Orthopedic Anesthesia
Fig. 25.1 The beach chair position for shoulder surgery Surgery in the lateral decubitus position is not associated with a large hydrostatic gradient. Thus, the risk of iatrogenic lowering of…
The Elderly Patient
Cardiovascular changes Arterial compliance Loss of arterial compliance, increase in SVR, LVH, diastolic dysfunction, hypertension Venous compliance Loss of venous compliance Cardiac output Resting cardiac output-normal, diminished ability to increase…
Obesity
Organ system Clinical manifestations Neurologic Cerebrovascular accident (stroke), idiopathic intracranial hypertension, dementia, depression Cardiovascular Coronary artery disease, chronic inflammation, obesity cardiomyopathy, congestive heart failure, hypertension, cor pulmonale, arrhythmias Respiratory Obstructive…
Postoperative Anesthesia Care
• Respiratory—airway patency, respiratory rate, oxygen saturation • Cardiovascular—heart rate, blood pressure, electrocardiogram • Neuromuscular strength assessment • Pain assessment • Mental status assessment • Presence of nausea/vomiting • Temperature measurement • Urine output measurement • Examination of surgical…
Allergic Reactions
Fig. 19.1 Incidence of allergic reactions to agents used in the perioperative period Pathophysiology Hypersensitivity is an excessive and undesirable reaction produced by a normal immune system. This reaction can…
Ambulatory Anesthesia
• Cosmetic surgeries: breast reduction or augmentation, rhinoplasty, liposuction, blepharoplasties • Orthopedic surgeries such as arthroscopies, carpal tunnel release • Endoscopic procedures such as colonoscopies • Minor urological procedures • Mini-laparoscopic procedures • Dental procedures • Ophthalmic…
Drug Interactions
Prolong Shorten Antibiotics: aminoglycosides (gentamicin, tobramycin), tetracycline Carbamazepine Calcium channel blockers Methylxanthines Lithium Phenytoin (chronic exposure) Local anesthetics Ranitidine Magnesium Theophylline Quinidine Volatile inhalational anesthetics 3. Effect on coagulation…
NSAIDs and Alpha-2 Adrenergic Agonists
Fig. 15.1 Mechanism of action of NSAIDs Clinical Uses In the perioperative period, NSAIDs are primarily used for their analgesic effect. They may be used alone for mild to moderate…
Opioids and Benzodiazepines
Fig. 12.1 Chemical structures of select opioid agonists and antagonist (naloxone) Pharmacokinetics Pharmacokinetics includes the processes of absorption, distribution, metabolism, and excretion. With respect to opioids, these processes characterize the…
