Nonobstetric Surgery during Pregnancy
An association between benzodiazepine use and oral cleft anomalies was reported in the 1970s, but later case-control and prospective studies failed to demonstrate a relationship between oral cleft anomalies and…
ANESTHESIA
Ethical and Legal Considerations in Obstetric Anesthesia
Ethical and Legal Considerations in Obstetric Anesthesia M. Joanne Douglas and William J. Sullivan I. Introduction to ethics II. Informed consent A. Background B. Can laboring women give informed…
Anesthetic Management for the Surgical Treatment of Valvular Heart Disease
KEY POINTS 1. Increasing utilization of intraoperative transesophageal echocardiography (TEE) has greatly expanded the role of the cardiac anesthesiologist in operations for valve repair and replacement. 2. Because atrial contraction…
Anesthetic Management for Patients with Congenital Heart Disease: The Pediatric Population
KEY POINTS 1. Three important channels characteristic of the circulation in utero allow preferential shunting of blood to sustain fetal viability. These include the ductus venosus, foramen ovale, and ductus…
Monitoring the Cardiac Surgical Patient
KEY POINTS 1. For cardiac anesthesia, a five-electrode surface ECG monitor should be used in the diagnostic mode, with a frequency response of 0.05 to 100 Hz. 2. After a…
Anesthetic Management for Surgery of the Lungs and Mediastinum
KEY POINTS 1. Preoperatively respiratory function should be assessed in three related but independent areas: Respiratory mechanics, gas exchange, and cardiopulmonary interaction. 2. The most useful preoperative predictor of difficult…
Anesthetic Management for Thoracic Aortic Aneurysms and Dissections
KEY POINTS 1. An aortic dissection usually occurs when blood penetrates the aortic intima, forming either an expanding hematoma within the aortic wall or simply a false channel for blood…
Cardiovascular Drugs
KEY POINTS 1. Drug errors are a common cause of accidental injury to patients. The author suggests referring to drug package inserts or the Physician Desk Reference to check any…
The Cardiac Surgical Patient
KEY POINTS 1. Inability to climb two flights of stairs showed a positive predictive value of 82% for postoperative pulmonary or cardiac complications. 2. Silent ischemia is more common in…
