Anesthesia Student Survival Guide.pdf - Index of

Recommendations

Info

AnesthesiA for uroloGicAl surGery ● 345 to resect all tissue protruding from the prostatic urethra. This procedure requires continuous irrigation fluid as well, placing the patient at risk for TURP syndrome (see “Complications of Urologic Surgery, pages 348-9). The patient is positioned in lithotomy and regional or general anesthesia can be used. If general anesthesia is used, muscle relaxation may be indicated or a deep level of anesthesia may be preferred. This will prevent coughing or movement, which may lead to prostatic capsule rupture. Advantages of general anesthesia include positive pressure ventilation, which can decrease the absorption of irrigant solution by increasing venous pressures. Regional anesthesia mandates a T10 level and offers the advantage of an atonic bladder along with the presence of awake patients, in whom TURP syndrome may be detected earlier. Laser Surgery in Urology Laser surgery in urology allows for treatment of condyloma acuminatum, interstitial cystitis, BPH, ureteral or bladder stricture, contracture or calculi, and superficial carcinoma of the urinary tract or external genitalia. Laser surgery allows for minimal blood loss and postoperative pain. The types of lasers include carbon dioxide, argon, and pulsed-dye lasers. Concern for ocular injury by lasers is paramount for the anesthesiologist during these procedures and eye protection must be worn by all OR personnel and the patient. Thermal injury by lasers may also be possible and can be avoided by limiting use to one operator and placing the device in standby to allow for cooling between uses. Inhalation of viral particles and smoke can also pose a safety threat; special laser masks that prevent small particles should be worn and the OR should be equipped with a smoke evacuation system. Radical Prostatectomy: Open, Laparoscopic, Robotic Open radical prostatectomy involves the complete resection of the entire prostate gland, the seminal vesicles, the ejaculatory ducts, and a portion of the bladder neck and is usually performed for prostate cancer. A pelvic lymph node dissection may also be done to aid in cancer staging. The patient is placed in a hyperextended supine position and a midline lower abdominal incision is used. Either general endotracheal anesthesia or regional anesthesia with a T6-8 level may be used for this surgery. Once the prostatic urethra has been removed and the urethra is reconstructed, diagnostic dyes (methylene blue or indigo carmine) may be requested by the surgeon. A methylene blue bolus may lead to hypotension or cause disruption of the pulse oximeter readings; Indigo carmine may cause hypertension via a-agonist effects. Complications of this surgery can include large
346 ● AnesthesiA student survivAl Guide amounts of blood loss, fluid shifts leading to coagulopathy or anemia, and air embolism from Trendelenburg positioning. Large bore IV access is needed and an arterial line or central venous catheter may also be used since urine output will not reliably reflect intravascular fluid status. Laparoscopic surgery or robotic assisted surgery is also becoming increasingly popular because of decreased invasiveness. However, retroperitoneal insufflation has been reported in some studies to be associated with increased systemic absorption of carbon dioxide and decreases in urine output, leading to iatrogenic excessive fluid repletion. Radical Cystectomy Radical cystectomy is indicated in patients with muscle invasive bladder cancer. Other less common indications include neurogenic bladder, chronic urinary obstruction, or pelvic malignancy. In men, the bladder, prostate, seminal vesicles, and urethra is removed. In women, the bladder, urethra, anterior vaginal wall, uterus, and bilateral ovaries and fallopian tubes are removed. A urinary diversion, either to the colon or ileum, is created at the end of the procedure. Anesthetic considerations and patient positioning are similar to a radical