Essential Anesthesia: From Science To Practice

This page intentionally left blank Essential Anesthesia This is a concise, accessible introduction to the essentials of anesthesia, suitable for medical students, junior doctors and all operating theater staff. It provides a brief, broad overview of the science and practice of anesthesia without overwhelming the reader with intimidating detail. The first section of the book describes the evaluation of the patient, the different approaches to anesthesia, and the post-operative care of the patient in pain. The next section introduces the essentials of physiology and pharmacology and their role in understanding the principles of anesthesia. The final section presents a step-by-step description of clinical cases, ranging from the simplest to the most complex. These clinical vignettes give a very real introduction to the practicalities of anesthesia and will give the non-anesthetist physician an idea of how to prepare a patient for a surgical procedure. Dr. Tammy Euliano, Associate Professor of Anesthesiology, received her M.D. from the University of Florida and continued there throughout residency and fellowship. She has received numerous awards for her dedication to teaching including the International Anesthesia Research Society Teaching Recognition Award (finalist), the University of Florida College of Medicine Exemplary Teacher, and is a member of the Society of Teaching Scholars. Her research in simulator technology and patient safety has also been recognized by the American Society of Anesthesiologists. Dr. J. S. Gravenstein is Graduate Research Professor of Anesthesiology, Emeritus, University of Florida College of Medicine. Dr. Gravenstein received his Dr. med. from the University of Bonn in Germany and his M.D. from Harvard University School of Medicine. Dr. Gravenstein is known worldwide for his work in patient monitoring, patient safety, and simulation technology. His numerous awards include the Massachusetts General Hospital Trustees’ Medal, and an honorary doctorate in medicine from the University of Graz, Austria. Essential Anesthesia From Science to Practice T. Y. Euliano and J. S. Gravenstein University of Florida College of Medicine, Gainesville, Florida, USA CAMBRIDGE UNIVERSITY PRESS Cambridge, New York, Melbourne, Madrid, Cape Town, Singapore, São Paulo Cambridge University Press The Edinburgh Building, Cambridge CB2 8RU, UK Published in the United States of America by Cambridge University Press, New York www.cambridge.org Information on this title: www.cambridge.org/9780521536004 © T. Y. Euliano & J. S. Gravenstein 2004 This publication is in copyright. Subject to statutory exception and to the provision of relevant collective licensing agreements, no reproduction of any part may take place without the written permission of Cambridge University Press. First published in print format 2004 ISBN-13 ISBN-10 978-0-511-26403-0 eBook (EBL) 0-511-26403-8 eBook (EBL) ISBN-13 ISBN-10 978-0-521-53600-4 paperback 0-521-53600-6 paperback Cambridge University Press has no responsibility for the persistence or accuracy of urls for external or third-party internet websites referred to in this publication, and does not guarantee that any content on such websites is, or will remain, accurate or appropriate. For Alix and Neil Contents Foreword Preface Acknowledgements Introduction A very short history of anesthesia page ix xi xii 1 Part I Clinical management 1 Pre-operative evaluation 5 2 Airway management 24 3 Vascular access and fluid management 38 4 Regional anesthesia 54 5 General anesthe