Recent Advances In Anaesthesia And Intensive Care 022 (recent Advances)

Aic22-FM.qxd 9/11/02 1:40 PM Page i 22 Recent Advances in Anaesthesia and Intensive Care This page intentionally left blank 22 Recent Advances in Anaesthesia and Intensive Care Edited by A.P. Adams MB BS, MRCS, LRCP, PhD, DA, FRCA, FANZCA Emeritus Professor of Anaesthetics University of London Honorary Consultant Anaesthetist Guy’s, King’s and St Thomas’ Hospitals London, UK Emeritus Consultant to the Army J.N. Cashman BSc, MB BS, BA, MD, FRCA Consultant Anaesthetist, St George’s Hospital, London Honorary Senior Lecturer in Anaesthesia University of London, UK R.M. Grounds MB BS, MRCS, LRCP, MD, DA, FRCA Consultant in Anaesthesia and Intensive Care Medicine St George’s Hospital, London Honorary Reader in Intensive Care Medicine University of London, UK LONDON 䊉 SAN FRANCISCO www.greenwich-medical.co.uk © 2003 Greenwich Medical Media Limited 137 Euston Road London NW1 2AA 870 Market Street, Ste 720 San Francisco CA 94102 ISBN 1 84110 1176 First Published 2003 While the advice and information in this book is believed to be true and accurate, neither the authors nor the publisher can accept any legal responsibility or liability for any loss or damage arising from actions or decisions based in this book. The ultimate responsibility for the treatment of patients and the interpretation lies with the medical practitioner. The opinions expressed are those of the authors and the inclusion in this book of information relating to a particular product, method or technique does not amount to an endorsement of its value or quality, or of the claims made by its manufacturer. Every effort has been made to check drug dosages; however, it is still possible that errors have occurred. Furthermore, dosage schedules are constantly being revised and new side-effects recognised. For these reasons, the medical practitioner is strongly urged to consult the drug companies' printed instructions before administering any of the drugs mentioned in this book. Apart from any fair dealing for the purposes of research or private study, or criticism or review, as permitted under the UK Copyright Designs and Patents Act 1988, this publication may not be reproduced, stored, or transmitted, in any form or by any means, without the prior permission in writing of the publishers, or in the case of reprographic reproduction only in accordance with the terms of the licences issued by the appropriate Reproduction Rights Organisations outside the UK. Enquiries concerning reproduction outside the terms stated here should be sent to the publishers at the London address printed above. The rights of A.P. Adams, J.N. Cashman & R.M. Grounds to be identified as editors of this work have been asserted by them in accordance with the Copyright Designs and Patents Act 1988. The publisher makes no representation, express or implied, with regard to the accuracy of the information contained in this book and cannot accept any legal responsibility or liability for any errors or omissions that may be made. A catalogue record for this book is available from the British Library Typeset by Mizpah Publishing Services, Chennai, India Printed in the UK by the Alden Group Ltd, Oxford Distributed by Plymbridge Distributors Ltd and in the USA by Jamco Distribution Contents Preface A.P. Adams, J.N. Cashman, R.M. Grounds vii Contributors xi 1. The COX enzyme system D. Bishop-Bailey, T.D. Warner 1 2. Drug chirality: stereoselectivity in the action and disposition of anaesthetic agents A.J. Hutt 31 3. New local anaesthetics G.A. McLeod 65 4. Asthma L. Cormican, J. Rees 95 5. Reducing mortality and complications in patients undergoing surgery at high risk for postoperative complications and death R.M. Grounds