prostatectomy. Bowel surgery introduces additional complications, including longer operative time and increased risk of bacteremia. In addition, in cancer patients, the anesthesiologist must consider effects of previously administered chemotherapeutic agents: doxorubicin has cardiotoxic effects, methotrexate has hepatic toxicity, cisplatin and methotrexate have neurotoxicity and renal toxicity. Nephrectomy: Open or Laparoscopic Removal of the kidney, fascia, adrenal gland and upper ureter, or a radical nephrectomy, is usually performed for malignancy/neoplasm, transplantation, cystic disease, or severe calculous disease. In about 5% of patients, the tumor extends into the vena cava, which can result in several complications. If the IVC is fully or partially occluded, there may be a decrease in venous return. The IVC may have to be temporarily clamped during resection, potentially requiring vasopressor support. Rarely, cardiopulmonary bypass may be indicated if there is extensive IVC infiltration. The patient is typically positioned in the kidney rest position for the retroperitoneal approach. This position can cause caval compression and
Page 2 and 3:
Anesthesia Student Survival Guide
Page 4 and 5:
Editors Jesse M. Ehrenfeld, MD, MPH
Page 6 and 7:
Foreword As anesthesiologists and H
Page 8 and 9:
Contents Case Studies xvii Section
Page 10 and 11:
ContEntS ● xi 19 Physiology and A
Page 12 and 13:
Contributors Basem Abdelmalak, MD S
Page 14 and 15:
David C. Lai, MD Partner, Allenmore
Page 16 and 17:
CASE STUDIES In order to focus your
Page 18 and 19:
CASE StUDIES ● xix inhalation ane
Page 20 and 21:
CASE StUDIES ● xxi around the job
Page 22 and 23:
CASE StUDIES ● xxiii ● Although
Page 24 and 25:
CASE StUDIES ● xxv ● You plan a
Page 26 and 27:
CASE StUDIES ● xxvii ● What oth
Page 28 and 29:
CASE StUDIES ● xxix Chapter 23 Ca
Page 30 and 31:
CASE StUDIES ● xxxi of her left h
Page 32 and 33:
CASE StUDIES ● xxxiii speechless.
Page 34 and 35:
CASE StUDIES ● xxxv things go ver
Page 36 and 37:
How to Be a “Star” Student, Car
Page 38 and 39:
hOw tO Be A “stAr” student, CAr
Page 40 and 41:
Pre-Op Holding Area Preoperative Ev
Page 42 and 43:
Page 44 and 45:
Page 46 and 47:
Page 48 and 49:
History of Anesthesia and Introduct
Page 50 and 51:
history of AnesthesiA And introduct
Page 52 and 53:
Page 54 and 55:
Page 56 and 57:
Page 58 and 59:
Page 60 and 61:
Pharmacology Section II
Page 62 and 63:
30 ● AnesthesiA student survivAl
Page 64 and 65:
Page 66 and 67:
Page 68 and 69:
Page 70 and 71:
Page 72 and 73:
Page 74 and 75:
Page 76 and 77:
Page 78 and 79:
Page 80 and 81:
Page 82 and 83:
Page 84 and 85:
Page 86 and 87:
Page 88 and 89:
Page 90 and 91:
Page 92 and 93:
Page 94 and 95:
Page 96 and 97:
Page 98 and 99:
Page 100 and 101:
Page 102 and 103:
Page 104 and 105:
Page 106 and 107:
Page 108 and 109:
Page 110 and 111:
Page 112 and 113:
Page 114 and 115:
Page 116 and 117:
The Preoperative Patient Evaluation
Page 118 and 119:
THe PreoPerATIve PATIenT evAluATIon
Page 120 and 121:
Page 122 and 123:
Page 124 and 125:
Page 126 and 127:
Therapy-based indications radiation
Page 128 and 129:
Table 8.5 Formulation an anesthetic
Page 130 and 131:
Page 132 and 133:
Page 134 and 135:
Page 136 and 137:
Page 138 and 139:
Page 140 and 141:
Page 142 and 143:
Page 144 and 145:
Page 146 and 147:
Page 148 and 149:
Page 150 and 151:
Page 152 and 153:
Page 154 and 155:
Page 156 and 157:
Page 158 and 159:
Page 160 and 161:
Page 162 and 163:
Anesthesia Equipment and Monitors B
Page 164 and 165:
AnesthesiA eQuiPment And mOnitOrs
Page 166 and 167:
Page 168 and 169:
Page 170 and 171:
● ● ● AnesthesiA eQuiPment An
Page 172 and 173:
Page 174 and 175:
Page 176 and 177:
Table 11.3 Data typically obtained
Page 178 and 179:
Page 180 and 181:
Page 182 and 183:
Page 184 and 185:
Page 186 and 187:
Anesthetic Techniques: General, Sed
Page 188 and 189:
Anesthetic techniques: GenerAl, sed
Page 190 and 191:
Table 12.2 Stages of general anesth
Page 192 and 193:
Page 194 and 195:
Page 196 and 197:
Table 12.6 (continued) Anesthetic t
