{"title":"Posterior Fossa","authors":"Talia S. Vogel, Penny Liu","doi":"10.2310/anes.18068","DOIUrl":"https://doi.org/10.2310/anes.18068","url":null,"abstract":"The posterior fossa houses essential brainstem nuclei, cranial nerves, cerebral vasculature, and mechanisms for cerebrospinal fluid drainage. Anesthetic considerations for posterior fossa surgery include thorough preoperative evaluation, intraoperative monitoring, and anesthetic planning to allow neurophysiological monitoring. Careful positioning is imperative to optimize surgical conditions and to risk stratify patients for complications, including venous air embolus. Venous air embolus is a common complication of posterior fossa surgery given the plentitude of venous channels in the posterior fossa, and rapid recognition is key to managing this complication. Posterior fossa surgery also has a number of other known complications including postoperative apnea, prolonged ventilation, and possible brainstem stroke. \u0000This review contains 4 tables, 1 video, and 31 references.\u0000Keywords: Posterior fossa surgery, Brainstem surgery, Neuroanesthesiology, Venous air embolism/embolus, Sitting craniotomy, Prone craniotomy, Transesophageal echocardiogram, Neurophysiologic monitoring","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126199628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spinal Cord Stimulation","authors":"Christopher R. Abrecht, E. Ross","doi":"10.1007/978-3-319-43133-8_103","DOIUrl":"https://doi.org/10.1007/978-3-319-43133-8_103","url":null,"abstract":"","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"48 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127594661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Renal Disease","authors":"É. Morell, F. Peralta","doi":"10.2310/anes.18198","DOIUrl":"https://doi.org/10.2310/anes.18198","url":null,"abstract":"Renal disease can lead to significant complications during pregnancy, both for mother and child, and must be managed appropriately and efficiently. Recommended intervention depends on the severity and the underlying cause, as well as the acute versus chronic nature of the disease, and should involve optimization both prior to and during pregnancy. With suboptimal treatment, chronic kidney disease can progress to end-stage renal disease necessitating dialysis. Furthermore, renal disease has a negative effect on the fetus including an increase in the risk of intrauterine growth restriction, preterm delivery, and fetal loss. Urolithiasis and pyelonephritis are not uncommon in pregnancy and require special attention. The diagnosis of urolithiasis is complicated, as ultrasonography is the safest modality for the developing fetus but is also associated with a substantial false-negative rate. Although the majority of stones will pass without intervention, some may require the placement of ureteral stents or manual extraction. It is unclear whether urolithiasis itself has a negative impact on pregnancy, as the data are conflicting; however, pyelonephritis has been shown to cause an increase in delivering a fetus with low birth weight and spontaneous preterm birth. Therefore, all urinary tract infections are treated aggressively during pregnancy.\u0000This review contains 5 figures, 6 tables, and 43 references.\u0000Key Words: acute kidney injury, chronic kidney disease, dialysis, end-stage renal disease, lupus nephritis, pyelonephritis, renal transplant, urolithiasis","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125201189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Commonly Associated Medical Syndromes","authors":"Elaine I. Yang, Genewoo J Hong","doi":"10.2310/anes.18094","DOIUrl":"https://doi.org/10.2310/anes.18094","url":null,"abstract":"Rheumatologic diseases such as RA, ankylosing spondylitis, psoriatic arthritis, SLR, and osteogenesis imperfecta make up a large percentage of pathologies in patients undergoing orthopedic surgery. These arthropathies are progressive, difficult to treat, and often lead to lifelong debilitating pain and disability. In addition to their effects on bones and joints, they are all characterized as medical syndromes, which affect many other organs and tissues throughout the body. Subsequently, these patients often have many comorbidities that make rendering a safe anesthetic challenging. Disease-modifying therapy combines aggressive immunomodulatory agents and immunosuppression. Severe joint destruction is treated surgically, but these surgeries are often at increased risk due to the effects of these syndromes on other organ systems. In this review, we address the approach to and evaluation of these five commonly associated medical syndromes and their medical and/or surgical treatment as well as any anesthetic considerations.\u0000This review 5 figures, 4 tables, and 50 references. \u0000Key Words: anesthetic considerations, ankylosing spondylitis, inflammatory arthropathies, psoriatic arthritis, orthopedics, osteogenesis imperfecta, rheumatoid arthritis, rheumatologic syndromes, systemic lupus erythematosus","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125612080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Neonatal Emergencies II: Infantile Hypertrophic Pyloric Stenosis & Intestinal Obstruction","authors":"I. Vesselinova","doi":"10.2310/anes.18398","DOIUrl":"https://doi.org/10.2310/anes.18398","url":null,"abstract":"This review focuses on the clinical presentation, diagnosis, preoperative stabilization and intraoperative management of infantile hypertrophic pyloric stenosis (IHPS) and neonatal gastrointestinal obstructions. IHPS poses medical emergency, which demands adequate preoperative optimization of the intravascular status and metabolic derangements before proceeding with surgery. In contrast, malrotation and volvulus require immediate surgical exploration under ongoing aggressive resuscitation in order to minimize further deterioration and preserve bowel length. Congenital anomalies, associated with disorders such as duodenal atresia, malrotation, volvulus, and anorectal malformations, warrant focused examinations to characterize the defect and severity of functional impairment, but they should not delay interventions for which time is a critical factor.\u0000This review contains 2 tables, and 41 references.\u0000Key words: neonatal, infantile pyloric stenosis, gastrointestinal, vomiting, metabolic, resuscitation, obstruction, malformation, apnea, rapid sequence.