Stoelting’s Pharmacology & Physiology in Anesthetic Practice

913 Pages·2014·44.53 MB·English

by  Pamela Flood

S T O E LT I N G ’ S
Pharmacology and
Physiology in
Anesthetic Practice
FIFTH EDITION
Shafer_FM.indd 1 10/24/14 11:34 PM
Shafer_FM.indd 2 10/24/14 11:34 PM
S T O E LT I N G ’ S
Pharmacology and
Physiology in
Anesthetic Practice
FIFTH EDITION
Pamela Flood, MD, MA
Professor of Anesthesiology, Perioperative and Pain Medicine
Stanford University
Palo Alto, California
James P. Rathmell, MD
Executive Vice Chair and Chief, Division of Pain Medicine
Department of Anesthesia, Critical Care and Pain Medicine
Massachusetts General Hospital
Henry Knowles Beecher Professor of Anaesthesia, Harvard Medical School
Boston, Massachusetts
Steven Shafer, MD
Professor of Anesthesiology, Perioperative and Pain Medicine
Stanford University
Palo Alto, California
Shafer_FM.indd 3 10/24/14 11:34 PM
Acquisitions Editor: Brian Brown
Product Development Editor: Nicole Dernoski
Editorial Assistant: Lindsay Burgess
Senior Production Project Manager: Alicia Jackson
Design Coordinator: Stephen Druding
Illustration Coordinator: Jennifer Clements
Manufacturing Coordinator: Beth Welsh
Marketing Manager: Daniel Dressler
Prepress Vendor: Absolute Service, Inc.
Fifth Edition
Copyright © 2015 Wolters Kluwer Health
Copyright © 2006, 1999 Lippincott Williams & Wilkins
All rights reserved. This book is protected by copyright. No part of this book may be reproduced or
transmitted in any form or by any means, including as photocopies or scanned-in or other electronic
copies, or utilized by any information storage and retrieval system without written permission from
the copyright owner, except for brief quotations embodied in critical articles and reviews. Materials
appearing in this book prepared by individuals as part of their official duties as U.S. government
employees are not covered by the above-mentioned copyright. To request permission, please contact
Wolters Kluwer Health at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via
email at [email protected], or via our website at lww.com (products and services).
9 8 7 6 5 4 3 2 1
Printed in the United States of America
Library of Congress Cataloging-in-Publication Data
Shafer, Steven L., author.
Stoelting’s pharmacology and physiology in anesthetic practice / Steven Shafer, James P. Rathmell,
Pamela Flood. — Fifth edition.
p. ; cm.
Pharmacology and physiology in anesthetic practice
Preceded by: Pharmacology & physiology in anesthetic practice / Robert K. Stoelting, Simon C.
Hillier. 4th ed. c2006.
Includes bibliographical references and indexes.
ISBN 978-1-60547-550-9 (hardback)
I. Rathmell, James P., author. II. Flood, Pamela, 1963- , author. III. Title. IV. Title: Pharmacology and
physiology in anesthetic practice.
[DNLM: 1. Anesthetics—pharmacology. 2. Physiological Phenomena. QV 81]
RD82.2
615.7'81—dc23
2014039745
This work is provided “as is,” and the publisher disclaims any and all warranties, express or
implied, including any warranties as to accuracy, comprehensiveness, or currency of the content of
this work.
This work is no substitute for individual patient assessment based on healthcare
professionals’ examination of each patient and consideration of, among other things, age, weight,
gender, current or prior medical conditions, medication history, laboratory data, and other factors
unique to the patient. The publisher does not provide medical advice or guidance, and this work is
merely a reference tool. Healthcare professionals, and not the publisher, are solely responsible for the
use of this work including all medical judgments and for any resulting diagnosis and treatments.
Given continuous, rapid advances in medical science and health information, independent
professional verifi ation of medical diagnoses, indications, appropriate pharmaceutical selections and
dosages, and treatment options should be made and healthcare professionals should consult a variety
of sources. When prescribing medication, healthcare professionals are advised to consult the product
information sheet (the manufacturer’s package insert) accompanying each drug to verify, among other
things, conditions of use, warnings, and side effects and identify any changes in dosage schedule or
contraindications, particularly if the medication to be administered is new, infrequently used, or has a
narrow therapeutic range. To the maximum extent permitted under applicable law, no responsibility is
assumed by the publisher for any injury and/or damage to persons or property, as a matter of products
liability, negligence law or otherwise, or from any reference to or use by any person of this work.
