhalation Agents......Page 749 Intravenous Agents......Page 750 Determinants of Intracranial Pressure......Page 751 Measurement of Intracranial Pressure......Page 752 Cerebrospinal Fluid Drainage......Page 753 Neurophysiologic Monitoring......Page 754 Somatosensory Evoked Potentials......Page 755 Intraoperative Monitoring......Page 756 Fluid Management......Page 757 Emergence......Page 758 Awake Phase......Page 759 Detection of Venous Air Embolus......Page 760 Surgical Positioning......Page 761 Surgical Approach......Page 762 Cerebral Aneurysms......Page 763 General Considerations......Page 764 Timing of Surgery......Page 765 Anesthetic Induction, Maintenance, and Emergence......Page 766 Head Trauma and Traumatic Brain Injury......Page 767 Cardiovascular Assessment......Page 768 Chronic Subdural Hematoma.......Page 769 Anesthetic Induction, Maintenance, and Emergence......Page 770 References......Page 771 References......Page 772 Renal Blood Supply......Page 776 Regulation of Renal Blood Flow......Page 777 Transport Mechanisms......Page 778 Atrial Natriuretic Factor......Page 779 Renal Regulation of Acid-Base Balance......Page 780 Anesthetic Effects......Page 781 Fluoride Ion Toxicity......Page 782 Classification......Page 783 Risk Factors......Page 785 Perioperative Strategies......Page 786 Chronic Kidney Disease......Page 787 Physiologic Effects......Page 788 Laboratory Tests for Renal Function......Page 789 Cardiovascular Alterations......Page 790 Electrolyte Abnormalities......Page 791 Intraoperative Monitoring......Page 792 Volatile Anesthetic Agents......Page 793 Vecuronium.......Page 794 Uremia......Page 795 Anesthesia......Page 796 Surgical Technique......Page 797 Glycine Absorption......Page 798 Anesthesia for TURP Procedures.......Page 799 Robotic Urologic Surgery......Page 800 Open Nephrectomy......Page 801 References......Page 802 References......Page 803 Anatomic, Physiologic, and Pathophysiologic Considerations......Page 806 Protein Synthesis......Page 807 Drug Metabolism/Transformation......Page 808 Laboratory Evaluation of Liver Function......Page 809 Site of Surgery......Page 810 Acute Hepatitis......Page 811 Cirrhosis......Page 812 Preoperative Assessment......Page 813 Hematologic Considerations......Page 815 Anesthetic Technique and Medication Choices......Page 816 Anatomic and Physiologic Overview......Page 817 Cholelithiasis and Choledocholithiasis......Page 818 Anatomic and Physiologic Overview......Page 819 Anatomic and Physiologic Overview......Page 820 Gastritis......Page 822 Gastric Neoplastic Disease......Page 823 Physiologic Overview......Page 824 Acute Pancreatitis......Page 825 Pancreatic Pseudocysts......Page 826 Pancreatic Tumors......Page 827 Anatomic and Physiologic Overview of the Small Intestine......Page 828 Anatomic and Physiologic Considerations of the Large Intestine......Page 829 Inflammatory Bowel Disease......Page 831 Diverticulitis and Diverticulosis......Page 832 Carcinoma of the Colon......Page 833 Diseases of the Rectum and Anus......Page 834 Anatomic and Physiologic Overview......Page 835 Anesthetic Considerations in Elective Splenectomy......Page 836 Carcinoid Tumors and Carcinoid Syndrome......Page 837 Anesthetic Management......Page 838 References......Page 839 References......Page 840 Physiologic Effects of the Pneumperitoneum......Page 842 Cardiovascular Effects......Page 843 Respiratory Effects......Page 844 Complications of Laparoscopic Surgery......Page 846 Anesthetic Management......Page 848 Postoperative Concerns......Page 849 References......Page 850 References......Page 851 Robotic Systems......Page 854 Physiologic Changes Associated With Extreme Positioning......Page 855 