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Access to the eBook is limited to the first individual who redeems the PIN, located on the inside cover of this book, at expertconsult.inkling.com and may not be transferred to another party by resale, lending, or other means. 2015v1.0 PHARMACOLOGY DPHYSIOLOGY N A ANESTHESIA R O F FOUNDATIONS AND CLINICAL APPLICATION Second Edition PHARMACOLOGY DPHYSIOLOGY N A ANESTHESIA R O F FOUNDATIONS AND CLINICAL APPLICATION Hugh C. Hemmings, Jr., MD, PhD, FRCA Joseph F. Artusio Jr. Professor and Chair of Anesthesiology Professor of Pharmacology Senior Associate Dean for Research Weill Cornell Medicine Anesthesiologist-in-Chief NewYork-Presbyterian Hospital Adjunct Professor The Rockefeller University New York, New York Talmage D. Egan, MD Professor and Chair of Anesthesiology Adjunct Professor of Pharmaceutics, Bioengineering, and Neurosurgery K.C. Wong Presidential Endowed Chair Holder University of Utah School of Medicine Salt Lake City, Utah 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 PHARMACOLOGY AND PHYSIOLOGY FOR ANESTHESIA: ISBN 978-0-323-48110-6 FOUNDATIONS AND CLINICAL APPLICATION, Second Edition Copyright © 2019 by Elsevier, Inc. All rights reserved. Previous edition copyrighted 2013 by Saunders, an affiliate of Elsevier, Inc. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Names: Hemmings, Hugh C., Jr., editor. | Egan, Talmage D., editor. Title: Pharmacology and physiology for anesthesia : foundations and clinical application / [edited by] Hugh C. Hemmings, Jr., Talmage D. Egan. Description: Second edition. | Philadelphia, PA : Elsevier, Inc., [2019] | Includes bibliographical references and index. Identifiers: LCCN 2017060069 | ISBN 9780323481106 (hardcover : alk. paper) Subjects: | MESH: Anesthesia | Pharmacological Phenomena | Physiological Phenomena Classification: LCC RD82 | NLM WO 200 | DDC 617.9/6—dc23 LC record available at https://lccn.loc.gov/2017060069 Senior Content Strategist: Sarah Barth Senior Content Development Specialist: Joan Ryan Publishing Services Manager: Catherine Jackson Senior Project Manager: Sharon Corell Book Designer: Ryan Cook Printed in China Last digit is the print number: 9 8 7 6 5 4 3 2 1 To my wife, Katherine, and daughter, Emma, whose support and understanding were essential to the completion of this book; and to my mentors and students who have taught me so much and from whom I continue to learn. H.C. Hemmings, Jr. To my wife, Julie, and our children, James, Adam, Ezekiel, Sarajane, and Elizabeth— I am the luckiest; to my mentors Drs. Merritt Egan, Glen Church, K.C. Wong, Mike Cabalan, Don Stanski, and Steve Shafer— you are the wind beneath my wings. T.D. Egan Contributors Contributors Associate Editors: Physics Sections Anatomy and Imaging Sections Kai Kuck, PhD Jeffrey D. Swenson, MD Geoffrey W. Abbott, PhD Edward A. Bittner, MD, PhD Professor Assistant Professor of Anesthesia Department of Pharmacology Harvard Medical School University of California, Irvine Program Director Irvine, California Critical Care Fellowship Department of Anesthesia, Critical Care, and Pain Medicine Martin S. Angst, MD Massachusetts General Hospital Professor of Anesthesiology, Perioperative and Pain Medicine Boston, Massachusetts Stanford University School of Medicine Stanford, California Daniel Bolliger, MD Department for Anesthesia Sherif I. Assaad, MD Surgical Intensive Care Assistant Professor of Anesthesiology Prehospital Emergency Medicine and Pain Therapy Department of Anesthesiology University Hospital Basel Yale University, School of Medicine Basel, Switzerland New Haven, Connecticut; Attending Anesthesiologist Michelle Braunfeld, MD Department of Anesthesiology Professor and Vice Chair Veterans Affairs Healthcare System Department of Anesthesiology and Perioperative Medicine West Haven, Connecticut David Geffen School of Medicine University of California, Los Angeles; Ani Bagdasarjana, PharmD Chief Clinical Pharmacist Department of Anesthesiology Department of Pharmacy Greater Los Angeles Veterans Hospital University of California Los Angeles, California Los Angeles Medical Center Los Angeles, California Shane E. Brogan, MB, BCh Associate Professor of Anesthesiology Travis Bailey, BS University of Utah School of Medicine Department of Anesthesiology Salt Lake City, Utah University of Utah School of Medicine Salt Lake City, Utah Kyle Burke, BS Departments of Anesthesiology and Bioengineering Renee