Theodore H. Stanley, M. D. What's New in, Anesthesiology in 1988 contains the Refresher Course manuscripts of the presentations of the 33rd Annual Postgraduate Course in Anesthesiology which took place at the Marriott Hotel Convention Center in Salt Lake City, Utah, February 19-23, 1988. The chapters reflect new data, ideas and concepts within the general framework of most recent developments in "evaluation and monitoring cardiac function before, during and after surgery," "new anesthetics and their actions on the heart and peripheral vasculature, and other organ systems," "metabolism and elimination of anesthetics and anesthetic adjuvants," and "recent developments in the anesthetic management of patients with congenital heart disease, renal and pulmonary dysfunction, and diabetes insipidus. " In addition, there are chapters on new developments in "obstetrics," "regional anesthesia," and "anesthetic management of the newborn. " The purposes of the textbook are to 1) act as a reference for the anesthesio logists attending the meeting, and,2) serve as a vehicle to bring many of the latest concepts in anesthesiology to others within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia expressed at the conference. This book and its chapters should not be considered complete treatises on the subjects addressed but rather attempts to summarize the most salient points. This textbook is the sixth in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City."

by E.K. ZSIGMOND, M.D. Department of Anesthesiology University of Illinois Chicago U.S.A. It is, indeed, a distinct honor and privilege to be invited by the authors to write a preface to this monumental monograph, Regional Opioid Analgesia. Regional Opioid Analgesia is a colossal undertaking by Drs. De Castro, Meynadier and Zenz shortly after the introduction of this revolutionary approach to pain relief which opened a new epoch in analgesiology. This is, indeed, the first authentic and comprehensive textbook encompassing the current knowl edge on this novel approach to pain relief. We are indebted to the authors for introducing the new opioids to regional analgesia with the scientists, who de veloped the potent short and ultrashort acting opioids with high therapeutic indices, which many researchers dreamt about but never before materialized. The side effect liabilities of these new opioids are minute as compared to morphine and meperidine. Regional Opioid Analgesia could not have been more authentically written than by Drs. De Castro, Zenz and Meynadier, who have conducted daily clinical investigations on all known opioids for regional analgesia as well as for neurolept analgesia. Therein lies the great value of this monograph: it is the most authentic work on this topic."

Chronic and persistent pain, which is a problem for the individual who suffers and the society that has to deal with it, has become increasingly appreciated. Over the last three decades, several books and journals have been specifically devoted to the topic of pain, especially chronic and persistent pain. It has been increasingly recognized that chronic and persistent pain, unlike acute pain, involves significant psychosocial factors and requires treatment strategies that deal with these issues. All measurements and factors that affect improvement seem to be in the psychosocial area rather than the medical/ biological/physical areas. Psychosocial conveys the importance of the environmental and interpersonal factors of the patient's functioning. The writing of this book has brought together some of the leading researchers and clinicians in the area of managing the patient with chronic pain. The authors express their opinions based on experience and review of the literature available to date. Each of the chapters focuses on an important element of the assessment and/or treatment intervention utilized for the individual with chronic pain. The concluding chapter summarizes the status of the assessment and treatment strategies for those patients.

Pain is universal. This can be traced from the first toothache evidence in fossil remains of a human jawbone to today's pharmacies packed with a huge spectrum of over-the-counter medications. Millions of people seek treatment for pain every year. In "Pain Management Solutions," author Debra S. Cole explores issues related to different types of pain and offers a visionary five-stage approach to pain management."

Cole provides a holistic process to help patients address pain issues due to injury or medical conditions. A comprehensive tool, Pain Management Solutions addresses current pain treatments and considers the various stages of the process of dealing with pain:

The crisis stage of pain

The fix-it stage

The management stage

The rebuilding stage

The resolution stage

Presented in a complete and easy-to-understand manner, Cole offers strategies for coping with pain to help patients rebuild their lives. This guide provides hope and inspiration for anyone who struggles with both physical and emotional pain.

