Understanding Anesthesiology - The Global Regional Anesthesia ...

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skills that contributes greatly to patient recovery and satisfaction. Large hospitals usually involve anesthesiologists in managing patients with chronic pain. Typically, the approach to chronic pain is multidisciplinary in that patients are assessed by a social worker, psychologist or psychiatrist, orthopedic surgeon and physiotherapist. Most often, these very complicated patients are referred to the clinic after seeing many other physicians. After taking a detailed history and performing a physical exam, the anesthesiologist may institute a nerve block, using local anesthetic and/or steroids. Examples of the indications for some of the more commonly performed blocks are given below: room practice. Despite the notion that the anesthesiologist doesn’t talk to his patients, this patient population must be treated with a good ear and a sympathetic tone if any treatment modality is to be successful. • Complex <strong>Regional</strong> Pain Syndrome (formerly Reflex Sympathetic Dystrophy): stellate ganglion block, lumbar sympathetic block • Chronic Back Pain: caudal or lumbar epidural steroid injection • Occipital Headaches: occipital nerve block • Myofascial Pain: trigger point injections • Chronic pancreatitis: celiac plexus block Often, these patients are followed over a period of time, giving the anesthesiologist an opportunity to establish the long-term rapport not feasible in operating 99
SECTION 5 Chapter 5 Review Review 5.1 Special Patients Question 1 of 15 All BUT ONE of the following are true regarding malignant hyperthermia (MH). Indicate the exception: A. Newer volatile anesthetics such as desflurane are not believed to trigger MH. B. Nitrous oxide is safe. C. Dantrolene is the only therapeutic drug treatment. D. Mortality is as high as 10% even with prompt treatment. Check Answer 100
Page 1 and 2:
1 ST EDITION Understanding Anesthes
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Preface ii
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GETTING THE MOST FROM YOUR IBOOK Th
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ACKNOWLEDGEMENTS Many individuals s
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THE ROLE OF THE ANESTHESIOLOGIST Dr
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CHAPTER 1 The ABC’s In this chapt
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There are many different laryngeal
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• Mouth opening: Three fingerbrea
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A patient who is deemed to be at ri
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Movie 1.1 Intubation technique The
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After intubation, correct placement
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The Difficult Airway Airway mismana
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volume, then the surgery should be
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Vascular Access Peripheral venous a
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Interactive 1.1 Body water distribu
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Complications of transfusion are nu
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CHAPTER 2 The Pre-operative Phase I
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are known to have cardiac disease o
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Premedication Pre-medication can in
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SECTION 2 Anesthetic Equipment and
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Monitoring The purpose of monitorin
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SECTION 3 Chapter 2 Review Review 2
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SECTION 1 Anesthetic Techniques In
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Table 9 Sedation VERBAL COGNITIVE A
Page 49 and 50: General Anesthesia General anesthes
Page 51 and 52: Epidural Anesthesia Epidural and sp
Page 53 and 54: Movie 3.1 Labour epidural insertion
Page 55 and 56: Figure 14 Sensory dermatomes tion i
Page 57 and 58: Figure 16 Anatomy relevant to spina
Page 59 and 60: cles (Figure 19).They then travel u
Page 61 and 62: SECTION 3 General Anesthesia In Thi
Page 63 and 64: amples of conditions which impair g
Page 65 and 66: and trauma surgery pose a higher ri
Page 67 and 68: Drugs for Maintenance of Anesthesia
Page 69 and 70: Contraindications to the inhaled ag
Page 71 and 72: Contraindications Opioids must not
Page 73 and 74: Table 15 Dose, onset, duration, eli
Page 75 and 76: tubation, leading to total airway o
Page 77 and 78: SECTION 4 Chapter 3 Review Review 3
Page 79 and 80: SECTION 1 Recovery In This Section
Page 81 and 82: Post-operative Nausea and Vomiting
Page 83 and 84: SECTION 2 Post-operative Pain Manag
Page 85 and 86: lead to a decreased stress response
Page 87 and 88: CHAPTER 5 Special Patients In this
Page 89 and 90: Successful treatment of an MH crisi
Page 91 and 92: SECTION 2 Obstetrical Anesthesia In
Page 93 and 94: There is good evidence that a labou
Page 95 and 96: SECTION 3 Pediatric Anesthesia In T
Page 97 and 98: tain types of noxious stimuli. Exam
Page 99: SECTION 4 Anesthesia Outside the Op
Page 103 and 104: Opioid agonists and antagonists •
Page 105 and 106: FENTANYL Class Synthetic opioid ana
Page 107 and 108: REMIFENTANIL Class Synthetic opioid
Page 109 and 110: MORPHINE SULFATE Class Opioid analg
Page 111 and 112: NALOXONE Class Opioid antagonist. U
Page 113 and 114: ROCURONIUM Class Non-depolarizing m
Page 115 and 116: PANCURONIUM BROMIDE Class Nondepola
Page 117 and 118: SUCCINYLCHOLINE CHLORIDE Class Depo
Page 119 and 120: SECTION 3 Anticholinesterase and An
Page 121 and 122: GLYCOPYRROLATE Class Anticholinergi
Page 123 and 124: SECTION 4 Induction Agents Drugs 1.