Bassaly, DO University of Utah School of Medicine Morsani College of Medicine Salt Lake City, Utah University of South Florida Tampa, Florida Michael Cahalan, MD Professor Jonathan Bilmen, MBChB(Hons), BMedSc(Hons), Department of Anesthesiology FRCA, PhD University of Utah School of Medicine Consultant Anaesthetist Salt Lake City, Utah Leeds Teaching Hospitals NHS Trust Leeds, United Kingdom vii viii Contributors June M. Chan, MB BS, FANZCA Charles W. Emala, Sr., MS, MD Assistant Professor Henrik H. Bendixen Professor of Anesthesiology Department of Anesthesiology Vice Chair for Research Weill Cornell Medicine Department of Anesthesiology Attending Anesthesiologist Columbia University NewYork-Presbyterian Hospital New York, NY New York, New York Katherine T. Forkin, MD Ben Chortkoff, MD Assistant Professor of Anesthesiology Professor Department of Anesthesiology Department of Anesthesiology University of Virginia Health System University of Utah School of Medicine Charlottesville, Virginia Salt Lake City, Utah Tong J. Gan, MD, MHS, FRCA George J. Crystal, PhD Professor and Chairman Professor Department of Anesthesiology Department of Anesthesiology Stony Brook University University of Illinois College of Medicine Stony Brook, New York Chicago, Illinois Paul S. García, MD, PhD Jennifer A. DeCou, MD Department of Anesthesiology Associate Professor Emory University School of Medicine Department of Anesthesiology Atlanta VA Medical Center University of Utah School of Medicine Atlanta, Georgia Salt Lake City, Utah Peter Gerner, MD Rebecca Desso, MD Professor and Chairman Assistant Professor Department of Anesthesiology, Perioperative Medicine, and Department of Anesthesiology Intensive Care University of Utah School of Medicine Salzburg General Hospital Salt Lake City, Utah Paracelsus Medical University Salzburg, Austria John C. Drummond, MD, FRCPC Professor of Anesthesiology Jacqueline A. Hannam, Ph.D., BSc (Hons) University of California, San Diego Lecturer Staff Anesthesiologist Department of Pharmacology and Clinical Pharmacology Veterans Affairs Medical Center The University of Auckland San Diego, California Auckland, New Zealand Thomas J. Ebert, MD, PhD Paul M. Heerdt, MD, PhD Vice Chair for Education Professor of Anesthesiology and Pharmacology Professor of Anesthesiology and Residency Program Director Weill Cornell Medicine Anesthesiology Member, Anesthesiology and Critical Care Medicine Medical College of Wisconsin Memorial Sloan-Kettering Cancer Center Milwaukee, Wisconsin New York, New York Talmage D. Egan, MD Hugh C. Hemmings, Jr., MD, PhD, FRCA Professor and Chair of Anesthesiology Joseph F. Artusio Jr. Professor and Chair of Anesthesiology Adjunct Professor of Pharmaceutics, Bioengineering, and Professor of Pharmacology Neurosurgery Senior Associate Dean for Research K.C. Wong Presidential Endowed Chair Holder Weill Cornell Medicine University of Utah School of Medicine Anesthesiologist-in-Chief Salt Lake City, Utah NewYork-Presbyterian Hospital Adjunct Professor Matthias Eikermann, MD, PhD The Rockefeller University Professor of Anesthesia and Vice Chair New York, New York Department of Anesthesia, Critical Care, and Pain Medicine Beth Israel Deaconess Medical Center Boston, Massachusetts Contributors ix Karl F. Herold, MD, PhD Joel O. Johnson, MD, PhD Research Associate Professor of Anesthesiology Department of Anesthesiology University of Wisconsin Hospital and Clinics Weill Cornell Medicine Madison, Wisconsin New York, New York Abhinav Kant, MD, MBBS, FRCA, FHEA Soeren Hoehne, Dipl.-Ing. Consultant in Anaesthesia and Critical Care Senior Biomedical Research Engineer Harrogate and District NHS Foundation Trust Department of Anesthesiology Harrogate, North Yorkshire, Great Britain University of Utah School of Medicine Salt Lake City, Utah Mark T. Keegan, MB, MRCPI, MSc Professor of Anesthesiology Harriet W. Hopf, MD Division of Critical Care Professor of Anesthesiology Mayo Clinic and Mayo Clinic College of Medicine University of Utah School of Medicine Rochester, Minnesota Salt Lake City, Utah Patrick Kolbay, BS Philip M. Hopkins, MBBS, FRCA, MD Departments of Anesthesiology and Bioengineering Professor of Anaesthesia University of Utah School of Medicine University of Leeds Salt Lake City, Utah Honorary Consultant Anaesthetist Leeds Teaching Hospitals NHS Trust Kai Kuck, PhD Leeds, United Kingdom Professor of Anesthesiology Adjunct Professor of Bioengineering Elizabeth