Ear, Nose, and Throat Surgery
• Airway is shared with surgeon • Patient is often positioned away from anesthesia provider • Airway irritability or obstruction due to presence of blood or secretions or frequent URIs…
Hepatic and Gastrointestinal Diseases
Fig. 32.1 Functional anatomy of the liver Fig. 32.2 A hepatic lobule Liver anatomy and function are intricately related. Liver functions include regulation of blood coagulation, synthesis of hormones, erythrocyte…
Patient Positioning and Common Nerve Injuries
Nerve injury Claims Ulnar Brachial plexus Lumbosacral nerve root Spinal cord Sciatic Median Radial Femoral Table 49.2 Prevention of perioperative peripheral nerve injuries Preoperative history and physical examination Ascertain if…
History of Anesthesia
William E. Clarke January 1842, Rochester, NY Teeth extraction of Ms. Hobbie by dentist E. Pope Crawford W. Long March 1842, Jefferson, Georgia Neck tumor excision of Mr. Venable. Fee…
Operating Room Management
Case duration The time from when the patient enters the OR to when the patient exits the OR Turnover time The time from when a patient exits the OR to…
Hazards of Working in the Operating Room
• Exposure limit of 2 ppm of halogenated anesthetic used alone or 0.5 ppm of halogenated anesthetic combined with 25 ppm of nitrous oxide • Proper functioning scavenging system • Low pressure leaks…
Vascular Anesthesia
Fig. 27.1 Abdominal aortic aneurysm and insert showing a graft repair Most abdominal aortic aneurysms (AAA) are silent clinically and are discovered incidentally during physical examination. Symptoms, if present, may…
Endocrine Diseases
Type I/juvenile/insulin dependent Type II/maturity onset/non-insulin dependent Gestational Stress related Age Children, young adults Adults Pregnant women Usually adults Etiology Immune mediated/idiopathic Resistance/deficiency to insulin Hormones/lack of insulin Stress…
Pulmonary Aspiration and Postoperative Nausea and Vomiting
Fig. 44.1 An assistant applies cricoid pressure to prevent aspiration during rapid sequence intubation Another means that could eventually screen for patients at high risk of aspiration is gastric sonography….
Robotic Surgery
Advantages Disadvantages Technical precision Loss of force and tactile perception Less pain Decreased natural hand-eye coordination Less blood loss Fixed/immobile robot Smaller incisions and better cosmetic results Effects of CO2…