Operating with bare hands, dressed in his street clothes, he had taken those first steps that every training surgeon must take-gripping the handle of a scalpel and making the first, irrevocable cut into live human flesh. For the surgeon training in the early 1840s, these first surgical milestones were performed on a person who would recoil in terror and horror, flinch, pull away, shake-and scream and scream and scream. Until 1846, surgery was performed without anaesthesia: extraordinary operations, carried out on conscious, terrified patients. Surgeons of that era were bold and courageous and saved many lives, but anaesthesia changed everything. With an unconscious patient, the surgeon could take his time. Surgery became slower, more careful and more delicate. And as anaesthesia removed the pain of surgery, the medical world gave more attention to surgical infection, heralding in the use of antiseptics and eventually aseptic surgery. By 1881, the operating theatre was unrecognisable. Much has been written about surgery in the nineteenth century, but little has been said about the development of the relationship between surgeon and anaesthetist. For anaesthesia to mature and allow further advances in surgery, a professional relationship had to develop between surgeons and anaesthetists. Joseph Clover arguably did more than any other anaesthetist to develop that relationship. In The Chloroformist, Christine Ball tells the captivating story of an innovative, hard-working and deeply humane pioneer of modern patient care.

A HISTORY OF MALIGNANT HYPERTHERMIA Malignant hyperthermia (MH) is a hereditary disorder of muscle. Undoubtedly, individuals have possessed this trait since time immemorial. However, because the trait is usually only unmasked in the presence of potent inhalational anaesthetic agents or non-depolarizing skeletal muscle relaxants, the existence of malignant hyperthermia was not suspected until we" after the dawn of the modern anaesthetic era. In the early years of ether and chloroform anaesthesia, monitoring was minimal. Body temperature was never measured. A finger on the pulse, and observation of respirations and skin colour were the most that could be expected. Death was not infrequent and usually unexplained (1). By the beginning of the twentieth century, reports of fulminant fever and tachycardia (rapid heart rate) during or immediately after anaesthesia often ending in death, were being described with increasing frequency in the medical literature (2-6). As a number of cases from New York had occurred during summer months, they were initially thought to be a form of heat stroke due to overly hot operating theatres (2-6). However, one enterprising anaesthetist (5: ' checked the weather reports for the days on which some of these so called "heat strokes" had occurred. He found that on the days i'n question the ambient 0 temperature had never been in excess of 72 F. Environmental heat, therefore, could not have been a cause of at least some of these reactions.

Thousands of articles and many books have been published on the acquired immunodeficiency syndrome (AIDS). There are, however, no studies or case reports and only several articles published on the anesthetic considerations for a person with AIDS or in pain with AIDS. There is no literature on the pain management of AIDS patients. Writing on this subject must be considered trailblazing. The reason anesthesiologists should know about AIDS has rapidly extended from concern over transmission of infection to anesthetic and analgesic considerations. The anesthesiologist may also be part of a pain management team on either an acute or a chronic pain service. The requirement may be to treat an HIV -positive or AIDS patient acutely postoperatively or in consult to a psychiatric, medical, or surgical service. In a pain clinic setting, the anesthesiologist may be concerned with diagnosis, treatment, or referral for other multidisciplinary consultation. The earlier question of central nervous system involvement in AIDS is now moot, rapidly replaced with the knowledge that the eNS, if not primarily infected, is so shortly thereafter. Protected by the blood-brain barrier, the eNS becomes both a sanctuary and reservoir for HIV. Because neurologic complications of HIV are common, and since knowledge of the nervous system is essential for anesthetic and pain management, it is important to review HIV infection of the nervous system.

