To an unusual degree, the shared "working space" of otolaryngologists and anesthesiologists means that issues important to one are important to the other. Anesthesiology and Otolaryngology is the first book to address the closely overlapping information needs of both groups of specialists. It is collaboratively written and edited by anesthesiologists and otolaryngologists, and the chapters are carefully designed to insure maximal relevance to members of both specialties. The heart of the book consists of chapters on managing patients during the full range of otolaryngologic procedures. These chapters are structured chronologically, and otolaryngologic and anesthesiologic perspectives are systematically presented for each operative stage. Foundational topics such as gross and radiographic anatomy, physiology, and pharmacology are covered. The book includes a unique chapter on oxygen delivery systems that serves as a comprehensive review for anesthesiologists and an overview for the otolaryngologist. Special topics addressed include acute and chronic pain management, and the logistics of managing an office-based surgical practice. * "All-in-one" reference for otolaryngologists and otolaryngologic anesthesiologists * Surgical and anesthesiologic perspectives marshaled for pre-operative, intraoperative, and postoperative periods * Pearls and Insights at end of chapters* Organized by surgical region * Special challenges of difficult airway and of pediatric otolaryngologic procedures addressed

This well-illustrated book provides step-by-step guidance on the various techniques - microlaryngoscopic, fiberoptic endoscopic and transcutaneous - that can be employed for the purpose of injection laryngoplasty, a surgical procedure in which a foreign material is injected into the vocal fold. The anatomy and function of the region are first explained, with identification of the causes and means of evaluation of glottic and neoglottic insufficiency. Advice is then provided on the choice of material for injection laryngoplasty, including absorbable and long-lasting options, on the basis of careful analysis that takes into account both the recent literature and the authors' own experiences. Detailed descriptions of the surgical indications and different procedures follow and for ease of reference, clear flow charts on diagnosis and indications are also included. The book concludes with chapters on the use of injection laryngoplasty specifically in the pediatric population and on postoperative care and speech therapy following the procedure. Injection Laryngoplasty will provide valuable assistance to all surgeons wishing to perform this kind of surgery.

The two previous editions of Applied Physiology in Intensive Care Medicine proved extremely successful, and the book has now been revised and split into two volumes to enhance ease of use. This first volume comprises three elements -- "physiological notes," "technical notes," and seminal studies. The physiological notes concisely and clearly capture the essence of the physiological perspectives underpinning our understanding of disease and response to therapy. The technical notes then succinctly explain some of the basics of "how to" in this technology-centered field of critical care medicine. Finally, a number of seminal studies are provided on diverse topics in intensive care. Applied Physiology in Intensive Care, written by some of the most renowned experts in the field, is an up-to-date compendium of practical bedside knowledge that will serve the clinician as an invaluable reference source on key issues regularly confronted in everyday practice.

The initial hours after surgery are a critical time in the care of the surgical patient. Familiarity with the clinical presentation of perioperative complications is important to achieving optimal outcomes. By taking an approach to complications based upon signs and symptoms seen in the early post-operative period among adult patients undergoing non-cardiac surgery, this book aids the practitioner in the clinical management of surgical patients during the often turbulent hours after surgery. After a brief introduction to PACU organization, this manual discusses the common and most serious symptoms encountered in the post-operative patient, giving guidance on diagnosis of the underlying disorder and the treatment options available. The book also includes chapters dedicated to subspecialty patients, including patients requiring post-operative mechanical ventilation, pediatric patients, patients with implantable cardiac devices, morbidly obese patients and the complex pain patient. This practical manual is essential reading for all practitioners working in the PACU environment.

Fully updated and expanded, the second edition of Clinical Fluid Therapy in the Perioperative Setting brings together the world's leading experts in fluid management to explain what you should know when providing infusion fluids to surgical and critical care patients. Current evidence-based knowledge, essential basic science, and modern clinical practice are explained in 34 focused and authoritative chapters. New chapters cover topics such as burn injury, monitoring of the microcirculation, the glycocalyx layer, intensive care, trauma, transplantations, and adverse effects of infusion fluids. Each chapter begins with an abstract, providing a quick overview of the topic, followed by detailed clinical and pre-clinical guidance. Together, the chapters guide the reader in the use of fluid therapy in all aspects of perioperative patient care. Edited by Robert G. Hahn, a clinical anesthesiologist and highly experienced researcher in fluid therapy, this is essential reading for all anesthesiologists, intensivists, and surgeons.

