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Handbook of Clinical Anaesthesia Fourth Edition Edited by Brian J Pollard Gareth Kitchen CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-4987-6289-2 (Paperback); 978-1-138-05799-9 (Hardback) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal responsibility or liability for any errors or omissions that may be made. The publishers wish to make clear that any views or opinions expressed in this book by individual editors, authors or contributors are personal to them and do not necessarily reflect the views/opinions of the publishers. 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May this book improve both your safety and your experience of anaesthesia. BJP http://taylorandfrancis.com Contents Preface vii Contributors ix List of abbreviations xiii PART 1 PATIENT CONDITIONS 1 1 Respiratory system 3 Matthew Stagg 2 Cardiovascular system 37 Redmond P Tully and Robert Turner 3 Central nervous system 91 Eleanor Chapman 4 Gastrointestinal tract 129 Matthew James Jackson 5 Genitourinary tract 145 Brian J Pollard and Gareth Kitchen 6 Endocrine system 163 Brian J Pollard and Gareth Kitchen 7 The blood 197 Alastair Duncan and Santosh Patel 8 Bones and joints 225 Brian J Pollard and Gareth Kitchen 9 Connective tissue 243 John-Paul Lomas PART 2 SURGICAL PROCEDURES 277 10 Abdominal surgery 279 Brian J Pollard and Gareth Kitchen 11 Gynaecological surgery 305 Amy Hobbs, Sophie Kimber Craig and Patrick Ross 12 Obstetric surgery 317 Amy Hobbs and Sophie Kimber Craig 13 Urology 339 Matthew James Jackson 14 Neurosurgery 353 Eleanor Chapman 15 Thoracic surgery 375 Matthew Stagg 16 Cardiac surgery 391 Akbar Vohra v Contents 17 Vascular surgery 423 Redmond P Tully 18 Ophthalmic surgery 439 Roger Martin Slater 19 ENT surgery 457 Ross Macnab, Katherine Bexon, Sofia Clegg and Adel Hutchinson 20 Head and neck surgery 475 Ross Macnab and Katherine Bexon 21 Plastic surgery 491 Brian J Pollard and Gareth Kitchen 22 Orthopaedics 503 Robert Peter Loveridge 23 Transplantation 513 Richard Wadsworth, Greg Cook, Andrew Roscoe, Zoka Milan, Ross Macnab and Kailash Bhatia 24 Paediatrics 533 Bernadette Lomas PART 3 ANAESTHETIC FACTORS 547 25 Preoperative assessment 549 Santosh Patel and Tom Wright 26 Airway 591 Cyprian Mendonca, Narcis Ungureanu, Aleksandra Nowicka, William Tosh, Benjamin Robinson and Carol L Bradbury 27 Equipment and monitoring 623 Baha Al-Shaikh, Sarah Hodge, Sanjay Agrawal, Michele Pennimpede, Sindy Lee, Janine MA Thomas and John Coombes 28 Techniques: General 645 Baha Al-Shaikh, Sanjay Agrawal, Sindy Lee, Daniel Lake, Nessa Dooley, Simon Stacey, Maureen Bezzina and Gregory Waight 29 Techniques: Regional 663 Robert Peter Loveridge 30 Management problems 679 Clifford Shelton Index 749 vi Preface Welcome to the fourth edition of the Handbook of have selected our authors principally from this area Clinical Anaesthesia. We have retained the overall as there is a huge amount of expertise here. structure as in the first three editions. The book Remember that this book is not an exhaustive continues to be a collection of individual entries treatise. It does not cover every eventuality; no book each covering a particular topic, condition or can do that. The Handbook of Clinical Anaesthesia is a problem which may be encountered in clinical distillation of facts and guidance and is intended to anaesthesia. The philosophy of the book has been complement the major texts in the subject. Individual retained in that all of the information is presented entries are referenced where appropriate but the ref- in a concise form without unnecessary informa- erences are limited to a small number of key sources tion or ‘padding’. and include up-to-date reviews wherever possible. Over its lifespan between the first and the fourth Over the years this book has proved popular with editions, this book has undergone a significant evo- trainees preparing for examinations in the special- lution which we believe has served to improve it. ity. It has also proved very popular with established The original idea was conceived by John Goldstone consultants and specialists who keep it beside the and Brian J Pollard in 1994. John unfortunately had phone, on the office desk or in the operating theatre to withdraw from the project at the second edition. suite for straightforward advice on problems or situ- For the fourth edition a second editor has been ations encountered. introduced again, Dr Gareth Kitchen. The choice of Finally, we would like to pay tribute to the many Gareth is clear. He is a young academic anaesthetist authors involved in the first three editions of this who has been able to instil new thoughts into the book. A significant proportion of their text and infor- book and assist in driving it forwards and bringing mation has been retained where the advice has not on board a number of new names as experts in their materially changed. Many sections have neverthe- fields. less been rewritten as appropriate and updated as In the first two editions, the authors of the various necessary. The authors involved in the first three edi- sections and monographs were drawn almost exclu- tions are too numerous to mention but to each and sively from the UK. In the third edition, the author- every one we thank you for your input to the previ- ship was widened into a much more international ous editions and hope that you approve of this new field. In this fourth edition, we have returned to it version and its updated information. being a UK-based field for the authors. Not only that but as we, the editors, are based in the Northwest, we BJP and GK vii http://taylorandfrancis.com Contributors Sanjay Agrawal FRCA Greg Cook MBChB FRCA FFICM Specialist Registrar Consultant in Anaesthesia and Intensive Care William Harvey Hospital Medicine Ashford, Kent, UK Manchester Royal Infirmary Manchester, UK Baha Al-Shaikh FRCA FCAI Consultant Anaesthetist and Visiting Professor John Coombes MBBS FCAI William Harvey Hospital Specialist Registrar Ashford, Kent, UK William Harvey Hospital Ashford, Kent, UK Kailash Bhatia MBBS FRCA EDRA DA DNB Consultant Anaesthetist Sophie Kimber Craig MBChB FRCA Central Manchester University Hospitals Consultant Anaesthetist and St Mary’s Hospital Bolton NHS Foundation Trust Manchester, UK Bolton, UK Maureen Bezzina MD Nessa Dooley FRCA Specialist Registrar Clinical Fellow William Harvey Hospital Bart’s Heart Centre Ashford, Kent, UK London, UK Katherine Bexon BMedSci BMBS FRCA Alastair Duncan MBChB MSc FRCA Consultant in Anaesthesia Specialty Trainee in Anaesthesia Central Manchester University Hospitals North West Deanery, UK NHS Foundation Trust Manchester, UK Amy Hobbs MBChB BSc FRCA Consultant Anaesthetist Carol L Bradbury FRCA Bolton NHS Foundation Trust Specialist Registrar in Anaesthesia Bolton, UK University Hospitals Coventry and Warwickshire Coventry, UK Sarah Hodge FRCA Specialist Registrar Eleanor Chapman MBChB BSc FRCA William Harvey Hospital Consultant Anaesthetist Ashford, Kent, UK Salford Royal Foundation Trust Salford, UK Adel Hutchinson MBChB BSc (hons) FRCA Consultant in Anaesthesia Sofia Clegg MbChB FRCA Central Manchester University Hospitals NHS Consultant in Anaesthesia Foundation Trust Central Manchester University Hospitals Manchester, UK NHS Foundation Trust Manchester, UK ix