A Surgeon's Guide to Anaesthesia and Perioperative Care PDF
Preview A Surgeon's Guide to Anaesthesia and Perioperative Care
’ A Surgeon s Guide to Anaesthesia and Peri-operative Care Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:30:55 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:30:55 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 ’ A Surgeon s Guide to Anaesthesia and Peri-operative Care Edited by Jane Sturgess ConsultantNeuroanaesthetist,Addenbrooke’sHospital, CambridgeUniversityHospitalsNHSFoundationTrust, Cambridge,UK Justin Davies ConsultantColorectalSurgeon,Addenbrooke’sHospital, CambridgeUniversityHospitalsNHSFoundationTrust, Cambridge,UK Kamen Valchanov ConsultantAnaesthetist,PapworthHospital, Cambridge,UK Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:30:55 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 UniversityPrintingHouse,CambridgeCB28BS,UnitedKingdom CambridgeUniversityPressispartoftheUniversityofCambridge. ItfurtherstheUniversity’smissionbydisseminatingknowledgeinthe pursuitofeducation,learningandresearchatthehighestinternationallevels ofexcellence. www.cambridge.org Informationonthistitle:www.cambridge.org/9781107698079 ©JaneSturgess,JustinDaviesandKamenValchanov Thispublicationisincopyright.Subjecttostatutoryexception andtotheprovisionsofrelevantcollectivelicensingagreements, noreproductionofanypartmaytakeplacewithoutthewritten permissionofCambridgeUniversityPress. Firstpublished2014 PrintedintheUnitedKingdombyClays,StIvesplc AcataloguerecordforthispublicationisavailablefromtheBritishLibrary LibraryofCongressCataloguinginPublicationdata Asurgeon’sguidetoanaesthesiaandperi-operativecare/editedbyJane Sturgess,JustinDavies,KamenValchanov. p.;cm. Includesbibliographicalreferencesandindex. ISBN978-1-107-69807-9(Paperback) I. Sturgess,Jane,editorofcompilation. II. Davies,Justin,editorof compilation. III. Valchanov,Kamen,editorofcompilation. [DNLM: 1. Anaesthesia–methods. 2. GeneralSurgery–methods. 3. Peri-operativeCare–methods.WO200] RD81 617.906–dc23 2013046224 ISBN978-1-107-69807-9Paperback CambridgeUniversityPresshasnoresponsibilityforthepersistenceor accuracyofURLsforexternalorthird-partyinternetwebsitesreferredtoin thispublication,anddoesnotguaranteethatanycontentonsuchwebsitesis, orwillremain,accurateorappropriate. .................................................................................................. Everyefforthasbeenmadeinpreparingthisbooktoprovideaccurateand up-to-dateinformationwhichisinaccordwithacceptedstandardsand practiceatthetimeofpublication.Althoughcasehistoriesaredrawnfrom actualcases,everyefforthasbeenmadetodisguisetheidentitiesofthe individualsinvolved.Nevertheless,theauthors,editorsandpublisherscan makenowarrantiesthattheinformationcontainedhereinistotallyfreefrom error,notleastbecauseclinicalstandardsareconstantlychangingthrough researchandregulation.Theauthors,editorsandpublisherstherefore disclaimallliabilityfordirectorconsequentialdamagesresultingfromthe useofmaterialcontainedinthisbook.Readersarestronglyadvisedtopay carefulattentiontoinformationprovidedbythemanufacturerofany drugsorequipmentthattheyplantouse. Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:30:55 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 Contents List of contributors vii Foreword:ProfessorMichaelParker ix Section I – Basic sciences 12. Vascular cases 137 Fay Gilder and Paul Hayes 1. Generalphysiology 1 13. Organ transplant cases 147 Kamen Valchanov Nicola Jones and Christopher J.E. 2. System-specific physiology 13 Watson Jane Sturgess 14. Otorhinology,head andneck 3. Pain and analgesia 35 cases 161 David Sapsford Helen Smith and Neil Donnelly 4. Local anaesthetics 48 15. Paediatric cases 168 David Tew Simon Whyte and Sonia 5. Sedation 59 Butterworth Justin Daviesand Jane Sturgess 16. Plastic, reconstructive and cosmetic cases 181 6. Physics andmeasurement 63 AndrewBaileyandCharles Ari Ercole Malata – 17. Neurosurgerycases 197 Section II Anaesthesia and Jane Sturgess and