Anemia

Jan 21, 2017 by in ANESTHESIA Comments Off on Anemia

Figure 40.1 Levels of 2,3-DPG versus hemoglobin (Hgb) over time. Etiology of postoperative anemia The incidence of preoperative anemia ranges from 11% to 76% depending upon the patient population studied,[2]…

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Oliguria and postoperative urinary obstruction

Jan 21, 2017 by in ANESTHESIA Comments Off on Oliguria and postoperative urinary obstruction

Figure 35.1 Initial evaluation of postoperative oliguria. Figure 35.2 Postoperative oliguria diagnosis and management. CVP, central venous pressure; PAP, pulmonary artery pressure; PPV, pulse pressure variation; US, ultrasound; MAP, mear…

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Seizure

Jan 21, 2017 by in ANESTHESIA Comments Off on Seizure

Figure 25.1 Mimickers of postoperative seizure. Myoclonus is common in surgical patients and in extreme form can appear like convulsions. Perioperative medications, such as metoclopramide, can trigger extrapyramidal symptoms and…

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Nausea and vomiting

Jan 21, 2017 by in ANESTHESIA Comments Off on Nausea and vomiting

Figure 19.1 Apfel criteria for PONV risk. Adapted from ref. [3]. Table 19.1 PONV risk factors Risk factors for PONV in adults Positive evidence Female sex History of PONV or…

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Hypoglycemia

Jan 21, 2017 by in ANESTHESIA Comments Off on Hypoglycemia

Figure 16.1 Hypoglycemia differential diagnosis algorithm. Many non-anesthetic pharmaceuticals have the potential to cause hypoglycemia in susceptible individuals; many more have drug–drug interactions that may potentiate the action of oral…

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Jaundice

Jan 21, 2017 by in ANESTHESIA Comments Off on Jaundice

↑direct bilirubin = intra-hepatic or post-hepatic↔direct bilirubin = pre-hepatic causeAlanine transaminase (ALT)Aspartate transaminase (AST)Blood↑ALT & ↑AST = hepatocellular damage↑ALT<↑↑AST = ethanol↑↑↑ALT>↑↑AST = viral, shock liverAlkaline phosphatase (ALP)Blood↑↑ALP = cholestasisNon-specific, also…

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Delayed emergence

Jan 21, 2017 by in ANESTHESIA Comments Off on Delayed emergence

Figure 28.1 Differential diagnosis of delayed emergence for the intubated patient. TOF, train-of-four; CVA, cerebrovascular accident; EEG, electroencephalogram. Figure 28.2 Differential diagnosis of delayed emergence for the extubated patient. BiPAP,…

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Pruritus

Jan 21, 2017 by in ANESTHESIA Comments Off on Pruritus

Figure 20.1 The clinical relationship between pain and pruritus. Pruritus is mediated via dermal itch receptors, and knowledge of these receptors is rapidly evolving. Until recently believed to be a…

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PACU emergencies

Jan 21, 2017 by in ANESTHESIA Comments Off on PACU emergencies

html xmlns=”http://www.w3.org/1999/xhtml” xmlns:mml=”http://www.w3.org/1998/Math/MathML” xmlns:epub=”http://www.idpf.org/2007/ops”> Chapter 50 PACU emergencies Robert F. OlszewskiJr. Post-Anesthesia Care: Symptoms, Diagnosis, and Management, ed. James W. Heitz. Published by Cambridge University Press. © Cambridge University Press…

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Special considerations for pain management

Jan 21, 2017 by in ANESTHESIA Comments Off on Special considerations for pain management

ESRD – Careful use or best to avoidFentanylAppears safeHydromorphoneCRF – Careful useESRD – Careful use, may accumulate but dialyzableHydrocodoneMetabolized to hydromorphone, see previousOxycodoneCRF – Careful useESRD – Best to avoidCodeineAvoidPropoxypheneAvoid…

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