One of the anesthesiologist's greatest challenges is managing high-risk patients with acute or severe conditions.? This issue brings the anesthesiologist up to date on the most important and latest approaches to management of the sickest of patients.? Topics covered include managing the patient with sepsis or septic shock; anesthetic considerations for patients in respiratory failure; anesthetic concerns in patients presenting with renal failure; perioperative management of patients with liver failure; management of acute coronary syndrome in the OR; intraoperative concerns in patients presenting with sever aortic stenosis, aortic insufficiency, mitral regurgitation, or mitral stenosis; intraoperative management of patients with cardiac tamponade; anesthetic concerns in trauma victims requiring operative intervention; patients presenting with acute toxin indigestion; anesthetic concerns in patients with known neurologic insufficiency; management of endocrine insufficiency in the OR; and management of patients with mediastinal mass or tracheal stenosis.

This book explores pain in a number of ways. At the heart of the book is an extension of Melzack's neuromatrix theory of pain into the social, cultural, and economic fields. Specific assemblages involving varied institutions, flows of capital, encounters, and social and economic structures provide a framework for the formation of pain, its perception, experience, meaning, and cultural production. Complementing the extended neuromatrix is a second theory, focussed on the propensity of western market capitalism to seek out new areas of life to subsume to capital. Pain is one such life area that is now ripe for exploitation. Although the book has theory at its heart, it draws extensively on case studies to identify the contradictions and complexities. Case studies are drawn from accounts of drug use in varied contexts such as prescription drugs, methamphetamine use, oxycodone use in North America, and the global rise of the medicinal cannabis marketplace.

Topics: Perioperative Care of Patient with Chronic Opioid Dependence; Anesthesia for Sites Outside the OR; New Developments in Anesthesia Ventilators and Machines; Future of Clinical Research/Ethics in Human Experimentation; Perioperative Glucose Management; Inflammatory Response to Anesthesia and Ways to Attenuate; Chemical Dependence; Anesthesia for Awake Craniotomies; Hyperthermic Peritoneal Chemotherapy; ACGME Competencies; Renal Function Update; Professionalism; New Developments in Neonatal Resuscitation; Automated Anesthesia

This issue brings together leading specialists from diverse fields including multiple subspecialties of anesthesiology, as well as surgery, cardiology, oncology, neurology, hospital medicine, endocrinology, and others. A multidisciplinary approach is essential to patient safety and optimal outcomes, so this valuable and unique monograph brings the anesthesiologist up to date on current integrated methods of preoperative assessment, consultation, and patient preparation for surgery. Article topics include preoperative evaluation and prep of the patient for cardiac surgery; noncardiac surgery in the patient with heart disease; identification and evaluation of the patient with lung disease; surgery on the patient with endocrine dysfunction; obesity, metabolic syndrome, and the surgical patient; surgery in a patient with liver disease; surgery in the patient with renal dysfunction; anemia in the preoperative patient; perioperative anticoagulant management; preop prep of the surgical patient with neurologic disease; and emergency and urgent surgery.

This issue of Anesthesiology Clinics prepares the anesthesiologist for the most challenging problems he will face with geriatric patients. Topics covered include delirium, postoperative cognitive dysfunction, fat embolism during hip replacement, Parkinson's disease and deep brain stimulator placement, diastolic dysfunction, atrial fibrillation, delayed arousal, severe atrial stenosis, multiple medications, informed consent and the ethical management of the older patient, dead bowel, acute perioperative beta-blockade in the older patient, urinary retention, and anesthetic care for patients with skin breakdown.

This issue of Anesthesiology Clinics covers the most cutting-edge topics in pediatric anesthesia that every practitioner must know to stay current in this changing field. Topics covered include new devices for difficult pediatric airway, the use of ultrasound in pediatric regional anesthesia, new concepts in treatment of pediatric traumatic brain injury, acute pain management, neurotoxicity of anesthetics in the developing brain, current thought on intraoperative awareness in children, current concepts on managing sepsis in children, the fontan patient, sedating the child with congenital heart disease, management of children with hemoglobinopathies, and current strategies for blood conservation in pediatric anesthesia.