Postoperative Visual Loss......Page 856 Enhanced Recovery After Surgery (ERAS)......Page 857 Robotically Assisted Totally Endoscopic Coronary Artery Bypass Surgery......Page 858 General Surgical Procedures......Page 859 Urologic Procedures......Page 860 References......Page 861 References......Page 862 Neuromuscular Junction......Page 864 Postjunctional End Plate......Page 865 Acetylcholine Receptor......Page 867 Extrajunctional Receptors......Page 868 Sliding Filament Mechanism......Page 869 Grading Contractile Force......Page 870 Pathophysiology......Page 872 Clinical Manifestations......Page 873 Anesthetic Implications......Page 874 Incidence......Page 875 Clinical Manifestations......Page 876 Epidemiology/Incidence......Page 877 Clinical Manifestations......Page 878 Management of an MH Episode......Page 879 Anesthesia for Malignant Hyperthermia–Susceptible Patients......Page 880 Myotonic Dystrophy......Page 881 Anesthetic Implications......Page 882 Systemic Involvement.......Page 883 Anesthetic Management......Page 884 References......Page 885 References......Page 886 Hormone Receptor Activation.......Page 890 Relationship Between Pituitary Gland and Hypothalamus......Page 892 Anterior Pituitary Lobe......Page 893 Anterior Pituitary Disorders......Page 894 Hypersecretion.......Page 895 Posterior Pituitary Lobe......Page 896 Deficient Antidiuretic Hormone and Anesthetic Implications.......Page 897 Calcium Regulation......Page 898 Effect on Bone.......Page 899 Effect on the Intestinal Tract.......Page 900 Hyperparathyroidism......Page 901 Anesthesia Implications for Hyperparathyroidism.......Page 902 Islets of Langerhans......Page 903 Effects on Carbohydrate Metabolism.......Page 904 Glucagon......Page 905 Type 2 Diabetes Mellitus......Page 906 Long-Term Diabetic Complications......Page 907 Preoperative Considerations......Page 908 Oral Glucose-Lowering Agents.......Page 909 Intraoperative Management......Page 910 Hypoglycemia......Page 911 Hyperglycemic Hyperosmolar State......Page 912 Glucocorticoids.......Page 913 Effect on Fat Metabolism.......Page 914 Disorders Associated With the Adrenal Cortex......Page 916 Diagnosis.......Page 917 Primary Adrenocortical Insufficiency (Addison Disease).......Page 918 Acute Adrenal Crisis.......Page 919 Pheochromocytoma......Page 920 Incidence and Associated Diseases.......Page 921 α-Adrenergic Receptor Blockade.......Page 922 Anesthetic Management.......Page 923 Thyroid Gland......Page 924 Increased Cellular Metabolic Activity......Page 925 Signs and Symptoms.......Page 926 Preoperative Assessment—Goiter.......Page 927 Thyroid Storm.......Page 928 Anesthetic Management—Hypothyroidism.......Page 929 References......Page 930 References......Page 931 The Normal Vessel Wall......Page 935 Vessel Injury......Page 936 Cell-Based Theory of Coagulation......Page 939 Preoperative Considerations......Page 940 Laboratory Tests......Page 941 Platelet Infusion Guidelines......Page 943 Cryoprecipitate Infusion Guidelines......Page 944 Hemophilia......Page 945 Disseminated Intravascular Coagulation......Page 946 Sickle Cell Disease......Page 947 Heparin-Induced Thrombocytopenia......Page 948 Antiplatelet Drugs and Noncardiac Surgery: Patients With Coronary Stents......Page 949 Outpatients Requiring Noncardiac Surgery......Page 952 References......Page 954 References......Page 955 Etiologies of Burn Injuries......Page 956 Airway Injury......Page 959 Hypovolemic Shock Associated With Thermal Injury......Page 960 Fluid Resuscitation......Page 961 Pathophysiologic Changes......Page 962 Gastrointestinal System/Nutrition.......Page 963 The Set-Up and Preparation.......Page 964 Fluid and Blood Replacement.......Page 965 