\u0000 \u0000 ","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"310 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124407096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Burns","authors":"E. Bittner, Connie W. Chaudhary","doi":"10.2310/anes.18300","DOIUrl":"https://doi.org/10.2310/anes.18300","url":null,"abstract":"Anesthetic management of burn-injured patients can be particularly challenging. Burn-injured patients exhibit pathophysiologic changes that can affect nearly all the organs in the body. Challenges the anesthesiologist may encounter when caring for burn patients include difficult airway management, impaired lung function, vascular access issues, hypothermia, pharmacokinetic and pharmacodynamic alterations, and pain management. Other important considerations that could affect the condition of burn patients include blood loss, hypermetabolism, pain control, and temperature management. Anticipating appropriate precautions can change the clinical outcome of these patients. Optimal care requires a full understanding of the unique preoperative, intraoperative, and postoperative issues of the burn-injured patient.\u0000\u0000This review contains 2 figures, 3 tables, and 77 references.\u0000Key Words: anesthetic management of acute burns, burn injury, electrical injury, fluid resuscitation, inhalation injury, Parkland formula, pain management","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"15 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125606720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Airway Basics: Functional Airway Management","authors":"Gilbert S Tang","doi":"10.2310/anes.18126","DOIUrl":"https://doi.org/10.2310/anes.18126","url":null,"abstract":"The anesthesiologist maintains patency of the airway through the use of various airway techniques, from simple maneuvers such as jaw thrust and chin lift, to the insertion of oropharyngeal or nasopharyngeal airways, to the placement of advanced airway devices such as supraglottic airways and endotracheal tubes. Understanding the structure, function and anatomic relationships of the airway provides the foundation to evaluate the patient and determine a safe plan for airway management.The nose and mouth are the beginning point of the airway, which can be divided into the upper airway consisting of nasal cavity, nasopharynx, oral cavity, oropharynx, hypopharynx and larynx, and the lower airway consisting of the trachea, bronchi and subdivisions of the bronchi. The airway is the conduit from which air flows to and from the alveoli, where oxygenation and ventilation occurs. It plays important functions in trapping airborne contaminants, producing mucus and secretions, permitting olfactory and general sensation, warming and humidifying the air, providing immunologic defense from infection through lymphoid tissues, allowing a mechanism for vocalization, creating a functional separation between the swallowing and breathing, and protecting from aspiration of oral and stomach contents.\u0000\u0000This review contains 2 tables and 34 references.\u0000Key words: airway, intubation, pharynx, larynx, kiesselbach’s plexus, vocal cord injury, swallow, cough, laryngospasm, bronchospasm, obstruction, aspiration, pediatric airway","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"149 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123681700","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sedation in the Intensive Care Setting","authors":"William John Wallisch IV, A. M. Kaynar","doi":"10.2310/anes.8262","DOIUrl":"https://doi.org/10.2310/anes.8262","url":null,"abstract":"The recent clinical trials on sedation and delirium in the ICU shifted the scales dramatically in the past 10 to 20 years and less sedation is now the accepted norm with titration goals. Now the art of sedation is in the hands of the clinicians to achieve a balance between alleviation of pain and anxiety while keeping patients calm, cooperative, and part of daily activities in the ICU. In this chapter we summarize the various assessment tools for optimal sedation in the ICU as well as the medications used to achieve sedation. However, the clinicians should not forget the nonpharmacologic approaches such as prevention of sleep interruption as part of a successful comprehensive sedation program in the ICU.\u0000This review contains 3 tables, and 22 references.\u0000Key Words: confusion assessment method, delirium, dexmedetomidine, etomidate, fentanyl, GABA, ketamine, propofol, Richmond agitation-sedation scale (RASS), sedation-agitation scale (SAS)","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"51 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130960520","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Principles of Cancer Diagnosis","authors":"Samantha Baker, J. Rose","doi":"10.2310/anes.2399","DOIUrl":"https://doi.org/10.2310/anes.2399","url":null,"abstract":"As knowledge of cancer pathology deepens, so does the complexity of cancer care. Recommendations from the National Cancer Policy Board Cancer Care System focus on using high-volume centers for patients undergoing high-mortality procedures and clinical trials to develop evidence-based guidelines for cancer prevention, diagnosis, treatment, palliative care, and quality care. Through the implementation of many of these principles, patient-centered care has become increasingly recognized as fundamental model for healthcare.\u0000This review contains 2 figures, 1 table, and 25 references.\u0000Key Words: Cancer, Cancer staging, Core needle biopsy, Fine needle aspiration, Liquid biopsy, Lymph nodes, Sentinel lymph node(s), Surgical biopsy","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"63 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125086273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Vaughan, Chadron Vassar, Nitin Kumar, Kerolos Yousef
{"title":"Neurophysiologic Monitoring","authors":"S. Vaughan, Chadron Vassar, Nitin Kumar, Kerolos Yousef","doi":"10.1017/cbo9781139584005.030","DOIUrl":"https://doi.org/10.1017/cbo9781139584005.030","url":null,"abstract":"Neurophysiologic monitoring is a diverse group of instruments that are used to monitor the central and peripheral nervous system during surgical procedures. Some are used to monitor anesthetic depth, whereas others are used by neurologists to monitor the integrity of the nervous system during surgical procedure. The goal of neurophysiologic monitoring is to have reliable, reproducible, and predictive monitors that can identify impending compromise to the neurologic system (or anesthetic) with minimal false predictive value and high positive predictive value. This allows for the identification of neurologic tissues by location and type that are at risk of compromise by vascular and/or mechanical injury.\u0000This review contains 3 figures, 8 tables, and 34 references.\u0000Key Words: auditory evoked potentials, bispectral index monitor, electrocorticography, electroencephalography, electromyographic monitoring, M-ENTROPY, motor evoked potentials, narcotrend index, sensory evoked potentials, spectral analysis","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116310449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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