This book would combine chapters written by the most qualified authors around the world whose research encompasses the effect of morphine or other opioids on tumor growth and metastasis. This includes clinicians involved in trials determining which type of post surgical pain management can minimize the risk of recurrence or metastasis, researchers working on animal models and studying the effect of morphine on tumors, and most importantly the mechanism for this effect, and lastly cell biologists. There is currently a lot of research going on trying to reconcile the pro- and anti-cancer aspects of opioids actions.

Many of the earliest books, particularly those dating back to the 1900s and before, are now extremely scarce and increasingly expensive. We are republishing these classic works in affordable, high quality, modern editions, using the original text and artwork.

Methadone and buprenorphine are the only two opioids that are indicated for the management of both pain and opioid-related drug addiction. Both present unique challenges to the general practitioner and pain specialist, requiring a separate analysis from the rest of the drugs in the same family. Handbook of Methadone Prescribing and Buprenorphine Therapy is an invaluable guide to the safe use of these opioids. Authored by clinical and academic leaders from a variety of settings and backgrounds, this book includes chapters on pharmacology, adverse effects, safe rotation from other opioids, cardiac toxicity, prescribing, pharmacokinetics, equianalgesic dose and replacement therapy. This comprehensive text provides clinicians, researchers, policy-makers and academicians a resource for all the relevant points in methadone prescribing and buprenorphine therapy.

Hemoglobin-based Oxygen Carriers is an exciting and evolving alternative to blood transfusion. This issue explores its potential with topics on: "HBOCs from Human or Bovine Hemoglobin," "Comparison of HBOCs to Stored Human Red Blood Cells," "HBOCs and Tissue Oxygenation," "HBOCs: Role in surgery, resuscitation or hemorrhagic shock?" and more!

For an anesthesiologist, though the challenge of managing an obstetric patient can be very satisfying and rewarding, it can also be extremely difficult given the potential for serious harm to the fetus and mother. For routine care, it is important to understand the risks and benefits of many practices to provide patients with informed decisions and the most satisfying experiences. There are also many less-usual patients and situations, however, that challenge the anesthesiologist's skills significantly. This issue of the Anesthesiology Clinics presents the most up-to-date information on both of these categories, and is written by an outstanding group of experienced clinicians from all over the world. Topics including high-risk analysis, use of simulators for training, major hemorrhage, off-labor-floor consultation, depth of anesthesia monitoring, pharmaceuticals, use of vasopressors, neurological infections after neuroaxial anesthesia, airway management, the HIV patient, ultrasound, and others.

This accessible, easy-to-read book provides readers with different perspectives on the subject of painkillers, examining their history, production, uses, and dangers. Many different drugs are effectively used as painkillers-substances that greatly improve the quality of life for those who suffer from temporary or recurring pain. This book presents an in-depth overview of opiates, opioids, and other painkilling substances such as non-steroidal anti-inflammatory drugs (NSAIDs) that have been in use from ancient times up to the contemporary era. It also addresses the risks of painkiller use, their misuse, and potential overdose concerns. The latest in the Story of a Drug series and written by a subject expert who has published widely on drug use and pharmacology, this book presents a brief review of the science of how different painkiller drugs work before covering these substances' respective effects and applications; the issues regarding the production, distribution, and regulation of painkiller drugs; and research findings on painkiller use, abuse patterns, addiction, and policy issues. The easy-to-understand text presents scientifically accurate information that enables readers to better understand the key role of painkillers in our 21st-century world. Documents the risks of painkiller use and explores the various issues centered around the production, distribution, and regulation of painkiller medications Examines painkillers from a variety of perspectives, including medical, historical, economic, and social Includes primary source documents such as guidelines, policy documents, and study findings on the topics covered that provide readers with more in-depth information and help students hone their critical thinking and analytical skills Examines the social dimensions of the use and abuse of painkiller drugs and considers the future of this particular type of drugs

