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Anesthesia Review Anesthesia Review Second Edition Kaushik Jothinath MBBS DNB FIACTA FCA Consultant Pediatric Cardiac Anesthesiologist G Kuppuswamy Naidu Memorial Hospital Coimbatore, Tamil Nadu, India JAYPEE BROTHERS MEDICAL PUBLISHERS The Health Sciences Publisher New Delhi | London Jaypee Brothers Medical Publishers (P) Ltd Headquarters Jaypee Brothers Medical Publishers (P) Ltd 4838/24, Ansari Road, Daryaganj New Delhi 110 002, India Phone: +91-11-43574357 Fax: +91-11-43574314 Email: [email protected] Overseas Office J.P. Medical Ltd 83 Victoria Street, London SW1H 0HW (UK) Phone: +44 20 3170 8910 Fax: +44 (0)20 3008 6180 Email: [email protected] Website: www.jaypeebrothers.com Website: www.jaypeedigital.com © 2021, Jaypee Brothers Medical Publishers The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) of the book. All rights reserved. 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Inquiries for bulk sales may be solicited at: [email protected] Anesthesia Review First Edition: 2016 Second Edition: 2021 ISBN 978-93-90020-75-1 AT THY LOTUS FEET  Preface It was during my postgraduate years that I realized that the subject of anesthesiology does not have a comprehensive and examination-oriented book. The pursuit of DNB as a postgraduation degree itself is an arduous task, owing to the difficult work schedule, and high expectations from the students at the time of examinations. This problem is compounded manifold for the subject of anesthesiology, as it is a discipline in which the students have to have a wide base of knowledge. Most of the textbooks available today are not student-friendly as there is a lot of information in them, from which the examinee has to pick and retain in memory only those details which are necessary. As a result, there is a whole lot of unwanted information to which he is subjected, which may be confusing at the time of examinations. Secondly, there is no single textbook which gives all the details in an examination-oriented format. As a result, the student is forced to study from several different textbooks spanning multiple subjects. Also, owing to the importance of knowledge of various clinical guidelines, it becomes mandatory for the anesthesiology examinee to be familiar with the latest guidelines across a wide variety of disciplines. I have attempted to address these problems by compiling a book, which is student-friendly, well researched and is based on the most recent clinical practice guidelines. This book has been written to cater to the DNB anesthesiology board examinations in a comprehensive and point-based system. Also, most of the references are from standard textbooks in order to prevent confusion arising due to numerous research papers published in the recent past. Therefore, the information has been provided in a highly concise, crisp and readable manner to help you crack the anesthesiology boards. Hope you enjoy reading it and wishing you all the best to crack your boards!! Kaushik Jothinath Acknowledgments My humble gratitude to my teacher, father figure and guiding spirit, Dr Krishnadasan, without whom this book would not have materialized. Your encouragement and motivation have been vital in bringing forth this second edition. I am also indebted to Dr Sathya Swaroop Patnaik for his help during those difficult years when life looked uncertain. He was an invaluable guide and helping hand, who showed me the way during this arduous journey. Bhishma sir, the man who lives up to his name, will always be remembered for the exceptional moral support he gave, during those years. I sincerely acknowledge all my anesthesiology professors Dr Debadas Bagchi, Dr Pandey, Dr Anand, Dr Hemadri, Dr Kolli S Challam, Dr Prabhakar, Dr Jayashree Simha, Dr Iyer, Dr Vasanth Nayak, Dr Prabhakar, Dr Parameshwar, Dr Suma, Dr Murthy, Dr Rehana, Dr Jalaja, Dr Ramachandra, Dr Sowmini, Dr Kumaresan, Dr Manjunath, Dr Niranjan, Dr Vaishali and Dr Anita for their enormous help and guidance during the formative years of this book. I am also immensely thankful to my mentors Dr Vindhya Kumar, Dr Shivananda N.V and Dr Nagaraj. I have been immensely lucky to have learnt the art of anesthesia from you all. My humble gratitude to the CEO of GKNM hospital Dr. Raghupathy Veluswamy for the immense support given to me for the second edition of this book. I would also like to thank my teachers in the department of Anesthesiology, GKNM hospital, Dr Rajani Sundar, Dr Soundaravalli Balakrishnan, Dr Sai Gopalakrishnan, Dr Anandhi Arul and Dr Palaniappan for being the sturdy, unrelenting backbone behind the entire process of giving shape to the second edition. I am also thankful to my colleagues Dr Karthik Babu, Dr Manikandan and Dr Naresh Kumar from GKNM Hospitals for their valuable guidance and support. I sincerely acknowledge Dr S Muralidharan, Dr P Chandrashekhar, Dr Sundar Ramanathan, Dr Madhav Rao and Dr Shobha Menon from GKNM Hospitals for their valuable inputs into this book. My acknowledgement would be incomplete if I do not mention my colleague and friend Dr Vijayakumar Raju who inspires everyone around with his sheer hard work and will power as a congenital heart surgeon. I will be indebted to my closest friend Mahesh T. Venkataramani, whose constant inputs and feedback at various stages made this book what it is My biggest source of strength has been my group of friends, Dr Satya Swaroop Patnaik, Dr Anoop Pothen John, Dr Gokulakrishnan, Dr Aamir Farooq Siddique, Dr Abhinay Indrakumar Reddy and Dr Sandeepan. I also appreciate the continuous moral support given by my parents and wife during this process. Thank you for your patience. I am also thankful to all my colleagues and staff at Sri Sathya Sai Institute of Higher Medical Sciences, Manipal Hospital and GKNM hospital for rendering a helping hand. I appreciate Shri Jitendar P Vij (Group Chairman) and Mr Ankit Vij (Managing Director), M/S Jaypee Brothers Medical Publishers (P) Ltd, for their patience, encouragement and punctuality for publishing this book. I would also like to thank Ms Chetna Malhotra Vohra (Associate Director–Content and Strategy), Ms Saima Rashid (Publishing Manager) and Mr Santosh Kumar (Commissioning Editor) from Jaypee Brothers for their thoughtful insights into making this second edition a more user friendly version. Finally I would like to thank all my students for making the first edition of this book an enormous success story. I owe this book to everyone who contributed directly or indirectly. Any oversight is purely unintentional.