{"title":"Management of Drug Interactions between Anti-infectives and Common Anesthetics","authors":"K. McLaughlin, James W. Schurr, Craig A. Stevens","doi":"10.2310/anes.18229","DOIUrl":"https://doi.org/10.2310/anes.18229","url":null,"abstract":"Interactions between various medications can lead to changes in the expected response of one or more of those medications. Drug interactions can be pharmacokinetic (altered absorption, distribution, metabolism or excretion of the medication) or pharmacodynamic (alterations based on similarities or differences in the mechanisms of medications with respect to their effect on the body). Although drug interactions exist in many specialties in medicine, this chapter focuses on those that affect the responses of common anesthetic agents or drugs given with those agents. While anesthesiologists monitor objective measures and titrate many medications to the desired effect, understanding and anticipating drug interactions can help reduce unexpected effects of medications.\u0000\u0000This review contains 2 figures, 4 tables and 36 references \u0000Key words: anesthetic agents, antiinfective agents, drug interactions, mechanism, pharmacodynamics, pharmacokinetics","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"283 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130004255","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":"Ophthalmologic Anesthesia: Open Eye Injuries","authors":"S. Estime, S. Rahmani","doi":"10.2310/anes.18346","DOIUrl":"https://doi.org/10.2310/anes.18346","url":null,"abstract":"Anesthetic management for ophthalmic surgery in a patient with an open eye injury requires a pragmatic, evidence-based approach to optimize success. Close communication with the ophthalmologist can make a significant impact on outcome. Additionally, providing appropriate pulmonary aspiration risk reduction using established guidelines; thoughtfully managing the challenging airway; and choosing the best medications during induction, maintenance, and emergence are all critical to minimizing the risks for further eye injury. Anesthetic goals can often be in opposition to one another, but with the appropriate knowledge, experience, and effective communication between patient and surgeon, the anesthesia provider can maintain patient safety while effecting the desired surgical outcome.\u0000This review contains 2 figures, 4 tables and 37 references\u0000Key Words: awake intubation, deep extubation, emergency eye surgery, eye trauma, full stomach, intraocular extrusion, intraocular pressure, open eye injury, succinylcholine and open eye sugammadex","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"10 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127071760","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 Physiology","authors":"Brian Frugoni, L. Downey","doi":"10.2310/anes.18007","DOIUrl":"https://doi.org/10.2310/anes.18007","url":null,"abstract":"The neonate has many unique physiologic characteristics that set it apart from older children and adults. Many of these differences arise from the requirements for fetal growth and development and the abrupt transition from fetal to extrauterine life. All organ systems are impacted, with critical implications for medical management. Understanding the unique features of the neonate is essential for the safe anesthetic care of these patients. This chapter reviews fetal development of the different organ systems, along with their function during the neonatal period. Placental physiology as it pertains to anesthetic management will be reviewed. Special attention will be paid to transitional cardiac and respiratory physiology as well as neonatal respiratory mechanics. Renal acid–base maintenance, fluid and electrolyte management, hematologic and neurologic systems will be discussed. Emphasis is on the term neonate, although preterm neonatal physiology is also briefly reviewed. Common neonatal disease states are also covered. The goal is for the anesthesia practitioner to gain a greater understanding of the unique aspects of the neonate so that they may better care for this vulnerable subset of patients.\u0000\u0000This review contains 8 figures, 13 tables, and 52 references.\u0000Key Words: apnea of prematurity, chronic lung disease, infant lung mechanics, intraventricular hemorrhage, neonate, patent ductus arteriosus, patent foramen ovale, persistent fetal circulation, transitional circulation, retinopathy of prematurity","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115576509","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":"Antepartum and Postpartum Hemorrhage","authors":"Lauriane Guichard, C. Pancaro","doi":"10.2310/anes.18202","DOIUrl":"https://doi.org/10.2310/anes.18202","url":null,"abstract":"Obstetric hemorrhage is among the leading causes and the most preventable cause, of maternal mortality. Hemorrhage can be divided into early (stage 1) to late stages (stage 3), depending on the amount of blood lost and vital sign changes. Etiologies include antepartum hemorrhage such as abnormal placentation and postpartum hemorrhage such as uterine atony and retained products of conception. Early recognition of ongoing hemorrhage based on risk factors, vital sign changes, and quantification of blood loss is essential to adequately resuscitate the patient. Obstetric hemorrhage emergency flowcharts and the use of point-of-care testing such as rotational thromboelastometry have been developed to guide clinicians in their resuscitative efforts and blood product use as hemorrhage progresses.