This text contains the edited presentations of the 39th Annual Postgraduate Course in Anaesthesiology, February 1994. The chapters reflect new data concepts within the general framework of pain research and basic science, and clinical topics in pain management. The purpose of the textbook is to serve as a vehicle to bring many of the latest concepts in anaesthesiology to those who did not attend the conference, within a short time of the formal presentation. Each chapter is a brief by sharply focused glimpse of the current interests in anaesthesia. This volume, as well as past and future volumes, reflects the rapid and continuing evolution of anaesthestiology in the late-20th century.

Practical Ultrasound in Anesthesia for Critical Care and Pain Management is a stand-alone comprehensive reference that covers important aspects of ultrasound for the practicing anesthesiologist. Beginning with a background on the physics of equipment and practical applications, this text takes the specialist through subjects like needle visualization, teaching, training, accreditation, and getting the best out of your ultrasound equipment. With high-resolution ultrasound photographs Practical Ultrasound in Anesthesia for Critical Care and Pain Management covers topics that explore: vascular access nerve blockade echocardiography transesophageal echocardiography - evaluation of the valves basic echo Doppler transesophageal Doppler transcranial Doppler the respiratory system Also included is a fully developed CD, that includes high-resolution video clips of actual ultrasound examples, organized in an easy cross-referenced fashion for the busy clinician.

"Anaesthesia and the Lung 1992" presents recent advances in the diagnosis, pre-, intra-, and postoperative anaesthetic management of patients with lung disease, presenting for pulmonary and non-pulmonary surgery. It also deals with ventilation - perfusion issues, the lung as a metabolic organ, the effects of anaesthesia on pulmonary mechanics and pulmonary blood flow. In addition, there are chapters that focus on hypoxia; regional differences in the lung; pulmonary surfactant; recent advances in the understanding of pulmonary edema; high altitude disease; anaesthesia and the control of breathing; recent development in oximetry; instrumentation designed to measure pulmonary oxygen tension, pO2 and pCO2 transcutaneously; differential lung ventilation; reactive airways; septic shock; the adult respiratory distress syndrome and numerous aspects of ventilatory support.

Written by a professional musician who is also a certified occupational therapist, Teaching Healthy Musicianship both helps music educators avoid common injuries that they themselves encounter and equips them with the tools they need to instill healthy musicianship practices in their students. Author Nancy Taylor combines her two unique skill sets to provide a model for injury prevention that is equally cognizant of the needs of music educators and their students. Through practical explanation of body mechanics, ergonomics, and the performance-related health problems and risk factors unique to musicianship, Taylor gives music educators the tools they need to first practice healthy posture, body mechanics, environmental safety, and ergonomics, and then to introduce these same practices to their students. Taylor also provides practical guidance for healthy musicianship practices in the wrists and shoulders, the most common site of music-related injuries. The final sections address issues of vocal and hearing health, both of which are at high risk in music classroom environments. Working from the dual observations that busy music teachers sometimes overlook taking care of themselves, and that music teachers are not always able to guide students through instrument-related stresses, Taylor provides here a book that addresses injury prevention for the music student and the music educator alike. Thoroughly illustrated with 125 photographs, Teaching Healthy Musicianship is a key resource for preservice and inservice teachers of middle school and high school band, orchestra, choir and general music.