Induction.......Page 966 References......Page 967 References......Page 968 Immediate Admission of the Trauma Patient......Page 970 Blunt Trauma......Page 971 Tracheal Injuries.......Page 972 Steps to RSI......Page 973 Direct Laryngoscopy.......Page 974 Circulation......Page 975 Fluid Resuscitation.......Page 976 Pathology and Causes of Coagulopathy.......Page 977 Shock.......Page 978 Head Injury......Page 979 Spinal Cord Injury......Page 980 Other Considerations......Page 981 Surgical Intervention and Anesthesia Approach......Page 982 Continuum of Care......Page 984 References......Page 985 References......Page 986 Pathophysiology of End-Stage Renal Disease and Indications for Transplant......Page 989 Preoperative Considerations for Renal Transplantation......Page 990 Intraoperative Considerations for Renal Transplantation......Page 991 Postoperative Considerations for Renal Transplantation......Page 992 Preoperative Considerations for Pancreas Transplant......Page 993 Postoperative Considerations for Pancreas Transplant......Page 994 Liver Transplantation......Page 995 Preoperative Considerations for Liver Transplantation......Page 996 Intraoperative Considerations for Liver Transplant......Page 998 Lung Transplantation......Page 1000 Intraoperative Considerations for Lung Transplantation......Page 1003 Postoperative Considerations for Lung Transplantation......Page 1004 Anesthetic Considerations for the Organ Donor......Page 1005 References......Page 1006 References......Page 1007 Disadvantages......Page 1008 Premature Infant.......Page 1009 Geriatric Patients.......Page 1010 Obstructive Sleep Apnea.......Page 1011 Unacceptable Patient Conditions for Ambulatory Surgery......Page 1012 History and Physical......Page 1013 Electrocardiography.......Page 1014 Warfarin Sodium.......Page 1015 Rhinorrhea......Page 1016 Antacids......Page 1017 Pantoprazole.......Page 1018 Intravenous Fluid Therapy......Page 1019 Postoperative Pain......Page 1020 Discharge Criteria......Page 1021 References......Page 1022 References......Page 1023 Functional Anatomy of the Head and Neck......Page 1026 The Shared Airway and Considerations for Positioning......Page 1029 Endotracheal Tubes Designed for ENT Surgery......Page 1030 Pharmacologic Considerations......Page 1031 Laser Surgery......Page 1032 Endoscopy......Page 1034 Foreign-Body Aspiration......Page 1035 Middle Ear Procedures......Page 1036 Nitrous Oxide and Middle Ear Surgery......Page 1037 Tonsillectomy and Adenoidectomy......Page 1038 Thyroid Surgery......Page 1039 Preoperative Assessment and Preparation......Page 1040 Postoperative Management......Page 1041 Cleft Palate (Hard Palate and Soft Palate)......Page 1042 Initial Assessment......Page 1043 Radical Neck Dissection......Page 1044 References......Page 1046 References......Page 1047 Cranial Nerves......Page 1049 Orbital Fossa......Page 1052 Orbit......Page 1053 Systemic Absorption of Eye Drops......Page 1054 Sub-Tenon Block......Page 1055 Ocular Regional Anesthesia......Page 1056 Needle Angle......Page 1057 Description.......Page 1058 Description.......Page 1060 Description.......Page 1061 Positive Orbital Pressure......Page 1062 Nothing-per-Mouth Status.......Page 1063 Monitoring for Regional Anesthesia......Page 1064 Open-Eye Injury and the Use of Succinylcholine......Page 1065 Intravascular Injection......Page 1066 Ocular Ischemia......Page 1067 Other Complications......Page 1068 References......Page 1069 References......Page 1070 Pneumatic Tourniquet......Page 1072 Tourniquet Pain......Page 1073 Arthroscopy......Page 1074 Anesthetic Management......Page 1075 Hip Surgery......Page 1076 Thromboprophylaxis.......Page 1077 Anesthetic Management......Page 