The pain center/clinic is in the stage of transition. It has come a long way since chronic pain was a nonexistent entity and patients with difficult pain problems did not receive well-deserved attention or were lost in the busy practices of vari ous specialty clinics. Thirty-five years ahead of the rest of us, John]. Bonica was the first physician who had a clear vision of a pain center's potential. Twenty years later, in response to loud public demands for relief of chronic pain, this idea was put into practice by a number of others on a somewhat larger scale. A team of specialists from various disciplines, trained in the management of chronic pain, now offer approaches ranging from simple outpatient care to inpatient hospital ization for comprehensive care including drug detoxification, behavior modi fication, and total rehabilitation of these patients. Hospitals have entered this arena with renewed enthusiasm. The pain center/clinic is now an established, ac cepted, and expanding method of providing care for chronic pain patients. The chapters in this book are based on examples of multidisciplinary projects that deal comprehensively with management of chronic pain. Aimed primarily at the pain center/clinic in the university hospital setting, this book ranges from his torical perspectives to current pain centers with their less orthodox methods of re lieving chronic pain to the future of algology as a specialty."

Here is the perfect text you need to provide your learners with real-life clinical scenarios that are ideal for Case-Based Learning and Discussion. Presents real-world patients in a real-world clinical setting, making learning fun and engaging. The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as arthritis, deltoid ligament strain, Achilles tendinitis and tendon rupture, bunion and bunionette pain, plantar fasciitis, metatarsalgia, and more. Cases unfold just the way they do in your clinic. Each case is accompanied with thoughtful clinical commentary and key messages from the author. Each chapter uses high-quality radiographic images, clinical photos, and full-color drawings to facilitate a clear, easy-to-understand approach to evaluation and diagnosis. An ideal self-assessment and review tool for pain medicine practitioners and trainees, as well as those preparing for the American Board of Anesthesiology Pain Medicine certification and recertification exam. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Here is the perfect text you need to provide your learners with real-life clinical scenarios that are ideal for Case-Based Learning and Discussion. Presents real-world patients in a real-world clinical setting, making learning fun and engaging. The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as costosternal syndrome, Tietze's syndrome, devil's grip, fractured ribs, post-thoracotomy pain, acute and chronic pancreatitis, diverticulitis, and more. Cases unfold just the way they do in your clinic. Each case is accompanied with thoughtful clinical commentary and key messages from the author. Each chapter uses high-quality radiographic images, clinical photos, and full-color drawings to facilitate a clear, easy-to-understand approach to evaluation and diagnosis. An ideal self-assessment and review tool for pain medicine practitioners and trainees, as well as those preparing for the American Board of Anesthesiology Pain Medicine certification and recertification exam. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Evidence-based medicine is a concept that is at the forefront of anaesthesia. Clinicians are increasingly encouraged to practise patient management based on available evidence in the scientific literature. For example, new anaesthesia methods, e.g. regional anaesthesia, are being used more frequently based on case studies that show the efficacy and cost-savings associated with the treatment. Additionally, considering that many anaesthetists are required to cover a range of areas, information discussing proven methods as well as pitfalls to avoid are valuable to all those working in the field.
This book provides a detailed summary of the most important trials and studies in anaesthesia, ranging from neuroanaesthesia and anaesthesia for transplant, to paediatric and thoracic anaesthesia, allowing the reader to rapidly extract key results. Each chapter is written by a prominent anaesthetist in that particular field, and papers have been selected on a number of criteria, included impact factor, authors' choices, or even because the conclusions reached do not indicate best practice. With this wealth of information collected into this newest volume in the 'Landmark Papers in' series, Landmark Papers in Anaesthesia is essential reading for all practicing anaesthetists.