Pediatric Anesthesiology: A Comprehensive Board Review is a high-yield, streamlined study aid. It contains more than 800, realistic, multiple-choice questions tailored to the keywords in the outline of the Pediatric Anesthesiology Certification Examination published by the American Board of Anesthesiology (ABA). To maximize reading efficiency, annotated answers are followed by bulleted key facts and key references. With this book as guide, readers will be able to efficiently prepare for the written primary certification pediatric anesthesiology board exam.

This is a no-nonsense guide to drug treatment in the intensive care unit. It covers the most commonly encountered conditions and is organized by system. Management of each condition is tersely outlined step-by-step in table format. The book also includes non-drug information that is essential to making informed, evidence-based pharmacotherapy decisions, such as risk scores, scales, and assessment tools. The Second Edition has been revised to reflect the latest critical care practice guidelines and up-to-date drug and non-drug information.

The accuracy with which clinicians can locate nerves and blood vessels has increased greatly with the development of portable handheld ultrasound scanners, and no specialty has felt the benefit more than anesthesia. This practical atlas of ultrasound anatomy addresses the two main challenges for anyone learning ultrasound-guided techniques: 1. Where do I place the probe? 2. What exactly am I looking at? Each nerve block or vascular access site is illustrated with: * An anatomical line illustration * A clinical photograph showing the correct ultrasound probe position * The ultrasound scan * A line illustration of the scan labelled to indicate the salient anatomical features All relevant anatomic regions are included: upper limb, lower limb, neck, thorax and abdomen. Concise notes for each entry indicate scan landmarks and give useful tips and advice on potential complications. Sonoanatomy for Anesthetists is an essential resource for anesthetists, intensivists and chronic pain specialists.

This concise, evidence-based board review book, organized according to the ABA keyword list, covers all the fundamental concepts needed to pass written and re-certification board examinations. Each chapter begins with a case scenario or clinical problem from everyday practice, followed by concise discussion and clinical review questions and answers. Discussion progresses logically from preoperative assessment and intraoperative management to postoperative pain management, enhancing the reader's knowledge and honing diagnostic and clinical management skills. New guidelines and recently developed standards of care are also covered. Serving as a companion to the popular textbook Essential Clinical Anesthesia, this resourceful work reflects the clinical experiences of anesthesia experts at Harvard Medical School as well as individually known national experts in the field of anesthesiology. This practical review is an invaluable resource for anesthesiologists in training and practice, whether studying for board exams or as part of continuing education and ABA recertification.

This book is an up-to-date guide to the most widely debated practical and management issues in anesthesia and intensive care. It provides validated information on the state of the art regarding a wide range of topics, including choice of imaging techniques in the management of ARDS patients, the value and limits of continuous renal replacement therapy in intensive care, the prevention and treatment of postoperative shivering, the diagnosis and treatment of postoperative paralytic ileus, ways to prevent acute lung injury, the prevention of perioperative myocardial ischemia, and the management of invasive candidiasis in intensive care. All subjects are addressed in a lively and straightforward manner by recognized experts in the field. Anesthetists and intensivists, including trainees, will find Practical Issues in Anesthesia and Intensive Care 2013 to be an ideal source of rapidly retrievable practical information ."

The book presents more than 60 real-life cases which together memorably and succinctly convey the depth and breadth of clinical anesthesiology. Each chapter includes a case summary, questions, lessons learned, and selected references. Tables and distinctive visual synopses of key teaching points enhance many chapters. The cases have been selected by Dr. Benumof from the Morbidity and Mortality (M & M) conferences of the Department of Anesthesiology, University of California, San Diego, which he has moderated the last several years, and residents and junior faculty have crafted them into the chapters of this book. Structured in a novel way, the UCSD Anesthesiology M&Ms maximize teaching and learning, and these cases bring that experience right to the reader's finger tips. * Case coverage of respiration- and circulation-related problems, obstetrics, neurology, pain and regional anesthesia, pediatrics, outpatient surgery, and special topics * Resource for anesthesiology and critical care medicine trainees * Review tool for board certification or recertification * Fun reading - valuable lessons