1078 Spinal Surgery......Page 1079 Anesthetic Management......Page 1081 Postoperative Visual Loss......Page 1082 Forearm and Hand Surgery......Page 1083 References......Page 1084 References......Page 1085 Innate Immune System......Page 1087 Monocytes and Macrophages......Page 1088 Cytokines......Page 1090 B Cells......Page 1091 T Cells......Page 1093 Passive Immunity......Page 1095 Monoclonal Antibodies......Page 1096 Intraoperative Anaphylaxis......Page 1097 Type II Hypersensitivity......Page 1098 Autoimmunity......Page 1099 Rheumatoid Arthritis......Page 1100 Primary Immunodeficiency Disorders......Page 1101 IgG Subclass Deficiency......Page 1102 Acquired Immune Deficiency Syndrome......Page 1103 Acute Lymphocytic Leukemia......Page 1104 Hodgkin Lymphoma......Page 1105 Surgical Site Infections......Page 1106 Perioperative Hyperglycemia......Page 1107 Regional Anesthesia......Page 1108 Summary......Page 1109 References......Page 1110 References......Page 1111 Spontaneous and Stimulated Absorption and Emission of Energy......Page 1114 Laser Physics......Page 1115 Laser Operation......Page 1116 Carbon Dioxide Laser......Page 1117 Krypton Laser......Page 1118 Laser Safety......Page 1119 Thermal Trauma......Page 1120 Ocular Trauma......Page 1121 Air Contamination......Page 1122 Fuel Sources......Page 1123 Prevention of a Surgical Fire......Page 1124 Management of a Surgical Fire......Page 1126 Anesthesia for Laser Procedures......Page 1127 References......Page 1128 References......Page 1129 Risk Factors......Page 1130 Adipose Tissue......Page 1131 Cardiovascular Considerations......Page 1132 Obstructive Sleep Apnea......Page 1133 Obesity Hypoventilation (Pickwickian) Syndrome......Page 1134 Gallstones......Page 1135 Pediatric Obesity......Page 1136 Treatment of Obesity......Page 1137 Pharmacologic Considerations......Page 1138 Laboratory Tests......Page 1139 Airway Evaluation......Page 1140 Aspiration and Postoperative Nausea and Vomiting Prophylaxis......Page 1141 Intubation......Page 1142 Choice of Anesthetic Technique......Page 1143 Intraoperative Positioning......Page 1144 Postoperative Complications......Page 1145 References......Page 1146 References......Page 1147 Applied Anatomy and Physiology of the Central Neuraxis......Page 1150 Physiology and Mechanisms of Action......Page 1153 Central Neuraxial Blockade: Indications and Preoperative Considerations......Page 1154 Equipment and Techniques......Page 1157 Intrathecal Drugs, Spread, and Block Levels......Page 1159 Physiologic Alterations and Their Management......Page 1162 Postdural Puncture Headache......Page 1163 Nausea......Page 1164 Epidural Anesthesia......Page 1165 Equipment and Techniques......Page 1166 Ultrasound Epidural Placement......Page 1168 Epidural Drugs, Spread, and Block Levels......Page 1169 Epidural Opioids......Page 1170 Management of Epidural Anesthesia......Page 1171 History and Development......Page 1172 Management of CSE Anesthesia......Page 1173 Catheter Migration......Page 1174 Equipment and Techniques......Page 1175 References......Page 1176 References......Page 1177 Contraindications......Page 1180 Electrical Stimulators in Regional Anesthesia......Page 1181 Ultrasound-Guided Regional Anesthesia......Page 1182 Applied Anatomy of the Brachial Plexus......Page 1183 Approaches to Brachial Plexus Block......Page 1184 Interscalene Approach.......Page 1185 Continuous Catheter Technique.......Page 1186 Potential Problems.......Page 1187 Ultrasound Guided Infraclavicular Block.......Page 1188 Loss-of-Resistance Technique.......Page 1189 Ultrasound-Guided Axillary Block.......Page 1190 Median Nerve Block at the Elbow......Page 1191 Ulnar Block at the Wrist......Page 