Chronic pain is a silent epidemic, with one in five people suffering in their day-to-day life. An indispensible guide to understanding why your pain persists, what is going on inside your body and the symptoms that pain triggers, Manage Your Pain presents possible medical treatments and guides you through practical exercises for daily life. Dr Nicholas and Dr Molloy's strategies make it possible to set short and long term goals that will minimise the impact of pain on both work and leisure. In short, this book offers clarity and control. - Draws on the authors' extensive experience and the latest research - Clearly explains the causes of pain - Offers positive and practical ways to minimise the impact of pain - Revised and updated - Includes a chapter on pain management for older people Highly qualified and experienced medical professionals who specialise in pain management, the authors of this book offer complementary specialisms, ensuring that the widest range of treatments are covered.

Now divided into four parts, the second edition of Cancer Pain delivers broad coverage of the issues that arise in the management of malignancy-related pain, from basic science, through end of life care and associated ethical issues, to therapies, both medical and complementary. Part One reviews basis considerations in cancer pain management, including epidemiology, pharmacology, history-taking and patient evaluation and teamworking. Part Two brings together the drug therapies for cancer pain, their underlying basis, and potential side-effects. Part Three covers the non-drug therapies, including nerve blocks, stimulation-induced analgesia, radiotherapy, complementary therapies and psychological interventions. The control of symptoms other than pain, so critical to cancer patients, is also considered here. Part Four describes special situations. Cancer pain management in children and older patients, and in the community setting, and pain in the dying patient and the cancer survivor are all covered here.

In an interesting survey amongst doctors, fibromyalgia was considered the least prestigious disease. Although this survey was done in a Scandinavian country and was done more than 13 years ago, the grim situation is still the same today all over the world. Patients suffering with fibromyalgia feel that they are not believed and they are not listened to. Despite knowledge being gathered on this disease for a few centuries, and having definite diagnostic criteria and management pathways, the healthcare system still fails many patients who are left without a diagnosis or treatment plan. Fibromyalgia is a disease that causes widespread pain in many areas of the body and has significant accompanying symptoms like fatigue, waking unrefreshed and cognitive symptoms. Fibromyalgia affects patients as a whole including their cognitive performance, physical skills, psychological status, ability to work and social life. It can present as a part of the spectrum of functional pain syndromes, often accompanied by other systemic conditions such as irritable bowel syndrome, headaches and chronic fatigue. It is estimated that 1 in 20 can suffer with this debilitating condition. This textbook will cover the condition in great detail and is written in an easy-to-understand style. Doctors, nurses, medical students, physiotherapists, occupational therapists, psychologists, and other healthcare professionals will find this book informative. Patients who suffer from fibromyalgia will also find it useful to understand their medical condition; the book will help to direct them to specific treatment strategies, explaining the benefit and risk in detail. As this is a common chronic pain presentation, it will be of immense use to candidates preparing for examinations conducted by the Royal College of Anaesthetists, UK (FRCA), Faculty of Pain Medicine, UK (FFPMRCA), American Board of Anesthesiology (AB), College of Anaesthesiologists of Ireland (FCAI), European Society of Anaesthesiology and Intensive Care (EDAIC), Australian and New Zealand College of Anaesthetists (FANZA), World Institute of Pain (FIPP/CIPS), Canadian Board exams, National Board of Examinations of India (Dip NB) and other competitive exams across the globe. The author is a senior consultant in pain medicine practising in the United Kingdom and is consulted by thousands of chronic pain patients every year. He has won many educational awards including a national innovative award in pain medicine. One of his innovations is published in the list of examples of excellence by the Faculty of Pain Medicine, London. He has lectured at many international, national and regional meetings, and is a regular invited expert lecturer in public groups and fibromyalgia patient support groups. He has also published many articles and textbooks on pain medicine.

This book deals with the management of labour, guiding the readers to recognize problems by keen monitoring, based on anatomical and physiological understanding of labour. In this era of technology, this book revives the fading art of identification of clinical signs and symptoms. The chapters are well-structured, covering different aspects from suspicion to identification of the problems by recognizing subtle warning signals by the fetus and the uterus. Operative deliveries and common obstetric emergencies with their appropriate management are also covered. It provides practical points to prevent, anticipate, recognize, and manage problems during labour. Key Features Helps to identify clinical signs and symptoms that infuses the reader with confidence to identify and manage abnormal situations during labour and childbirth through the feel of their fingers and awakened understanding. A must have book for all postgraduate trainees and practitioners of obstetrics, eager to learn the fundamentals of labour management. Features illustrated cases helpful in learning management of normal labour and pick abnormal labour, at the earliest possible deviation from normalcy.