Analysis of blood gas can be a daunting task. However, it is still one of the most useful laboratory tests in managing respiratory and metabolic disorders. Busy medical students have struggled ineffectively with Hasselbach's modification of the Henderson equation, been torn between the Copenhagen and the Boston schools of thought; and lately, been confronted with the radically different strong-ion approach. In modern medical practice, the health provider's time is precious: it is crucial to retain focus on those aspects of clinical medicine that are of key importance. Adoption of an algorithm-based approach in the study of topics that are hard to understand (particularly those that are rooted in clinical physiology) can be extremely advantageous. Handbook of Blood Gas/Acid-Base Interpretation, 2nd edition, is organized in a logical sequence of flow charts that introduce concepts and gradually build upon them. This approach facilitates understanding and retention of the subject matter. Medical students, residents, nurses, and practitioners of respiratory and intensive care will find it possible to quickly grasp the principles underlying respiratory and acid-base physiology, and apply them effectively in clinical decision making.

Comprehensive Guide to Education in Anesthesia is the first single-source volume on the current practice of teaching and learning in this specialty which has long been at the forefront of innovation in medical education. It is edited by one of the great anesthesiology educators in the United States and brings together contributions from leading educators from across the US covering all aspects of anesthesiology education, from medical school and post-graduate training to board certification and continuing medical education.

Topics include best educational practices, closed claim analysis, giving feedback to superiors, residency and fellowship training and requirements, maintenance of certification, the role of simulation, interacting with other specialties, community and global outreach, and more. The book conveys the unique nature of the specialty and is aimed at medical students contemplating a career in anesthesiology, residents and fellows, educators, and administrators.

Brain Injury is the second volume in the book series, Molecular and Cellular Biology of Critical Care Medicine. In this volume, a group of internationally regarded experts in important areas of neuroscience and neurointensive care research address the molecular and cellular basis of acute brain injury. This text covers acute brain injury within a context relevant to the care of patients with critical neurologic injuries such as cardiac arrest, trauma and stroke. It includes recent data pertaining to established pathways such as neurotransmission, exitotoxicity, ionic-mechanisms, oxidative stress, inflammation, and cerebral vascular injury. In addition, rapidly developing areas such as cell signaling, adenosine pharmacology, apoptosis, mitochondrial dysfunction, neurocytoskeletal changes, and the role of trophic factors are reviewed from the level of in vitro modeling to human data. Other topics covered that are highly clinically relevant include the effect of genetic background and gender differences in outcome after brain injury, preconditioning, and the effects of currently used anesthetics and sedative agents in patients with brain injury.

Innovation, training and research are the pillars that support a process deriving from basic science and multi-professional/multidisciplinary interventions. The APICE 2012 yearbook deals with several innovations for optimising prevention and management measures for the critically ill, by integrating diagnostic procedures with pharmacological and technological options. Peri- and postoperative managements as well as treatment of surgical infections and of pain, new and old artificial ventilation strategies are some of the most relevant topics the volume deal with in this new edition. The volume focuses also on the improvement standards and quality of care; on the expanding concept of clinical governance and professionalism and on the importance of ethical principles for establishing a process of patient-centered and evidence-based care.

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 administration of intravenous fluids is one of the most common and important therapeutic practices in the treatment of surgical, medical and critically ill patients. The international literature accordingly contains a vast number of works on fluid management, yet there is still confusion as to the best options in the various situations encountered in clinical practice. The purpose of this volume is to help the decision-making process by comparing different solution properties describing their indications, mechanisms of action and side-effects according to physiologic body water distribution, electrolytic and acid-base balance, and to clarify which products available on the market represent the best choice in different circumstances. The book opens by discussing in detail the concepts central to a sound understanding of abnormalities in fluid and electrolyte homeostasis and the effect of intravenous fluid administration. In the second part of the monograph, these concepts are used to explain the advantages and disadvantages of solutions available on the market in different clinical settings. Body Fluid Management: From Physiology to Therapy will serve as an invaluable decision-making guide, including for those who are not experts in the subject.

At the turn of the century it is appropriate to take stock of this relatively young but rapidly developing subject. For the first time, this book brings together information on the status of obstetric regional analgesia in many parts of the globe, and on the intriguing variability of maternal attitudes towards it. Advances in the field over the last decade in new applications, new drugs and techniques and new research tools are also reviewed. Controversial topics such as the effects of regional analgesia on the progress of and outcome of labour, the indications, contraindications and complications, and the place of regional anaesthesia for operative delivery are discussed by numerous experts in the field. The problem of consent and medicolegal aspects are also addressed. Regional Analgesia in Obstetrics should be read by all those involved in the medical care of women in childbirth. Professor Felicity Reynolds is Emeritus Professor of Obstetric Anaesthesia, St Thomas' Hospital, London, UK.