Ramez Kirollos peri-operative care for surgical 18. Traumacases 208 specialties Rhys Thomas andWayneSapsford 7. Cardiothoracic cases 77 19. Orthopaedic cases 223 KamenValchanovandPedroCatarino David Tew and Alan Norrish 8. Colorectal cases 91 20. Urology cases 236 Jane Sturgess and Justin Davies HemanthaAlawattegama and Manit Arya 9. Upper gastrointestinalcases 102 MarkAbrahamsandRichardHardwick 21. Bariatric cases 246 Michael Margarson and Christopher 10. Hepatobiliary andpancreatic Pring cases 116 HemanthaAlawattegama and Paul – Section III At a glance Gibbs 11. Endocrine cases 125 22. Scoring systems 259 Pete Hambly and Radu Mihai Jane Sturgess and Justin Davies v Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:31:03 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 vi Contents 23. Modesof mechanical 29. Medicolegal aspects of ventilation 269 consent 294 Kamen Valchanov Kamen Valchanov 24. Fluids 273 30. Nerveinjury 298 Jane Sturgess Jane Sturgess 25. Coagulation 277 31. Pre-operative investigations 302 Jane Sturgess Joseph E. Arrowsmith 26. Pre-operative 32. Enhancedrecovery 310 echocardiography 281 Jane Sturgess Kamen Valchanov 33. Post-operative cognitive 27. Common drugs and doses 285 dysfunction 312 Jane Sturgess Ram Adapa 28. Physiology and risk inspecial circumstances 288 Jane Sturgess List of abbreviations 317 Index 320 Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:31:03 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 Contributors Mark Abrahams Justin Davies Consultant Anaesthetist, Addenbrooke’s Consultant Colorectal Surgeon, Hospital, Cambridge University Addenbrooke’s Hospital, Cambridge HospitalsNHS Foundation Trust, University HospitalsNHS Foundation Cambridge, UK Trust, Cambridge, UK Ram Adapa Neil Donnelly Consultant Anaesthetist and Honorary Consultant ENT Surgeon, Addenbrooke’s Visiting SeniorResearchFellow, Hospital, Cambridge University Hospitals Addenbrooke’s Hospital, Cambridge NHS Foundation Trust, Cambridge, UK University HospitalsNHS Foundation Ari Ercole Trust, Cambridge, UK Consultant in Anaesthesiaand Intensive Hemantha Alawattegama Care, Addenbrooke’s Hospital, Cambridge Consultant Anaesthetist, Addenbrooke’s University HospitalsNHS Trust, Hospital, Cambridge University Cambridge, UK HospitalsNHS Foundation Trust, Paul Gibbs Cambridge, UK Consultant HPB and Transplant Surgeon, Joseph E. Arrowsmith Addenbrooke’s Hospital, Cambridge Consultant Anaesthetist, Papworth University HospitalsNHS Foundation Hospital, Cambridge, UK Trust, Cambridge, UK Manit Arya Fay Gilder SeniorLecturer andConsultant Urological Consultant Anaesthetist, Addenbrooke’s Surgeon,Divisionof Surgeryand Hospital, Cambridge University Hospitals Interventional Science,University College NHS Foundation Trust, Cambridge, UK London,London,UK Pete Hambly Andrew Bailey Consultant Anaesthetist, John Radcliffe Consultant Anaesthetist, Addenbrooke’s Hospital, Oxford, UK Hospital, Cambridge University Hospitals Richard Hardwick NHS Foundation Trust, Cambridge, UK Consultant Surgeon,Addenbrooke’s Sonia Butterworth Hospital, Cambridge University ConsultantPaediatricSurgeon,andClinical HospitalsNHS Foundation Trust, AssistantProfessorofSurgery,BC Cambridge, UK Children’sHospital,Vancouver,BC, Paul Hayes Canada Consultant Vascular Surgeon, Pedro Catarino Addenbrooke’s Hospital, Cambridge Consultant Cardiothoracic Surgeon, University HospitalsNHS Foundation PapworthHospital, Cambridge, UK Trust, Cambridge, UK vii Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:31:17 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 viii Listofcontributors Nicola Jones University HospitalNHSFoundation Consultant in Anaesthesiaand Trust, and RAF Consultant Adviser in Critical Care,PapworthHospital, Surgery, TheRoyal London Hospital, Cambridge, UK London,UK RamezKirollos Helen Smith Consultant Neurosurgeon, Addenbrooke’s Consultant Anaesthetist, Addenbrooke’s Hospital, Cambridge University Hospitals Hospital, Cambridge University NHS Foundation