Written by two anaesthetists, one British and one American, this unique book focuses on the transatlantic story of anaesthesia. The authors have both worked at the two hospitals where the first general anaesthetics for surgery were given in 1846, Massachusetts General Hospital in Boston, Massachusetts and University College Hospital, London. Each with more than fifty years' experience of working in anaesthesia, they combine their knowledge and expertise to offer a fresh outlook on the development of anaesthesia through the ages. This highly informative and intriguing text details the origins of anaesthesia, outlines the different techniques of anaesthesia and traces its progress with illuminating and enlightening commentaries. This is a fascinating book which considers the role key figures have played in developing anaesthesia including, Queen Victoria, William Morris, La Condamine, Bjorn Ibsen and Henry Beecher. Broken down into four sections, which are divided into easy-to-read chapters and filled with top quality photographs, this book makes compelling reading. It is recommended to all those interested in the history and development of medicine through the ages, and is of particular interest to anaesthetists. More than just the science of anaesthesia, this is the story about the people and personalities who have made anaesthesia what it is today.

Linking theory to practice through the use of authentic clinical cases, Dr. Steven D. Waldman's Pain Medicine: A Case-Based Learning Series helps readers acquire the valuable skill of effective diagnostic thinking in daily practice. The Knee volume uses an in-depth case format, preparing you to correctly analyze clinical vignettes and formulate a clinically sound, evidence-based approach to realistic patient scenarios. This highly effective leaning and assessment tool provides practical clinical insights into the best methods for diagnosis and treatment for the successful management of patients with knee-related pain. Presents real-world patients in a real-world clinical setting, making learning fun and engaging. The Case-Based Learning approach focuses learners and clinicians on the key elements for each diagnosis and helps develop a deep understanding of how to diagnose and treat each condition. Covers everyday clinical problems such as Osteoarthritis and Rheumatoid Arthritis of the Knee; Medical and Lateral Meniscal Tear, Anterior Cruciate Ligament Tear, Jumper's and Runner's Knee, Bursitis, Osgood Schlatter Disease, Hamstring Tendinitis, and more. Cases unfold just the way they do in your clinic. Each case is accompanied with thoughtful clinical commentary and key messages from the author. Each chapter uses high-quality radiographic images, clinical photos, and full-color drawings to facilitate a clear, easy-to-understand approach to evaluation and diagnosis. An ideal self-assessment and review tool for pain medicine practitioners and trainees, as well as those preparing for the American Board of Anesthesiology Pain Medicine certification and recertification exam. Enhanced eBook version included with purchase. Your enhanced eBook allows you to access all of the text, figures, and references from the book on a variety of devices.

Phantom pain is an intriguing mystery that has captured the imagination of health care providers and the public alike. How is it possible to feel pain in a limb or some other body part that has been surgically removed? Phantom pain develops among people who have lost a limb or a breast or have had internal organs removed. It also occurs in people with totally transected spinal cords. Unfortunately, phantom pain is a medical night mare. Many of the people reporting phantom pain make dispropor tionately heavy use of the medical system because their severe pains are usually not treated successfully. The effect on quality of life can be devas tating. Phantom pain has been reported at least since 1545 (Weir Mitchell as related by Nathanson, 1988) and/ or experienced by such diverse people as Admiral Lord Nelson and Ambroise Pare (Melzack & Wall, 1982; Davis, 1993). The folklore surrounding phantom pain is fascinating and mirrors the concepts about how our bodies work that are in vogue at any particu lar time. Most of the stories relate to phantom limbs and date from the mid-1800s. The typical story goes like this: A man who had his leg ampu tated complained about terrible crawling, twitching feelings in his leg. His friends found out where the leg was buried, dug it up, and found maggots eating it. They burned it, and the pain stopped. Another man complained of a swollen feeling with frequent stinging or biting pains."

