Obstetric Anesthesia
Preoperative considerations: All patients are considered to have full stomachs. These patients are also usually allowed to have small amounts of clear liquids during labor. For elective cesarean sections, patients…
Cholinesterase Inhibitors and Other Pharmacologic Antagonists to Neuromuscular Blocking Agents
ACh degradation: ACh is hydrolyzed by the enzyme acetycholinesterase into acetate and choline. The two receptors types are nicotinic and muscarinic. Nicotinic receptors stimulate autonomic ganglia and skeletal muscle….
Airway Management
1. Sensory innervation: The trigeminal nerve divisions innervate the nose. The lingual nerve (branch of trigeminal nerve V3) and glossopharyngeal nerve provide sensation to the anterior two-thirds and posterior…
Geriatric Anesthesia
Elderly patients have a high incidence of diastolic dysfunction. Diastolic dysfunction prevents the ventricle from relaxing and consequently creates higher pressures during diastolic ventricular filling, this leading to lower…
Maternal and Fetal Physiology and Anesthesia
Central Nervous System • The minimal alveolar concentration (MAC) decreases by up to 40% at term and returns to normal by the third day after delivery. Respiratory System •…
Anesthesia for Patients with Kidney Disease
General Surgery Acute Kidney Injury Risk Index Risk Factors General Surgery Acute Kidney Injury Risk Index classes based on number of risk factors present: class I (0–2 risk factors), class…
Anesthetic Complications
(Reproduced, with permission, from Katzung BG [editor]: Basic & Clinical Pharmacology, 8th ed. McGraw-Hill, 2001.) Immediate Hypersensitivity Clinical Manifestations • Atopic: Affects the skin and respiratory tract ° Allergic rhinitis,…
Anesthesia for Patients with Endocrine Disease
Diabetes Mellitus Intraoperative: Keep blood sugar below 180 mg/dL but avoid hypoglycemia as well. Hyperglycemia increases the risk of infection, risk of poor wound healing, and mortality. For common perioperative…
Fluid Management and Blood Component Therapy
Laboratory evaluation: Laboratory signs of dehydration may include a rising hematocrit (acute blood loss will not result in an acute change of hematocrit), metabolic acidosis, a urinary specific gravity…
Perioperative Pain Management and Enhanced Outcomes
(Adapted from Kehlet H, Wilmore DW. Evidence-based surgical care and the evolution of fast-track surgery. Ann Surg 2008; 248:189–198, with permission) Perioperative Elements Contributing to Enhanced Recovery After Surgery (ERAS)…