Trust, Cambridge, UK HospitalsNHS Foundation Trust, Cambridge, UK Charles Malata Consultant in Plastic and Reconstructive Jane Sturgess Surgery, Addenbrooke’sHospital, Consultant Neuroanaesthetist, Cambridge University Hospitals NHS Addenbrooke’s Hospital, Cambridge Foundation Trust, Cambridge, UK University HospitalsNHS Foundation Trust, Cambridge, UK MichaelMargarson Consultant Anaesthetist and Directorof David Tew Critical Care,StRichard’s Hospital, Consultant Anaesthetist, Addenbrooke’s Chichester, UK Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Radu Mihai Consultant in EndocrineSurgery, Rhys Thomas HonorarySenior Clinical Lecturer, John Consultant TraumaAnaesthetist and RadcliffeHospital, Oxford,UK Pre-Hospital Care,16th Air Assault Medical Regiment;Honorary Consultant Alan Norrish Anaesthetist, Swansea Morriston NHS Consultant Orthopaedic Surgeon, Trust (AMBU Health Board), Addenbrooke’s Hospital, Cambridge Swansea, UK University HospitalsNHS Foundation Trust, Cambridge, UK Kamen Valchanov Consultant Anaesthetist, Papworth Christopher Pring Hospital, Cambridge, UK Consultant Surgeon,Department of BariatricSurgery, StRichard’s Hospital, Christopher J.E. Watson Chichester, UK Professorof Transplantation, University of Cambridge and Honorary David Sapsford Consultant Surgeon,Addenbrooke’s Consultant Anaesthetist, Addenbrooke’s Hospital, Cambridge, UK Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK Simon Whyte Associate Head and ClinicalAssistant Wayne Sapsford Professorof Paediatric Anaesthesia, BC Consultant Vascular andTrauma Surgeon, Children’s Hospital, Vancouver, BC, Barts Health NHS TrustandHomerton Canada Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:31:17 BST 2014. http://ebooks.cambridge.org/ebook.jsf?bid=CBO9781139628808 Cambridge Books Online © Cambridge University Press, 2014 Foreword Successfuloutcomefromsurgerydoesnotcomeaboutbecauseofasurgeon’sencyclopaedic knowledge of surgical conditions, nor from his or her masterly ability as a technical operator,althoughbothofthesecomponentssurelycontribute.Goodoutcomeistheresult of multiple factors within a team framework, all contributing to the end result of surgery. Implicit within these constituents is the close relationship between the surgeon and the anaesthetistandtheunderstandingeachhasofthecomplexitiesanddifficultieswithwhich theothermighthavetocontendthroughouttheperiodofanoperation,whichincludesthe pre- and post-operativephases. Thisbookservestoinformsurgeonsoftheintricaciesandminutiaeofanaesthesiainall aspects,rangingfromdaycarelocalanaesthesiatocardiacbypasstechniques.Itiscompre- hensiveandyeteminentlyreadableandinformative.Theearlychaptersonbasicphysiology, combined with later chapters on fluids and commonly used drugs and dosages are funda- mental to any trainee or practising surgeon and are beautifully composed. To miss these gems would be akin to ignoring the basic science lectures that are so important in the understanding of allmedicine andsurgery. Subsequent chapters relate to specialty specific surgical fields and are particularly interestingandsuitablydetailed.Inaddition,therearechaptersonassociatedsubjectssuch as enhanced recovery, post-operative cognitive dysfunction and medico-legal aspects of consent. The editors have gone to considerable trouble to find authors with the specific knowledgeandintereststoproduceaconciseandyetwide-rangingbook,whichleavesthe surgical readeradmirably informedabouthisorhercolleague’sarmamentarium ofanaes- thetic approaches, potentialpitfalls and rescue strategies. AtthisstageinmycareerIcanonlystatethatIwishthisbookhadbeenwritten40years ago! MichaelParker Professorof Laparoscopic and Colorectal Surgery, Councilmember, Royal College of Surgeons of England ix Downloaded from Cambridge Books Online by IP 128.125.52.140 on Sun Aug 24 08:31:39 BST 2014. http://dx.doi.org/10.1017/CBO9781139628808.001 Cambridge Books Online © Cambridge University Press, 2014
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