Pain management is a growing area of interest for many health care professionals. It is a truly integrated approach involving a team comprising medical practitioners, clinical psychologists, physiotherapists, occupational therapists and nurse practitioners. Different professions may work together but the approach may also be adopted by individual practitioners. Pain Management: An Interdisciplinary Approach deals specifically with the management of potentially chronic l pain, how to assess patients with pain, the factors involved in the development of chronic pain and the setting up and running of a pain management programme. The main focus is on musculoskeletal and fibromyalgic type pain. Cancer pain is not addressed. The authors address not only what is recommended in the management of pain but also whether and why it is done, thereby covering not only the content of interdisciplinary pain management but also the processes involved. An increasing number of courses on pain management are now being set up around the world. This has created an increasing and continuous demand for a textbook which could be used by those attending these courses and which would provide others who have to deal with the problems as part of their day to day practice with guide to best practice. The book provides an essential reference for all health professionals involved in all aspects of pain management. Provides extensive background material and covers broad issues which other books lack Focuses on not only what is done with the management of pain but whether and why it is done Includes the nuts and bolts of setting up and running a pain management programme Addresses the application of pain management programmes in a wide range of fields Has a multidisciplinary approach and therefore appeals to a multidisciplinary market Two new co-authors: Kay Greasley and Bengt Sjolund. Major restructuring of chapters and rewriting of content with new authors for many of them. Greatly increased discussion of biopsychosocial management in individual clinical practice. Addresses the needs of the individual practitioners as well as those working in specialised pain management units. Includes more on primary care and secondary pain prevention. Expanded discussion of the clinical-occupational interfaces. Particular emphasis on the identification and targeting of modifiable risk factors for chronic pain and prolonged disability. The following topics stregthened throughout: communication, the nature of groups, medication and iatrogenics. Potential of an evidence-based biopsychosocial approach to pain management highlighted.

Decision making regarding fluid volume loading, fluid restriction, or administration of vasoactive drugs may vary among physicians, depending solely upon their clinical experience in the absence of evidence-based measurement. The initial distribution volume of glucose (IDVG) is believed to be clinically relevant as a marker of cardiovascular and fluid management in critically ill patients without a significant modification of glucose metabolism. This book covers all aspects of IDVG measurement, including the basic concept, its relationship with other fluid volumes, and the clinical application of this technique in the intensive care unit based on both the authors studies and their clinical experience with more than 4000 IDVG determinations. When the concept of IDVG is properly understood and its measurement is then performed routinely, daily fluid and cardiovascular management in critically ill patients can be improved based on evidence-based measurement."

Indispensable for both the trainee and experienced professional, this is the only truly comprehensive account of the major role of the neurosurgeon in the diagnosis and treatment of chronic pain. The elite panel of contributors were chosen due to their expertise and international reputations. The result of their achievement covers the whole spectrum from criteria for patient selection and the details of operative techniques, to the risks, complications, and expected outcomes for a wide variety of anatomic, ablative, and augmentative neurosurgical procedures in treating chronic, intractable pain. The neurosurgeon will find here chapters on the latest neuroaugmentative advances utilizing electrical stimulation and implantable drug infusion systems as well as a useful section providing algorithms and guidelines for the evaluation and treatment of specific pain syndromes. Over 100 photographs and exquisite line drawings - many specifically commissioned for this book - enhance the text. Invaluable for acquiring the critical judgement and clinical skills necessary to apply the procedures involved.

This groundbreaking analysis moves our knowledge of pain and its effects from the biomedical model to one accounting for its complex psychosocial dimensions. Starting with its facial and physical display, pain is shown in its manifold social contexts-in the lifespan, in a family unit, expressed by a member of a gender and/or race-and as observed by others. These observations by caregivers and family are shown as vital to the social dynamic of pain-as observers react to sufferers' pain, and as these reactions affect those suffering. The book's findings should enhance practitioners' understanding of pain to develop more effective individualized treatments for clients' pain experience, and inspire researchers as well. Among the topics covered: Why do we care? Evolutionary mechanisms in the social dimension of pain. When, how, and why do we express pain? On the overlap between physical and social pain. Facing others in pain: why context matters. Caregiving impact upon sufferers' cognitive functioning. Targeting individual and interpersonal processes in therapeutic interventions for chronic pain. Social and Interpersonal Dynamics in Pain will be a valuable resource for clinicians who deal in pain practice and management, as well as for students and researchers interested in the social, interpersonal, and emotional variables that contribute to pain, the processes with which pain is associated, and the psychology of pain in general.