1192 Intravenous Regional Anesthesia: Upper Extremity Block......Page 1193 Intercostal Nerve Blocks......Page 1194 Ultrasound-Guided Transversus Abdominis Plane Block......Page 1195 Psoas Compartment Block......Page 1196 Continuous Femoral Nerve Block......Page 1197 Technique of Sciatic Nerve Block......Page 1198 Tibial Nerve.......Page 1199 Ankle Block Technique......Page 1200 References......Page 1201 References......Page 1202 Aortocaval Compression......Page 1204 Respiratory Changes......Page 1205 Renal Changes......Page 1206 Placental Transfer and Fetal Effects of Drugs......Page 1207 Intrapartum Fetal Evaluation......Page 1208 Early Decelerations.......Page 1209 Fentanyl......Page 1211 Neuraxial Analgesia for Labor and Vaginal Delivery......Page 1212 Bupivacaine.......Page 1213 Neuraxial Anesthetic Placement......Page 1214 Anesthetic Effects on the Progress of Labor......Page 1215 Programmed Intermittent Epidural Boluses......Page 1216 Regional Opioids for Labor Analgesia......Page 1217 Neuraxial Anesthesia for Cesarean Section......Page 1218 Spinal Anesthesia for Cesarean Section......Page 1219 Combined Spinal-Epidural for Cesarean Section......Page 1220 Maintenance of Anesthesia.......Page 1221 Nausea and Vomiting......Page 1223 Treatment......Page 1224 Neurologic Injuries......Page 1225 Description......Page 1226 Obstetric Management......Page 1227 Placental Abruption......Page 1228 Anesthesia for the Pregnant Patient Undergoing a Nonobstetric Procedure......Page 1229 Summary......Page 1230 References......Page 1231 References......Page 1232 Persistent Pulmonary Hypertension of the Newborn......Page 1237 Cardiovascular System......Page 1238 Respiratory System......Page 1239 Mechanics of Breathing......Page 1240 Development of Neuromuscular Junction......Page 1241 Cerebral Metabolic Requirement......Page 1242 Renal System......Page 1243 Temperature Regulation......Page 1244 Protein Binding......Page 1245 Inhalation Agents......Page 1246 Reversal of Neuromuscular Blockade......Page 1247 Water Requirements......Page 1248 Blood Replacement......Page 1249 Anesthetic Equipment......Page 1250 Prematurity......Page 1251 Cardiovascular System Abnormalities......Page 1252 Central Nervous System Abnormalities......Page 1253 Preoperative Treatment of Significance for Anesthesia......Page 1254 Spinal Anesthesia......Page 1255 Inguinal Hernia......Page 1256 Omphalocele and Gastroschisis......Page 1257 Tracheoesophageal Fistula and Esophageal Atresia......Page 1258 Malrotation and Midgut Volvulus......Page 1259 Myelomeningocele......Page 1260 References......Page 1261 References......Page 1262 Protein Binding......Page 1264 Inhalation Agents......Page 1265 Neuromuscular Blocking Agents......Page 1266 Review of Systems......Page 1267 Fasting Status......Page 1268 Laboratory Testing......Page 1269 Premedication......Page 1270 Pediatric Breathing Circuits......Page 1271 Intravenous Induction......Page 1272 Laryngeal Mask Airway.......Page 1273 Maintenance of a Patent Airway......Page 1274 Airway Complications......Page 1275 Fluid Management......Page 1277 Maintenance-Fluid Calculation......Page 1278 Crystalloid Intravenous Fluids......Page 1279 Postoperative Care......Page 1280 Pediatric Anesthetic Morbidity and Mortality......Page 1281 References......Page 1282 References......Page 1283 Cardiovascular System......Page 1286 Respiratory System......Page 1287 Hepatic Function......Page 1290 Central Nervous System......Page 1291 Nutritional Status......Page 1292 Age-Related Pharmacologic Implications in the Older Adult......Page 1293 Ethical Issues in the Treatment of the Older Adult......Page 1294 Postoperative Delirium......Page 1295 