Page 198 and 199:
Page 200 and 201:
Anesthetic Techniques: Regional Ant
Page 202 and 203:
Figure 13.2 Surface anatomy for neu
Page 204 and 205:
Table 13.1 Risks of neuraxial anest
Page 206 and 207:
Anesthetic techniques: reGionAl ●
Page 208 and 209:
Page 210 and 211:
Page 212 and 213:
Page 214 and 215:
Page 216 and 217:
Page 218 and 219:
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Page 226 and 227:
Page 228 and 229:
Page 230 and 231:
Page 232 and 233:
Page 234 and 235:
Table 14.6 Advantages, disadvantage
Page 236 and 237:
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
Page 244 and 245:
Page 246 and 247:
Table 14.11 Transfusion of bloodpro
Page 248 and 249:
Page 250 and 251:
Page 252 and 253:
Page 254 and 255:
Chapter 15 IV, Gastric Tube, Arteri
Page 256 and 257:
iv, GAstric tube, ArteriAl & centrA
Page 258 and 259:
Page 260 and 261:
Page 262 and 263:
Page 264 and 265:
Page 266 and 267:
Page 268 and 269:
Common Intraoperative Problems Fran
Page 270 and 271:
Pneumothorax Uncommon, but may spon
Page 272 and 273:
COMMON INTRAOPERATIVE PROBLEMS ●
Page 274 and 275:
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Table 16.3 Common intraoperative dy
Page 282 and 283:
Table 16.3 (continued) Problem Diff
Page 284 and 285:
Page 286 and 287:
Page 288 and 289:
Systems Physiology and Anesthetic S
Page 290 and 291:
Page 292 and 293:
Page 294 and 295:
Page 296 and 297:
Page 298 and 299:
Page 300 and 301:
Page 302 and 303:
Page 304 and 305:
Page 306 and 307:
Page 308 and 309:
Page 310 and 311:
Page 312 and 313:
Page 314 and 315:
Page 316 and 317:
Page 318 and 319: 294 ● AnesthesiA student survivAl
Page 348 and 349: Chapter 20 Physiology and Anesthesi
Page 350 and 351: PhysioloGy And AnesthesiA for Gener
Page 364 and 365: Anesthesia for Urological Surgery P
Page 366 and 367: AnesthesiA for uroloGicAl surGery
Page 376 and 377: Physiology and Anesthesia for Pedia
Page 378 and 379: PhysioloGy And AnesthesiA for PediA
Page 386 and 387: Table 22.6 Common pediatric emergen
Page 392 and 393: Physiology and Anesthesia for Elder
Page 394 and 395: PhysioloGy And AnesthesiA for elder
Page 404 and 405: Chapter 24 Ambulatory Surgery and O
Page 406 and 407: AmbulAtOry Surgery ANd Out-Of-Or (O
Page 418 and 419:
AmbulAtOry Surgery ANd Out-Of-Or (O
Page 420 and 421:
Page 422 and 423:
Page 424 and 425:
Page 426 and 427:
Page 428 and 429:
Page 430 and 431:
Page 432 and 433:
Page 434 and 435:
Perioperative Acute and Chronic Pai
Page 436 and 437:
PerioPerAtive ACute And ChroniC PAi
Page 438 and 439:
Page 440 and 441:
Page 442 and 443:
Page 444 and 445:
Page 446 and 447:
Page 448 and 449:
Page 450 and 451:
Chapter 27 Postoperative Anesthesia
Page 452 and 453:
POstOPerAtive AnesthesiA CAre unit
Page 454 and 455:
Page 456 and 457:
Page 458 and 459:
Page 460 and 461:
Page 462 and 463:
Page 464 and 465:
Introduction to Critical Care Bever
Page 466 and 467:
introduction to criticAl cAre ● 4
Page 468 and 469:
Page 470 and 471:
SVR = [(MAP - CVP)/CO] ´ 80 introd
Page 472 and 473:
Page 474 and 475:
Page 476 and 477:
Page 478 and 479:
Page 480 and 481:
Page 482 and 483:
Page 484 and 485:
● ● ● ● ● introduction to
Page 486 and 487:
Page 488 and 489:
Page 490 and 491:
Chapter 29 Professionalism, Safety,
Page 492 and 493:
ProfessionAlism, sAfety, And teAmwo
Page 494 and 495:
Page 496 and 497:
Page 498 and 499:
Page 500 and 501:
Page 502 and 503:
Chapter 30 Quality Assurance, Patie
Page 504 and 505:
QuAlity AssurAnce, PAtient And Prov
Page 506 and 507:
Page 508 and 509:
Page 510 and 511:
Page 512 and 513:
Page 514 and 515:
Page 516 and 517:
Page 518 and 519:
Page 520 and 521:
Chapter 32 Clinical Simulation in A
Page 522 and 523:
Table 32.1 Matrix of categories of
Page 524 and 525:
CliniCAl simulAtion in AnesthesiA e
Page 526 and 527:
Page 528 and 529:
Page 530 and 531:
Page 532 and 533:
ASA Difficult Airway Algorithm Appe
Page 534 and 535:
518 ● ANESTHESIA STUDENT SURVIVAL
show all

Anesthesia Student Survival Guide.pdf - Index of

Create successful ePaper yourself

Delete template?

Save as template?