Practice Single Best Answer Questions for the Final FRCA: A Revision Guide covers the complete syllabus of this new-style exam. The book includes 10 papers, each of which consists of 30 questions on clinical anaesthesia, intensive care medicine and pain management. Each practice paper matches the style, number and level of questions that candidates will face in their FRCA exam. Written by a group of anaesthetists experienced in teaching clinical anaesthesia and preparing trainees for their exams, every question is supplemented with a thorough explanation, incorporating the latest research and guidelines, and further reading suggestions. The book also includes guidance on how to go about answering single best answer questions. Pitched at just the right level for the exam, Practice Single Best Answer Questions for the Final FRCA: A Revision Guide is an essential resource for all Final FRCA candidates.

This book provides a comprehensive overview of current standards of anesthesia and intensive care in neonates and children, with a view to promoting standardization in clinical practice.

The first part of the book, devoted to issues in intensive care, opens by considering scoring systems for the assessment of sick children. The diagnosis, prevention, and management of ventilator-associated pneumonia are then discussed, and the roles of high-frequency oscillatory ventilation and noninvasive respiratory support are reviewed. Further chapters address procedural sedation and analgesia in children, the progress toward open ICUs with liberal visiting policies, and advances in long-term home mechanical ventilation.

In the second part of the book, a range of important topics in anesthesia and perioperative medicine are discussed. After a review of safety issues, current trends in pediatric regional and locoregional anesthesia are described and a synopsis is provided on current knowledge regarding the use of central blocks in infants and children. Subsequent chapters are devoted to awareness monitoring, single-lung ventilation techniques, anesthesia in the context of severe prematurity, and emergence delirium.

"Pediatric Anesthesia, Intensive Care and Pain: Standardization in Clinical Practice" will be an extremely useful source of information for both novices and more experienced practitioners in the field."

This treatise commemorates the 32nd anniversary of the first successful allogenic kidney transplant in a human being and the beginning of a con tinuing challenge for well over a generation of anesthesiologists. If compari sons can be permitted, this epoch-making event can be ranked with the first pulmonary lobectomy and subsequently the initial ligation of a patent ductus arteriosus in the late 1930s when thoracic and cardiac surgery began. Was it merely a coincidence that brought these events to the fore so close upon one another after many years of ideation and frustration? Not so, according to Lewis Thomas, for this was the time of medicine's second revolution-its transformation from an empirical art into a powerfully effective science. The remote Galenic conception of disease with its emphasis on disturbed body humors was about to be supplanted by effective therapeutics, as signified by the introduction of the sulfonamides and antibiotics for the specific treatment of infection. Anesthesiology had been dormant up to that era, still relying upon a few agents, more or less utilized from the beginning, and purveyed by a handful of specialists who had not yet begun to ask the scientific questions necessary for their maturation into a bona fide discipline. However, anesthesiology was in evitably caught in the ferment, for as Peter Caws observed, "It serves to re mind us that the development of science is a step-wise process: nobody starts from scratch and nobody gets very far ahead of the rest."

Theodore H. Stanley, M.D. W. Clayton Petty, M.D. Anesthesiology 1986 contains the Refresher Course manuscripts of the presentations of the 31st Annual Postgraduate Course in Anesthesiology which took place at the Westin Hotel Utah Convention Center in Salt Lake City, Utah, February 14-18, 1986. The chapters reflect recent and future developments in anesthetic techniques, monitoring instruments and devices, and anesthetic drugs. The purposes of the textbook are to 1) act as a reference for the anesthesiologists attending the meeting, and 2) serve as a vehi cl e to bri ng many of the 1 atest 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 anesthesi a expressed at the conference. Thi s book and its chapters should not be considered complete treatises on the subjects addressed but rather attempts to summarlze the most salient points. This textbook is the fourth in a continuing series documenting the proceedings of the Postgraduate Course in Salt Lake City. We hope that this and the past and future volumes reflect the rapid and continuing evolution of anesthesiology in the late twentieth century. TABLE OF CONTENTS PHARMACOLOGY The New Neuromusucular Blocking Agents D. Ryan Cook, M.D.