LWW.com
Shafer_FM.indd 4 10/24/14 11:34 PM
CONTRIBUTORS
Nicholas Anast, MD Maya Jalbout Hastie, MD
Cardiovascular Anesthesia Fellow Assistant Professor of Anesthesiology
Stanford University Department of Anesthesiology
Palo Alto, California Columbia University Medical Center
New York, New York
Bihua Bie, MD, PhD
Bessie Kachulis, MD
Postdoctoral Research Fellow
Anesthesiology Institute Assistant Professor of Anesthesiology
Cleveland Clinic Department of Anesthesiology
Cleveland, Ohio Columbia University Medical Center
New York, New York
Mark Burbridge, MD
Mihir M. Kamdar, MD
Clinical Instructor
Stanford University Instructor, Harvard Medical School
Palo Alto, California Associate Director, Palliative Care Service
Massachusetts General Hospital
Kenneth Cummings III, MD, MS
Boston, Massachusetts
Assistant Professor of Anesthesiology
Joseph Kwok, MD
Anesthesiology Institute
Cleveland Clinic Clinical Instructor
Cleveland, Ohio Department of Anesthesiology and Pain Medicine
Stanford University School of Medicine
Hesham Elsharkawy, MD, MSc
Stanford, California
Assistant Professor of Anesthesiology
Barrett Larson, MD
Cleveland Clinic Lerner College of Medicine
Staff Resident in Anesthesiology
Department of Outcomes Research Department of Anesthesiology, Perioperative, and Pain Medicine
Anesthesiology Institute Stanford University School of Medicine
Cleveland Clinic Stanford, California
Cleveland, Ohio
Jerrold H. Levy, MD
Pamela Flood, MD, MA
Professor of Anesthesiology
Professor of Anesthesiology, Perioperative and Pain Medicine Associate Professor of Surgery
Stanford University Codirector
Palo Alto, California Cardiothoracic Intensive Care Unit
Duke University School of Medicine
Sumeet Goswami, MD, MPH
Durham, North Carolina
Associate Professor of Anesthesiology
Sansan S. Lo, MD
Columbia University Medical Center
New York, New York Assistant Professor of Anesthesiology
Division of Cardiothoracic Anesthesia
David A. Grossblatt, MD
Columbia University
Postdoctoral Residency Fellow New York, New York
Mayo Clinic
Kamal Maheshwari, MD
Phoenix, Arizona
Staff Anesthesiologist
Jonathan Hastie, MD
Regional Anesthesia and Acute Pain Management
Assistant Professor of Anesthesiology Department of Outcomes Research
Department of Anesthesiology Cleveland Clinic
Columbia University Medical Center Cleveland, Ohio
New York, New York
v
Shafer_FM.indd 5 11/3/14 10:55 PM
vi Contributors
Jillian A. Maloney, MD James P. Rathmell, MD
Department of Anesthesiology Executive Vice Chair and Chief, Division of Pain Medicine
Mayo Clinic Department of Anesthesia, Critical Care and Pain Medicine
Phoenix, Arizona Massachusetts General Hospital
Henry Knowles Beecher Professor of Anaesthesia,
Steven Miller, MD
Harvard Medical School
Assistant Professor Boston, Massachusetts
Department of Anesthesiology
Carl E. Rosow, MD, PhD
Columbia University Medical Center
New York-Presbyterian Hospital Professor
New York, New York Department of Anesthesia, Critical Care and Pain Medicine
Massachusetts General Hospital
Vivek K. Moitra, MD
Boston, Massachusetts
Associate Professor of Anesthesiology
Steven Shafer, MD
Department of Anesthesiology
Division of Critical Care Professor of Anesthesiology, Perioperative and Pain Medicine
Columbia University Medical Center Stanford University
New York, New York Palo Alto, California
Teresa A. Mulaikal, MD Jack S. Shanewise, MD, FASE
Assistant Professor of Anesthesiology Professor of Anesthesiology
Columbia University Medical Center Columbia University Medical Center
Divisions of Cardiothoracic and Critical Care Medicine, New York, New York
Department of Anesthesiology
Peter Slinger, MD, FRCPC
Columbia University Medical Center
New York, New York Professor of Anesthesiology
University of Toronto
Michael J. Murray, MD, PhD
Toronto, Canada
Consultant
Sarah C. Smith, MD
Department of Anesthesiology
Mayo Clinic Assistant Professor of Anesthesiology
Phoenix, Arizona Division of Cardiothoracic Anesthesiology
Professor of Anesthesiology Department of Anesthesiology
Mayo Medical School Columbia University Medical Center
Scottsdale, Arizona New York, New York
Mohamed A. Naguib, MD, MSc, FFARCSI Jessica Spellman, MD
Professor of Anesthesiology Assistant Professor of Anesthesiology
Cleveland Clinic Lerner College of Medicine Department of Anesthesiology
Faculty Division of Adult Cardiothoracic Anesthesiology
Department of General Anesthesiology Columbia University Medical Center
Cleveland Clinic New York, New York
Cleveland, Ohio
Robert K. Stoelting, MD
Carter Peatross, MD
Emeritus Professor
Cardiovascular and Thoracic Anesthesiology Fellow Department of Anesthesia
Mayo Clinic Indiana University School of Medicine
Rochester, Minnesota Indianapolis, Indiana
James Ramsay, MD Hui Yang, MD, PhD
Professor of Anesthesiology Anesthesiology Institute
Department of Anesthesia and Perioperative Care Cleveland Clinic
University of California Cleveland, Ohio
San Francisco, California
Shafer_FM.indd 6 11/3/14 10:56 PM
FOREWORD
My journey with Pharmacology and Physiology in Anes- going to continue to meet its original goal of providing
thetic Practice began in the early 1980s with what seemed an an in-depth but concise and current presentation of those
impossible dream, a single-author anesthesia textbook de- aspects of pharmacology and physiology that are relevant
voted to the daily application of principles of pharmacology either directly or indirectly to the perioperative anesthetic
and physiology in the care of patients. Many yellow tablets management of patients.
