ANESTHESIA
ANESTHESIA
• Reduction of risk (Anesth Analg 2007;105:1615–1628) • Regional techniques (general anesthesia has 11-fold ↑ risk of PONV) • Propofol (19% ↓ PONV risk compared to inhalational agents) • Avoid…
FOR OTOLARYNGOLOGY SURGERY, NEURORADIOLOGY, AND ECT
Intracranial Pressure (ICP) ICP = cranial (closed space) pressure on brain, CSF, & blood components • Brain components: Brain mass/cells (80%); blood (10%); CSF (10%) • Normal range: 0–10 mm…
PATIENT EVALUATION
PREOPERATIVE PHYSICAL EXAMINATION • Vital signs: Resting heart rate, BP, SpO2 height, weight, body mass index • CV & pulm: Heart & lung sounds, JVD, pulm/periph edema, carotid bruits • …
VENTILATION
CAPNOGRAPHY CO2 identified in expired gas by spectrographic properties (using IR, Raman, or mass spectroscopy) Hazards of Capnography: • Old in-line IR detectors can heat up, causing facial thermal injury…
FOR GENERAL SURGERY
ANESTHETIC CONSIDERATIONS IN ABDOMINAL SURGERY Preoperative Evaluation • Fluid status: Patients often hypovolemic • Inadequate fluid intake (fasting, anorexia) • Fluid loss (emesis, bowel preps, GI bleeding, fevers = insensible…
SYSTEM AND ANESTHESIA FOR UROLOGIC SURGERY
Acute Renal Failure • ↑ of Cr by ≥0.5 mg/dL or ↑ of Cr by ≥20% over 2 wks • Prerenal • Renal hypoperfusion resulting in ↓ GFR • Causes…
TRANSPLANTATION
ANESTHESIA FOR KIDNEY TRANSPLANTATION Indications • Polycystic kidney disease • Diabetes mellitus–related kidney failure • Hypertensive kidney disease • Glomerular disease • Tubulointerstitial disease • Other familial or congenital diseases…
OF ANESTHESIA
AIRWAY/DENTAL COMPLICATIONS Airway Complications Incidence • Unknown owing to varying significance/detection of injuries • Minor trauma to larynx & pharynx may be as common as 6% • Damage typically ↑…