Horncastle, MBChB Harry C. Wong Presidential Endowed Chair Specialist Trainee Director of Bioengineering Research Department of Anaesthesia Department of Anesthesiology Leeds Teaching Hospitals NHS Trust University of Utah School of Medicine Leeds, United Kingdom Salt Lake City, Utah Andrew E. Hudson, MD, PhD Shreyajit R. Kumar, MD Assistant Professor-in-Residence Assistant Professor of Clinical Anesthesiology Anesthesiology and Perioperative Medicine Division of Critical Care Medicine University of California, Los Angeles Weill Cornell Medicine David Geffen School of Medicine New York, New York Los Angeles, California James P. Lee, MD Julie L. Huffmyer, MD Assistant Professor Associate Professor of Anesthesiology Department of Anesthesiology Department of Anesthesiology University of Utah School of Medicine University of Virginia Health System Salt Lake City, Utah Charlottesville, Virginia Brian P. Lemkuil, MD Natalia S. Ivascu, MD Director of Neuroanesthesia and Neurocritical Care Associate Professor of Clinical Anesthesiology University of California, San Diego Weill Cornell Medicine San Diego, California New York, New York Roberto Levi, MD, DSc Robert H. Jenkinson, MD Professor Assistant Professor Department of Pharmacology Department of Anesthesiology Weill Cornell Medicine University of Utah School of Medicine New York, New York Salt Lake City, Utah Jerrold H. Levy, MD, FAHA, FCCM Ken B. Johnson, MD Professor of Anesthesiology Professor Professor of Surgery (Cardiothoracic) Department of Anesthesiology Co-Director University of Utah School of Medicine Cardiothoracic ICU Salt Lake City, Utah Duke University Hospital Durham, North Carolina x Contributors Cynthia A. Lien, MD Jennifer Nguyen-Lee, MD John P. Kampine Professor and Chair Assistant Clinical Professor Department of Anesthesiology David Geffen School of Medicine Medical College of Wisconsin University of California, Los Angeles Milwaukee, Wisconsin Los Angeles, California Philipp Lirk, MD, PhD Shinju Obara, MD, PhD Attending Anesthesiologist Assistant Professor of Anesthesiology Brigham and Women’s Hospital Fukushima Medical University, School of Medicine Associate Professor of Anesthesia Deputy Director Harvard Medical School Intensive Care Department Boston, Massachusetts Fukushima Medical University Hospital Fukushima, Fukushima Prefecture, Japan Andrew B. Lumb, MB, BS, FRCA Consultant Anaesthetist Daniel W. Odell, MD Department of Anaesthesia Assistant Professor of Anesthesiology St. James’s University Hospital University of Utah School of Medicine Leeds, United Kingdom Salt Lake City, Utah Srinand Mandyam, MD Takahiro Ogura, MD, PhD Georgia Pain and Wellness Research Fellow Lawrenceville, Georgia Department of Anesthesiology National Defense Medical College Robert G. Martindale, MD, PhD Tokorozawa, Saitama, Japan Professor of Surgery Japan Maritime Self Defense Force Hospital Chief of Gastrointestinal and General Surgery Yokosuka, Kanagawa Prefecture, Japan Medical Director Hospital Nutritional Service Shannon M. Page, MD Professor of Surgery Assistant Professor Division of Gastrointestinal and General Surgery Department of Anesthesia School of Medicine Duke University Medical Center OHSU Healthcare Durham, North Carolina Portland, Oregon Hahnnah Park, BS J.A. Jeevendra Martyn, MD, FRCA, FCCM Department of Anesthesiology Professor of Anesthesiology David Geffen School of Medicine Harvard Medical School University of California, Los Angeles Anesthetist-in-Chief Los Angeles, California Shriners Hospital for Children Boston, Massachusetts Piyush M. Patel, MD, FRCPC Professor of Anesthesiology Joseph S. Meltzer, MD University of California, San Diego Associate Clinical Professor of Anesthesiology and Perioperative Staff Anesthesiologist Medicine Veterans Affairs Medical Center University of California, Los Angeles San Diego, California David Geffen School of Medicine Los Angeles, California Misha Perouansky, MD Professor Edward C. Nemergut, MD Anesthesiology and Perioperative Care Professor of Anesthesiology and Neurosurgery University of Wisconsin SMPH Department of Anesthesiology Madison, Wisconsin University of Virginia Health System Charlottesville, Virginia Nicholas Pierson, MD Assistant Professor Christine T. Nguyen-Buckley, MD Department of Radiology Clinical Instructor University of Utah School of Medicine David Geffen School of Medicine Salt Lake City, Utah University of California, Los Angeles Los Angeles, California