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ANESTHESIOLOGY NOTICE Medicine is an ever-changing science. As new research and clinical experi- ence broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. ANESTHESIOLOGY Edited By: David E. Longnecker, MD, FRCA Robert D. Dripps Professor Emeritus Department of Anesthesiology and Critical Care University of Pennsylvania Philadelphia, Pennsylvania David L. Brown, MD Edward Rotan Distinguished Professor and Chairman Department of Anesthesiology and Pain Medicine University of Texas, MD Anderson Cancer Center Houston, Texas Mark F. Newman, MD Merel H. Harmel Professor and Chairman Department of Anesthesiology Duke University Medical Center Durham, North Carolina Warren M. Zapol, MD Anesthetist-in-Chief Department of Anesthesia and Critical Care Massachusetts General Hospital Reginald Jenney Professor of Anaesthesia Harvard Medical School Boston, Massachusetts Medical New York Chicago San Francisco Lisbon London Madrid Mexico City New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2008 by The McGraw-Hill Companies, Inc. All rights reserved. Manufactured in the United States of America. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. 0-07-159333-0 The material in this eBook also appears in the print version of this title: 0-07-145984-7. All trademarks are trademarks of their respective owners. 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If you’d like more information about this book, its author, or related books and websites, please click here. Dedication “Life is no brief candle to me; it is a sort of splendid torch which I've got a hold of for the moment and I want to make it burn as brightly as possible before handing it on to future generations.” George Bernard Shaw Irish playwright (1856–1950) The editors were fortunate indeed to have outstanding mentors who dedicated their professional lives to the development of our generation in the specialty. Through their guidance, wisdom and actions, they truly handed the torch to us. As their progeny, we are ever grateful for both their professional guidance and their personal friendship. In recognition of their influence on us individually, and the specialty overall, we dedicate this book to: Robert M. Epstein, Harold Carron Professor and Chair Emeritus of Anesthesiology, University of Virginia, on behalf of David E. Longnecker Richard J. Kitz, Henry Isaiah Dorr Distinguished Professor of Research and Teaching in Anaesthetics and Anaesthesia, Harvard Medical School and Massachusetts General Hospital, on behalf of Warren M. Zapol Edward Lowenstein, Henry Isaiah Dorr Professor of Research and Teaching in Anaesthetics and Anaesthesia, Harvard Medical School and Massachusetts General Hospital, on behalf of Warren M. Zapol Daniel C. Moore, Chair Emeritus of Anesthesiology, Virginia Mason Medical Center, Seattle, Washington, on behalf of David L. Brown Jerry Reves, Vice-President for Medical Affairs and Dean, College of Medicine, Medical University of South Carolina, Professor of Anesthesiology and Pharmacology (former Chair, Duke University Department of Anesthesiology), on behalf of Mark F. Newman Copyright © 2008 by The McGraw-Hill Companies, Inc. Click here for terms of use. This page intentionally left blank For more information about this title, click here Contents CONTRIBUTORS xiii SECTION B: Preoperative Evaluation of the Anesthesia Patient FOREWORD xxiii CHAPTER 6 89 PREFACE xxv Appropriate and Effective Use of Consultants Lee Goldman, MD, and Thomas H. Lee, MD PART 1 CHAPTER 7 95 THE SPECIALTY OF ANESTHESIOLOGY Evaluation of the Patient with Cardiovascular Disease CHAPTER 