\u0000\u0000This review contains 5 figures, 6 tables and 29 references\u0000Key Words: abnormal placentation, antepartum hemorrhage, blood products, massive hemorrhage, maternal early warning signs of hemorrhage, postpartum hemorrhage, rotational thromboelastometry, uterine atony","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"41 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116691351","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":"Neurovascular Critical Care","authors":"J. Sarmiento, S. Lahiri","doi":"10.2310/anes.18365","DOIUrl":"https://doi.org/10.2310/anes.18365","url":null,"abstract":"Ischemic stroke and intracranial hemorrhage are among the most devastating and debilitating injuries in medicine. Initial management principles for acute ischemic stroke rely on prompt revascularization before the brain parenchymal is infarcted. Large hemispheric infarctions and malignant cerebral edema occur uncommonly in a subset of patients with acute ischemic stroke and are associated with high morbidity and mortality rates. The indications for decompressive hemicraniectomy for malignant cerebral edema are reviewed. Medical management of intraparenchymal hematomas and aneurysmal subarachnoid hemorrhage in the intensive care setting is emphasized. Important clinical sequelae of subarachnoid hemorrhage such as rebleeding, cerebral vasospasm, and cerebral salt wasting are reviewed.\u0000 \u0000This review contains 5 figures, 4 tables and 52 references\u0000Key Words: acute ischemic stroke, cerebral aneurysm, cerebral vasospasm, decompressive hemicraniectomy, intracerebral hemorrhage, large hemispheric infarctions, subarachnoid hemorrhage, malignant cerebral edema","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"26 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126082235","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":"Neurosurgical Critical Care","authors":"J. Sarmiento, S. Lahiri","doi":"10.2310/anes.18400","DOIUrl":"https://doi.org/10.2310/anes.18400","url":null,"abstract":"The overarching goal of neurosurgical critical care is to prevent potential deleterious effects of secondary brain injury. The initial management of patients with traumatic brain injury prioritizes the assessment of injury severity and prevention of hypotension and hypoxemia. The assessment of severity in patients with traumatic brain injury is important for determining the need for intubation and need for placement of intracranial monitoring. The stepwise management of increased intracranial pressure following traumatic brain injury is emphasized to prevent cerebral herniation syndromes and cerebral infarcts. Treatment with glucocorticoids following acute spinal cord injury is not recommended. Operative indications for intracranial monitor placement, hemicraniectomy, and spinal decompression are reviewed.\u0000 \u0000This review contains 1 figure, 3 tables and 32 references\u0000Key Words: glucocorticoids in spinal cord injury, hemicraniectomy, intracranial hypertension, multimodal monitoring, secondary brain injury, spinal cord injury, spinal decompression, traumatic brain injury","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"77 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131285110","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":"Robotic Surgery","authors":"A. Carbonell, J. Warren","doi":"10.2310/anes.2212","DOIUrl":"https://doi.org/10.2310/anes.2212","url":null,"abstract":"Robots have revolutionized industrial production, from automobiles to pharmaceutical manufacturing, and offer an exciting, novel approach to surgical diseases. Robots employed in surgical use initially raised some concern related to malfunction and independent action. However, the surgeon’s decision-making capability is still crucial for each surgical procedure because of the anatomic or physiologic variables of each clinical situation. Currently, surgical robots consist of instruments that are remotely manipulated by a surgeon using an electromechanical interface and represent extensions of the surgeon’s mind and hands. This review provides an overview of robotic surgery, and covers the application of robotic surgery in general surgery. Figures show the AESOP 3000 robotic arm, the da Vinci robotic surgical system, the ZEUS Surgical System, the ZEUS robotic arms, the da Vinci Si, the da Vinci wristed endoscopic stapler, the da Vinci Xi patient side cart and robotic arms, the da Vinci Single-Site robotic instruments, and the da Vinci Single-Site port with instruments positioned and robotic arms docked. The video shows a robotic Rives-Stoppa retromuscular incisional hernia repair with bilateral transversus abdominis release.