later (my computer skills were in their infancy), an under- In this regard, I could not be more pleased and hon-
standing family, residents and faculty in the Department of ored that Drs. James P. Rathmell, Steven Shafer, and
Anesthesia at Indiana University School of Medicine, and Pamela Flood agreed to act as coeditors of a multi authored
the unwavering support and encouragement of a special fifth edition. Their unique expertise and access to recog-
friend and publisher, the fi st edition of Pharmacology and nized authorities in the wide and expanding areas of phar-
Physiology in Anesthetic Practice appeared in the fall of 1986. macology and physiology that impact the perioperative
The acceptance of the textbook by students, trainees, care of patients is clearly evident in this fifth edition.
and practitioners over the years has been incredibly re- On behalf of myself and all our past (and future) read-
warding to me personally and served as the stimulus to ers, I thank the new coeditors and their authors for keep-
create revisions for the next three editions with Simon C. ing Stoelting’s Pharmacology and Physiology in Anesthetic
Hillier, MB, ChB joining me as a coeditor for the fourth Practice current with the times and fulfilling the dream I
edition that appeared in 2006. had more than 30 years ago.
It is clearly time for a new edition and a new approach
if Pharmacology and Physiology in Anesthetic Practice is Robert K. Stoelting, MD
vii
Shafer_FM.indd 7 10/24/14 11:34 PM
Shafer_FM.indd 8 10/24/14 11:34 PM
PREFACE TO THE FIFTH EDITION
Robert Stoelting is among the best writers in our spe- final book reflects their dedication to Dr. Stoelting’s text-
cialty. His signature textbook, Pharmacology and Physiol- book. They knew he had created a gem. They were deter-
ogy in Anesthetic Practice, resonated with residents and mined to keep it polished.
young faculty, including us, because it was exceptionally We are proud to bring the fifth edition of Dr.
well written. Dr. Stoelting’s clear prose succinctly cov- Stoelting’s textbook to anesthesiology residents, clini-
ered the drugs we were using in our daily practice. His cians, and investigators. The name has been changed,
explanations of physiology were intuitive and sensible. forever, to reflect where this started. It is now Stoelting’s
Every chapter in the earlier editions spoke with the same Pharmacology and Physiology in Anesthetic Practice.
voice, reflecting the many years he invested in a single- Making no pretense of reproducing the elegant writing
authored textbook. Even though Dr. Hillier joined him as of Dr. Stoelting’s original textbook, we have tried to cap-
coauthor of the fourth edition, the text always resonated ture the current state-of-the-art in anesthetic pharma-
as a single voice. cology and physiology.
When first approached about revising the textbook, Is everything in this book correct? No. The authors of
we turned down the project. It seemed impossible to each chapter have imperfect understanding; knowledge
reproduce the clarity of Dr. Stoelting’s work. However, the changes and mistakes happen. Wikipedia brilliantly ad-
option for the publisher was to transform Pharmacology dresses this by allowing readers who catch errors to fix
and Physiology in Anesthetic Practice into a conventional them. We can’t implement the Wikipedia approach in
multiauthored textbook. That felt like sacrilege, r educing a textbook, but we can come close by inviting you, the
one of the revered texts in our specialty to a “me too” reader compulsive enough to read the Preface, to bring
multiauthored textbook. We agreed to take on the task. any errors, corrections, or suggestions to our attention.
It took a half decade longer than expected. Too much The e-mail address is [email protected].
had changed in the 30 years since Dr. Stoelting produced We invite our readers to become “peer reviewers,” point-
his initial textbook to simply revise the chapters. The text- ing out errors, out-of-date references, drugs no longer
book required a complete reorganization. Every chapter used, or missing content relevant to pharmacology and
was nearly completely rewritten. physiology in anesthesia practice. In this manner, readers
The job was too much for one person or even three. will become collaborators for all future editions.
We chose a hybrid model, in which a small number of This fifth edition is our tribute to the profound con-
authors oversaw major blocks. The final editing was done tribution to education and clinical practice made by
by two editors, Flood and Rathmell, to approximate the Dr. Stoelting with his now eponymous textbook.
single voice that distinguished the fi st four editions.
We have to acknowledge the efforts of our publishers Pamela Flood, MD
Brian Brown and Nicole Dernoski, who never gave up on James P. Rathmell, MD
us during the 7 years it took to produce this textbook. The Steven Shafer, MD
ix
Shafer_FM.indd 9 10/24/14 11:34 PM