Ophthalmic Anaesthesia is a new textbook written by an international group of authors who are recognized experts in the fields of anaesthesia and ophthalmology. Covering the entire subspecialty of anaesthesia for surgery of the eye, the book offers chapters on a variety of subjects including: the history of ophthalmic anaesthesia, physiology and pharmacology, anatomy, pre-operative assessment, paediatric anaesthesia, orbital regional anaesthesia, general anaesthesia, complications, high-volume cataract surgery, and future developments. Written by both academicians and experienced clinicians, this is a well-referenced and illustrated text describing the techniques used in the anaesthetic management of patients undergoing the most commonly performed surgical procedures in the world.

Addresses the most important aspect of anaesthetic training - learning in the operating suite. It has been written by experts in this area from both the UK and the USA to assist both experienced and new trainers. It is particularly helpful to advanced trainees who are just developing their teaching skills. The information is clearly presented and can easily be incorporated into the practice of clinical anaesthesia. It provides an unequivocal guide to the process of developing a safe and conscientious colleague from the novice anaesthetist in their first few days to the latter days of advanced training just prior to independent practice. Written by specialists in anesthetics from the UK and US, this text addresses the learning that takes place in the operating room Coverage includes many aspects of the pedagogical project, from providing the right environment for learning and clinical supervision to the ethics of learning on patients, and problem-based learning (PBL); clinical teachinggiving feedback and monitoring progress; and using simulators for teachingtechnical and non-technical skills that may be taught using simulation, how to set up a high-fidelity simulator center, and how to organize a major obstetric hemorrhage "fire drill."

In spite of today's increasing body of knowledge in regard to central nervous func tion and/or the mode of action of centrally active compounds, little is done to monitor those patients which are at risk of cerebral lesions either in the OR or in the ICU. Due to the inconsistency of reports regarding the application and the benefits computerized EEG and/or evoked potential monitoring will bring to the clinician, physicians still are reluctant to get involved with a technique, which they think, will have little or no effect on the outcome of a patients well being. However, due to the development in computer technology, data acquisition and comprehension, it now is possible to monitor such a viable organ as the Central Nervous System (CNS) on a routine base without being a specialist in neurology or electroencephalography. Thus, the book is intended to guide the clinician to use BEG and evoked potential monitoring in a day to day situation, without going too deep into technical details. As an improvement of cerebral care is needed, various representative cases underline the interpretation of EEG power spectra and evoked potential changes in regard to the underlying clinical situation. It is hoped that this book will serve as a guide to anyone who considers cerebral monitoring a necessity in today's patient care. This may be the anesthesiologist, the intensive care therapist, the nurse anesthetist as well as the medical personnel in the lCU setting."

With a focus on practical acute pain management in adults in the hospital setting, this book provides health professionals with simple and practical information to help them manage patients with acute pain safely and effectively. * Combines evidence-based information with practical guidelines and protocols * Covers the pharmacology of opioids, local anesthetics, and nonopioid and adjuvant analgesic agents * Discusses management of acute pain in both surgical and nonsurgical acute pain settings including in patients with spinal cord or burns injuries and selected medical illnesses * Includes evidence-based information about management of acute pain in some specific patient groups , including the older patient, opioid-tolerant patients, and those with addiction disorders, pregnant or lactating patients and patients with obstructive sleep apnea or who have renal or hepatic impairment * Considers the role of acute pain management in the context of the current opioid epidemic and identifies possible strategies to minimise the risks. This resource will be helpful to a variety of professionals in assessing and managing acute pain.