\u0000 \u0000This review contains 9 highly rendered figures, 1 video, and 85 references\u0000Key words: Robotic, surgery, hernia, inguinal, ventral, incisional, fundoplication, paraesophageal hernia, myotomy, gastrectomy, cholecystectomy, pancreatectomy, splenectomy, bariatric, adrenalectomy, colon, colectomy, colorectal\u0000 ","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"23 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121206677","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":"Antepartum Complications of Pregnancy","authors":"G. Moore","doi":"10.2310/anes.8111","DOIUrl":"https://doi.org/10.2310/anes.8111","url":null,"abstract":"Pregnancy presents unique considerations and challenges to the critical care provider, including the physiologic adaptations to the pregnant state, recruitment and collaboration with a multidisciplinary care team, determination of fetal status, preparing for and managing cardiac arrest in pregnancy, and evaluation and management of diseases unique to pregnancy (including preeclampsia and acute fatty liver of pregnancy).\u0000This review contains 48 references, and 4 tables.\u0000Key words: acute fatty liver of pregnancy, maternal cardiac arrest, perimortem cesarean section, preeclampsia, pregnancy","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"109 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2018-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123148781","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":"Patient-Controlled Analgesia","authors":"D. Peck","doi":"10.2310/anes.15038","DOIUrl":"https://doi.org/10.2310/anes.15038","url":null,"abstract":"Patient-controlled analgesia (PCA) is a method for controlling pain in which a patient is able to self-administer pain medications via activation of a mechanical distribution system. The key element of PCA is that the patient is in control of the analgesia. Respiratory depression is preceded by sedation, and a sedated patient is unable or unlikely to push the PCA button. The pump can also be programmed to have a continuous infusion rate, which is administered to the patient regardless of whether the patient activates a dose. Basal rates bypass the safety mechanism of patient control and can place the patient at higher risk for respiratory depression and sedation. Initiation of a PCA is often most appropriate in patients requiring frequent as-needed dosing of medications or when such dosing is anticipated. Patients’ acceptance of the technique is high, related in part to a sense of control over their own pain relief, a reduction in the delay for the receipt of pain medications, not receiving injections, and not having to interrupt or to bother nurses.\u0000This review contains 2 tables and 20 references. \u0000Key words: analgesic delivery systems, morphine metabolism, multimodal pain management, opioid pharmacology, opioid side effects, patient-controlled analgesia, patient safety, respiratory depression ","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"176 3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2016-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"120958649","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":"Awake Craniotomy","authors":"Dennis J. McNicholl","doi":"10.2310/anes.18060","DOIUrl":"https://doi.org/10.2310/anes.18060","url":null,"abstract":"Prior to the advent of anesthesia, performing surgical procedures on patients in the awake state was the order of the day. In modern times, especially with the continued advancement and safety of anesthesia, such a practice of performing surgery on a patient in the awake state might appear unnecessary, and perhaps even medieval. However, this practice still does intentionally occur for a subset of neurosurgery patients. This unique dimension of the procedure places special demands on the anesthesiologist’s knowledge base, skill and training in order to produce a successful patient outcome. This chapter delves into salient aspects of patient selection, operating room setup, monitoring and communication considerations, pharmacologic regimens, regional anesthetic options and a thorough list of complications for which to be prepared.\u0000This review contains 5 figures, 5 tables, and 69 references.\u0000Keywords: awake craniotomy, functional neurosurgery, eloquent cortex, awake-asleep-awake, electrocorticography, epilepsy, deep brain stimulator, dexmedetomidine, intraoperative seizure","PeriodicalId":345138,"journal":{"name":"DeckerMed Anesthesiology","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130260540","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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