References......Page 1296 References......Page 1297 Initial Postanesthesia Care Unit Assessment......Page 1299 Major Body Systems......Page 1300 Obstruction......Page 1301 Pulmonary Edema......Page 1302 Aspiration......Page 1303 Hypotension......Page 1304 Hypertension......Page 1305 Reversal of Neuromuscular Blockade......Page 1307 Delayed Awakening......Page 1308 Serotonin Syndrome......Page 1309 Pain......Page 1310 Hypothermia......Page 1311 Nausea and Vomiting......Page 1312 Urinary Output and Voiding......Page 1315 Discharge From the Postanesthesia Care Unit......Page 1316 References......Page 1318 References......Page 1319 Anatomy and Physiology......Page 1321 Acute Pain Assessment......Page 1324 Preemptive Analgesia......Page 1325 Acetaminophen......Page 1326 N-Methyl-d-Aspartate Antagonists......Page 1327 Local Anesthetics......Page 1328 Acute Pain in a Patient with Chronic Pain......Page 1329 Corticosteroids.......Page 1330 Methadone.......Page 1331 Intraoperative Management.......Page 1332 Elderly......Page 1333 Pediatric......Page 1334 Summary......Page 1335 References......Page 1336 References......Page 1337 Pain Pathophysiology......Page 1340 Evolution of Chronic Pain (Wind-Up)......Page 1341 Cerebral......Page 1342 Nonsteroidal Antiinflammatory Drugs......Page 1343 Anticonvulsants for Neuropathic Pain......Page 1344 Polypharmacy in Pain Management......Page 1345 Therapeutic Injections......Page 1346 Other Therapeutic Nerve Blocks for Chronic Pain......Page 1347 Complications and Management......Page 1348 Failure to Treat Pain......Page 1349 References......Page 1350 References......Page 1351 A. Perform a Complete Preanesthesia Assessment......Page 1353 B. Obtain Informed Consent for the Planned Anesthetic Intervention From the Patient or Legal Guardian......Page 1354 G. Monitor and Document the Patient’s Physiologic Condition as Appropriate for the Type of Anesthesia and Specific Patient Needs......Page 1355 K. Summary......Page 1356 The Pediatric Patient......Page 1357 The Geriatric Patient......Page 1358 Procedure Overview.......Page 1359 Anesthetic Considerations.......Page 1360 Procedure Overview.......Page 1361 Postanesthesia Care.......Page 1362 Anesthetic Considerations.......Page 1363 Procedure Overview.......Page 1364 Oral and Maxillofacial Surgery.......Page 1365 Electroconvulsive Therapy......Page 1366 Anesthetic Considerations.......Page 1367 Repetitive Transcranial Magnetic Stimulation and Magnetic Seizure Therapy.......Page 1368 Interventional Radiology (Vascular and Nonvascular), and Radiotherapy or Radiosurgery.......Page 1369 Computed Tomography.......Page 1370 Magnetic Resonance Imaging.......Page 1371 Interventional Radiology (Vascular and Nonvascular), Radiotherapy, Stereotactic Radiosurgery, and Interventional Neuroradiology.......Page 1373 References......Page 1374 References......Page 1375 Morbidity in Anesthesia......Page 1378 Perioperative Mortality and Morbidity Over 70 Years of Age......Page 1379 Advanced Age and Noncardiac Surgery......Page 1381 Anesthetic Complications Related to the Growth and Development of Pediatric Brain......Page 1382 Sudden Cardiac Arrest......Page 1383 Perioperative Pulmonary Complications Associated With Supraglottic Devices and Endotracheal Intubation......Page 1384 Supraglottic Devices......Page 1385 Endotracheal Intubation......Page 1386 Intraoperative Awareness......Page 1387 Root Cause Analysis......Page 1388 Disclosure......Page 1389 The Second Victim......Page 1391 Human Error......Page 1392 Patient Handoff/Communication......Page 1393 References......Page 1396 References......Page 1397 Pages from @ebookers Nurse Anesthesia by John J. Nagelhout; Karen Plaus.1......Page 1