Page 125 and 126: SODIUM THIOPENTAL Class Short-actin
Page 127 and 128: KETAMINE Class Phencyclidine deriva
Page 129 and 130: ETOMIDATE Class Short-acting hypnot
Page 131 and 132: DESFLURANE Class Volatile inhaled a
Page 133 and 134: ISOFLURANE Class Volatile inhaled a
Page 135 and 136: SECTION 6 Anxiolytics Drugs 1. Mida
Page 137 and 138: SECTION 7 Antiemetics Drugs 1. Onda
Page 139 and 140: DIMENHYDRINATE Class Antihistamine,
Page 141 and 142: SECTION 8 Vasoactive Agents Drugs 1
Page 143 and 144: EPHEDRINE SULFATE Class Sympathomim
Page 145 and 146: SECTION 9 Local Anesthetics Drugs 1
Page 147 and 148: LIDOCAINE Class Local anesthetic. U
Page 149 and 150: KETOROLAC TROMETHAMINE Class Non-st
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DANTROLENE Dantrolene is used in th
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Acetylcholine Acetylcholine (Ach) i
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Adjunct An adjunct is something add
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Airway assessment The purpose of th
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Aldrete score Phase 1 of recovery m
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Analgesia Pain relief Related Gloss
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Antecubital fossa The antecubital f
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Anticholinesterase Anticholinestera
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Antisialagogue An antisialogogue is
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Apneic threshold Apneic threshold i
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Asepsis Asepsis is another word for
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Atracurium Class Nondepolarizing sk
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Autonomic nervous system The autono
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Bacterial endocarditis The 2007 Ame
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Balanced anesthesia Balanced anesth
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Bier Block An intravenous regional
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Brachial plexus The brachial plexus
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Bupivacaine Class Local anesthetic.
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Capnograph The capnograph is a moni
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Cholinesterase Cholinesterase is a
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Cis-Atracurium Class Non-depolarizi
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CO2 (carbon dioxide) absorber The C
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Competitive inhibitor Competitive i
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Cormack Lehane Cormack Cormack Leha
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Cricoid cartilage The cricoid is a
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Dantrolene Dantrolene is used in th
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Difficult airway The American Socie
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Diphenhydramine Class Antihistamine
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Dura The dura is the outermost (and
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Ephedrine Sulfate Class Sympathomim
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Epidural anesthesia In epidural ane
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Epiglottis The epiglottis is a cart
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Esophageal intubation Esophageal in
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Euvolemia Euvolemia indicates that
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Fentanyl Class Synthetic opioid ana
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Flowmeter The anesthetic flowmeter
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Forced air warming system A forced
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Functional residual capacity Functi
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Glycopyrrolate Class Anticholinergi
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Hypothermia Hypothermia indicates a
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Induction Induction is the phase of
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Intralipid Intralipid is a fat emul
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Intravenous regional anesthetic An
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Isoflurane Class Volatile inhaled a
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Ketorolac Tromethamine Class Non-st
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Laryngoscope A laryngoscope is the
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Larynx The larynx is that part of t
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Lidocaine Class Local anesthetic. U
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Local anesthetic toxicity Local ane
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MAC MAC refers to the concentration
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Magill blade A Magill blade, used i
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Maintenance fluid requirements Main
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Mallampati classification The Malla
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Mechanical ventilation Mechanical v
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Metabolic acidosis Metabolic acidos
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Morphine Sulfate Class Opioid analg
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Muscarinic Muscarinic acetylcholine
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Myoglobinuria When pathological mus
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Nasotracheal intubation Nasotrachea
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Needle cricothyrotomy A needle cric
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Neonatal opioid depression The resp
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Neuromuscular junction The neuromus
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Nicotinic Nicotinic receptors are t
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Non-depolarizing muscle relaxants T
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Ondansetron Class Seratonin ( 5-HT
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Oxygen saturation The oxygen satura
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Oxytocin Oxytocin is used in obstet
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Parturient The parturient is the pr
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Patient controlled analgesia Patien
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Peripheral nerve stimulator A perip
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Phrenic nerve The phrenic nerve, ar
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Positive pressure ventilation Posit
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Post-operative nausea and vomiting
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Pre-operative assessment Every pati
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Pre-oxygenation The purpose of pre-
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Prone In the prone position, the pa
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Pseudocholinesterase deficiency Pse
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Pulse oximeter The oxygen saturatio
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Radiculopathies Radiculopathy descr
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Re-narcotization A narcotized patie
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Recurrent laryngeal nerve The recur
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Remifentanil Class Synthetic opioid
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Reticular activating system The ret
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Rocuronium Class Non-depolarizing m
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Second stage of labour The second s
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Serotonin syndrome Serotonin syndro
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Shock Shock occurs when perfusion o
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Sodium citrate Sodium citrate is a
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Spinal anesthesia Spinal anesthesia
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Subarachnoid space The subarachnoid
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Succinylcholine Class Depolarizing
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Superior laryngeal nerve The superi
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Sympathetic nervous system The symp
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Theophylline Theophylline is a medi
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Thrombocytopenia Low platelet count
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Tidal volume Tidal volume is the vo
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Transcutaneous electrical nerve sti
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Trendelenburg The trendelenburg pos
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Urticaria Hives. Urticaria is cause
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Vagolytic Drugs with a vagolytic ef
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Vallecula The vallecula is the spac
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Venous air embolism Venous air embo
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Videolaryngoscope The videolaryngos
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