1 2 Ronald P. Olson, MD The Evolution of Anesthesiology CHAPTER 8 122 as a Clinical Discipline—A Lesson in Developing Professionalism Evaluation of the Patient with a Difficult Airway Douglas R. Bacon, MD, MA James C. Phero, DMD, Andranik Ovassapian, MD, CHAPTER 2 12 and William E. Hurford, MD The Scope and Future of Anesthesia Practice CHAPTER 9 134 Michael S. Avidan, MBBCh, DA, FCA and Alex S. Evers, MD Evaluation of the Patient with Pulmonary Disease CHAPTER 3 20 Philip G. Boysen, MD, MBA Safety and Quality: The Guiding Principles of Patient-Centered Care CHAPTER 10 145 Jeffrey B. Cooper, PhD, and Evaluation of the Patient David E. Longnecker, MD, FRCA with Neuropsychiatric Disease John Morris, MD, and Dell Burkey, MD PART 2 CHAPTER 11 156 PREPARING FOR ANESTHESIA Evaluation of the Patient with Neuromuscular or Skeletal Disease SECTION A: Approach to the Anesthesia Patient Philip D. Bailey, Jr., DO, and Joseph R. Tobin, MD CHAPTER 4 40 CHAPTER 12 173 Overview of Preoperative Assessment Evaluation of the Patient with and Management Endocrine Disease or Diabetes Mellitus Bobbie Jean Sweitzer, MD A.D. John, MD, and F.E. Sieber, MD CHAPTER 5 68 CHAPTER 13 194 The Anesthetic Plan for Healthy Patients Evaluation of the Patient with Renal Disease Patrick E. Benedict, MD, Mark Stafford-Smith, MD, CM, FRCPC, and Kevin K. Tremper, PhD, MD George Lappas, MD, and Andrew D. Shaw, MB, BS, FRCA viii CONTENTS CHAPTER 14 216 PART 3 Evaluation of Patients with Hepatic Disease SAFETY AND RISK REDUCTION Richard A. Wiklund, MD IN ANESTHESIA PRACTICE CHAPTER 15 239 CHAPTER 24 424 Anesthetic Considerations for the Patient Anesthesia Risk with Anemia or Coagulation Disorders Fredrick K. Orkin, MD, MBA, MSc, Edwin G. Avery, IV, MD and David E. Longnecker, MD, FRCA CHAPTER 16 267 CHAPTER 25 452 Evaluation of the Patient Approaches to Quality Improvement with Perioperative Malnutrition in Anesthesia Care Jacob T. Gutsche, MD, and David S. Smith, MD, PhD, and Lee A. Fleisher, MD Clifford S. Deutschman, MS, MD, FCCM CHAPTER 26 465 CHAPTER 17 279 Positioning of Patients for Operation Principles of Antimicrobial Therapy Vijaya Gottumukkala, MB, BS, Richard Teplick, MD, and MD (Anes), FRCA, DipABA Robert H. Rubin, MD, FACP, FCCP CHAPTER 27 476 CHAPTER 18 300 Electricity, Electrical Safety, Preoperative Assessment of the Newborn and Instrumentation in the Operating Room Myron Yaster, MD, and Richard A. Elliott, MD Robert H. Stiefel, MS, CCE, and Julian M. Goldman, MD CHAPTER 19 310 Evaluation of Children PART 4 Randall C. Wetzel, MBBS, MRCP, LRCS, MBA, FAAP, FCCM MANAGING ANESTHESIA CARE CHAPTER 20 341 SECTION A: Monitoring the Anesthesia Patient Evaluation of the Geriatric Patient Stanley Muravchick, MD, PhD, CHAPTER 28 498 and Katherine Grichnik, MD Perioperative Information Management Systems CHAPTER 21 358 J.P. Abenstein, MSEE, MD Evaluation of the Pregnant Patient Robert Gaiser, MD CHAPTER 29 519 Hemodynamic Monitoring CHAPTER 22 374 Shahar Bar-Yosef, MD, Rebecca A. Schroeder, MD, and Evaluation of the Obese Patient Jonathan B. Mark, MD Babatunde O. Ogunnaike, MD, and Charles W. Whitten, MD CHAPTER 30 552 Intraoperative Transesophageal Echocardiography: CHAPTER 23 396 A Systematic Approach Evaluation of the Patient Larry Field, MD, George Lappas, MD, with Alcohol or Drug Addiction Angus Christie, MD, Andrew Green, MD, Paul S. Pagel, MD, PhD, Judith A. May, MD, Steven Morozowich, MD, Tamas Szabo, MD, PhD, and David C. Warltier, MD, PhD Qin Zhang, MD, Stephen Murphy, MD, Ravi Bissessar, MD, and Solomon Aronson, MD CHAPTER 31 579 Monitoring Respiratory Function Dean R. Hess, PhD, RRT, and Robert M. Kacmarek, PhD, RRT