For many of the millions of people who undergo anaesthesia each year, it is the source of great fear and fascination. In Counting Backwards, anaesthetist Henry Jay Przybylo has written an unforgettable account of the routine procedure's daily dramas and fundamental mysteries. Przybylo has administered anaesthesia more than 30,000 times on newborn babies, screaming toddlers and sullen teenagers, his own son and even a gorilla. With compassion and candour, he weaves his experiences into stories that explore the nature of consciousness, the politics of pain relief and the wonder of modern medicine. Through its intense and humane tales of mistakes, near-disasters, life-saving successes and moments of grace, Counting Backwards shines a light on a fascinating but unexplored corner of the medical world.

This important book fills a need in the developing area of Pain Medicine. It provides physicians with an up-to-date resource that details the current understanding about the basic science underlying the mechanism of action of the various CAM therapies used for pain. It summarizes the clinical evidence both for efficacy and safety, and finishes with practical guidelines about how such treatments could be successfully and safely integrated into a Pain practice.

Sleep and anesthesia resemble in many ways at a first glance. The most prominent common feature of course is the loss of consciousness, i.e. the loss of awareness of external stimuli. However a closer look at the loss of consciousness reveals already a difference between sleep and anesthesia: anesthesia is induced by an anesthetic drug whereas we may fall asleep without external cause. Other questions may arise about the difference of the two effects: do we dream during surgery under anesthesia, do we feel pain during sleep? Essentially, we may ask: what is common and what are the differences between sleep and anesthesia? To answer these questions, we may take a look at the neural origin of both effects and the involved physiological pathways. In which way do they resemble? Moreover, we ask what are the detailed features of normal sleep and general anesthesia as applied during surgery and which features exist in both phenomena? If yes in which way?

To receive answers to these questions, it is necessary to consider several experimental techniques that reveal underlying neural mechanisms of sleep and anesthesia. Moreover, theoretical models of neural activity may model both phenomena and comes up with predictions or even theories on the underlying mechanisms. Such models may attack several different description levels, from the microscopic level of single neurons to the macroscopic level of neural populations. Such models may give deeper insight into the phenomena if their assumptions are based on experimental findings and their predictions can be compared to experimental results. This comparison step is essential for valuable theoretical models.

The book is motivated by two successful workshops on anesthesia and sleep organized

during the Computational Neuroscience Conferences in Toronto in 2007 and in Berlin 2009. It aims to cover all the previous aspects with a focus on the link to experimental findings. It elucidates important issues in theoretical models that at the same time reflect some current major research interests. Moreover it considers some diverse issues which are very important to get an overview of the fields. For instance, the book discusses not only neural activity in the brain but also the effects of general anesthesia on the cardio-vascular system and the spinal cord in the context of analgesia. In addition, it considers different experimental techniques on various spatial scales, such as fMRI and EEG-experiments on the macroscopic scale and single neuron and LFP-measurements on the microscopic scale.

In total all book chapters reveal aspects of the neural correlates of sleep and anesthesia motivated by experimental data. This focus on the neural mechanism in the light of experimental data is the common feature of the topics and the chapters. In addition, the book aims to clarify the shared physiological mechanisms of both phenomena, but also reveal their physiological differences.

Using rodent models, this volume explores the basic neurobiology of the relationship among chronic pain, opioid pharmacology, and addiction.

"Perioperative Addiction" addresses an issue that every anesthesiologist will encounter many times during the course of his or her career: the patient who arrives for operative care under the influence of legal or illegal drugs. The editors and contributors provide expert guidance on how to identify and manage the addicted patient, approaching the subject from the vantage points of the specific drug and of special patient populations.

Features:

Guidance for spotting and managing addicted patients

All common and important drugs of addiction, from opioids, cocaine, club drugs, and alcohol, to tobacco, marijuana, nitrous oxide, inhalants, and propofol

Special populations, including pregnant women, pain patients, adolescents, older patients, and healthcare professionals

Fascinating overview of the long history of addiction

Genetic basis of addiction, and the range of pharmacological treatments for addiction