Essentials of Neurosurgical Anesthesia & Critical Care: Strategies for Prevention, Early Detection, and Successful Management of Perioperative Complications

879 Pages·2011·6.3 MB·English

by  Ansgar M. Brambrink

Essentials of Neurosurgical
Anesthesia & Critical Care
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Ansgar M. Brambrink Jeffrey R. Kirsch
●
Editors
Essentials of Neurosurgical
Anesthesia & Critical Care
Strategies for Prevention, Early Detection,
and Successful Management of Perioperative
Complications
Editors
Ansgar M. Brambrink, MD, PhD Jeffrey R. Kirsch, MD
Professor, Department of Anesthesiology Professor and Chair, Department of
and Perioperative Medicine Anesthesiology and Perioperative Medicine
Oregon Health and Science University Oregon Health and Science University
School of Medicine School of Medicine
Portland, Oregon 97239 Portland, Oregon 97239
USA USA
ISBN 978-0-387-09561-5 e-ISBN 978-0-387-09562-2
DOI 10.1007/978-0-387-09562-2
Springer New York Dordrecht Heidelberg London
Library of Congress Control Number: 2011941433
© Springer Science+Business Media, LLC 2012
All rights reserved. This work may not be translated or copied in whole or in part without the written
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errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect
to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
To our families:
Petra, Jan, Phillip, Helen and Lucas (AB)
and
Robin, Jodi, Alan and Ricki (JK)
Thank you for your patience, love, and
understanding.
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Foreword
Caring for acutely ill neurosurgical patients is a diffi cult business. The illnesses are
serious and the stakes are high, particularly in the perioperative period. Further
complicating matters is that damage to the central nervous system almost invariably
leads either directly or indirectly to dysfunction in multiple organ systems. Essentials
of Neurosurgical Anesthesia and Critical Care recognizes this complexity and
comes at it not from the narrow perspective of a particular specialty but from the
standpoint of what the patient needs. The result is a multi-disciplinary, problem-
driven, solution-oriented compendium that will appeal to fi rst-line healthcare pro-
viders who care for acutely ill neurosurgical patients, whether they be physicians,
trainees, physician assistants, or perioperative or advanced practice nurses.
The editors are experienced and respected neuroanesthesiologists and neurocriti-
cal care physicians, and they have recruited an impressive group of authors from the
fi elds of neurosurgery, anesthesiology, neurology, critical care, and nursing to con-
tribute expertise. No handbook is a substitute for a full-length textbook or the read-
ing of original research in the fi eld, and this handbook is no exception. But, when
the rubber meets the road at the patient’s bedside, prevention, detection, and action
trump theory. The guidance provided in these pages is informed by theory and
science but is distilled by experts in the fi eld and presented in a practical, accessible
format that will help the provider anticipate problems and develop an informed and
reasonable action plan when complications do arise. For the neurosurgical patient in
the perioperative period or neurocritical care unit, that is the essence of good care.
That is what this Handbook is about.

Boston, Massachusetts Gregory Crosby, MD
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Preface

Today, treatment decisions are expected to be evidence-based, and the pursuit of
excellence in clinical practice is an essential element for achieving success in the
current health care environment.
Perioperative care of patients with central nervous system diseases is evolving
rapidly as increasing numbers of operative interventional techniques and strategies
are developed. Physicians, nurses, nurse practitioners and physician assistants treat
patients throughout the immediate perioperative period, including during diagnostic
procedures and interventional radiology procedures, and frequently participate in
critical care treatment for this patient population.
We believe that the broad spectrum of neuroanesthesiology and neurocritical
care providers should have a clear understanding of (1) the disease process includ-
ing pathophysiology, specifi c diagnostics, and treatment options, (2) the concepts
and relevant details of the available neurosurgical interventions, techniques, and
(3) means necessary to provide safe and comfortable anesthesia and perioperative
care for these patients.
This handbook, entitled E ssentials of Neurosurgical Anesthesia & Critical Care ,
is intended to serve as a quick reference guide for those involved in the perioperative
care of neurosurgical patients. It is not meant to substitute for a full-length textbook
in this fi eld.
Our handbook focuses on day-to-day clinical practice and supports the fi rst-line
healthcare provider by anticipating problems and complications in neurosurgical
anesthesia and critical care and suggesting solutions and appropriate management.
All chapters are dedicated to a single area of concern and designed to walk the
reader from the problem to the solution, using a structured algorithmic approach. In
addition, each chapter summarizes key knowledge for the practitioner in the fi eld,
as necessary, and tables and illustrations are included for quick and easy reference.
At the end of each chapter, the most important elements are highlighted for the
reader, and references for further reading are provided.
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