Contents

Front matter

• Preface
• Contributors
• Abbreviations

Chapter 1 General considerations

• Chapter 1 General considerations
• Good practice
• Preoperative tests
• Premedication drugs
• Fasting
• Prophylaxis of venous thromboembolism
• Perioperative guidelines for body piercing jewellery

Chapter 2 Consent and anaesthetic risk

• Chapter 2 Consent and anaesthetic risk
• Consent
• Anaesthetic risk
• Perioperative mortality
• Perioperative morbidity
• Nerve injury
• Peripheral nerve injury
• Spinal cord injury

Chapter 3 Cardiovascular disease

• Chapter 3 Cardiovascular disease
• Ischaemic heart disease
• Perioperative acute myocardial infarction
• Heart failure
• Hypertension
• Valvular heart disease
• Aortic stenosis (see also p332)
• Aortic regurgitation (see also p334)
• Mitral stenosis
• Mitral regurgitation
• The patient with an undiagnosed murmur
• Prosthetic valves
• Pericardial disease
• Cardiomyopathy
• Patients with a transplanted heart
• Congenital heart disease and non-cardiac surgery
• Specific CHD lesions
• Adults with congenital heart disease

Chapter 4 Perioperative arrhythmias

• Chapter 4 Perioperative arrhythmias
• Perioperative arrhythmias
• Narrow complex arrhythmias
• Broad complex arrhythmias
• Disturbances of conduction (heart block)
• Pacemakers and defibrillators

Chapter 5 Respiratory disease

• Chapter 5 Respiratory disease
• Effects of surgery and anaesthesia on respiratory function
• Predicting postoperative pulmonary complications
• Assessment of respiratory function
• Respiratory investigations
• Postoperative care
• Postoperative admission to HDU/ICU
• Respiratory tract infection and elective surgery
• Smoking
• Asthma
• Conduct of anaesthesia
• Chronic obstructive pulmonary disease (COPD)
• Bronchiectasis
• Cystic fibrosis
• Restrictive pulmonary disease
• Sleep apnoea syndrome
• Sarcoidosis
• Anaesthesia after lung transplantation

Chapter 6 Renal disease

• Chapter 6 Renal disease
• Patient with raised creatinine
• Renal dialysis/renal transplant
• Acute renal failure

Chapter 7 Hepatic disease

• Chapter 7 Hepatic disease
• Complications of liver disease
• Acute hepatic disease
• Chronic hepatic disease
• Drug metabolism and liver disease
• Anaesthetic management of the patient with liver failure
• Postoperative liver dysfunction or jaundice
• Renal failure and the hepatorenal syndrome
• Portal hypertension and oesophageal varices

Chapter 8 Endocrine and metabolic disease

• Chapter 8 Endocrine and metabolic disease
• Diabetes mellitus
• Acromegaly
• Thyroid disease
• Parathyroid disorders
• Adrenal insufficiency
• The patient on steroids
• Cushing's syndrome
• Conn's syndrome
• Apudomas
• Hypokalaemia
• Hyperkalaemia
• Hyponatraemia
• Hypernatraemia
• Obesity

Chapter 9 Bone, joint, and connective tissue disorders

• Chapter 9 Bone, joint, and connective tissue disorders
• Rheumatoid arthritis
• Ankylosing spondylitis
• Systemic lupus erythematosus (SLE)
• Systemic sclerosis
• Scoliosis
• ScoliosisAchondroplasia

Chapter 10 Haematological disorders

• Chapter 10 Haematological disorders
• Anaemia
• Sickle cell disease
• Porphyria
• Rare blood disorders
• Coagulation disorders
• Haemophilia and related clotting disorders
• Thrombocytopenia
• Anticoagulants
• Antiplatelet drugs
• Fibrinolytics
• Antifibrinolytics/haemostatic drug therapy
• Perioperative management of the bleeding patient
• Hypercoagulability syndromes

Chapter 11 Neurological and muscular disorders

• Chapter 11 Neurological and muscular disorders
• Epilepsy
• Cerebrovascular disease
• Parkinson's disease
• Anaesthesia in spinal cord lesions
• Myasthenia gravis
• Multiple sclerosis
• Guillain Barré syndrome
• Motor neuron disease (amyotrophic lateral sclerosis)
• Dystrophia myotonica
• Muscular dystrophy
• Malignant hyperthermia

Chapter 12 Psychiatric disorders and drugs

• Chapter 12 Psychiatric disorders and drugs
• Psychiatric disorders
• Tricyclic antidepressants (TCA)
• Selective serotonin reuptake inhibitors (SSRIs)
• Monoamine oxidase inhibitors (MAOIs)
• Antipsychotic drugs and lithium
• Sedation of agitated patients on the ward
• Anaesthesia for drug-misusing patients
• Anaesthesia for electroconvulsive therapy (ECT)

Chapter 13 Uncommon conditions

• Chapter 13 Uncommon conditions

Chapter 14 Cardiac surgery

• Chapter 14 Cardiac surgery
• Determinants of myocardial oxygen supply and de-mand
• Risk scoring
• Cardiopulmonary bypass
• Coronary arterial bypass grafting
• Emergency coronary arterial bypass graft (failed angio-plasty)
• Aortic valve replacement: stenosis
• Aortic valve replacement: regurgitation
• Mitral valve replacement: stenosis
• Mitral valve replacement: regurgitation
• Thoracic aortic surgery
• Pulmonary thromboembolectomy
• Redo cardiac surgery
• Cardioversion
• Anaesthesia for implantable defibrillators

Chapter 15 Thoracic surgery

• Chapter 15 Thoracic surgery
• Introduction
• Analgesia
• Isolation of the lungs
• Management of one lung ventilation
• Rigid bronchoscopy and stent insertion
• Mediastinoscopy/mediastinotomy
• Lung surgery: wedge resection, lobectomy, and pneumonectomy
• Thoracoscopy and video-assisted thoracoscopic surgery (VATS) procedures
• Lung volume reduction surgery and bullectomy
• Drainage of empyema and decortication
• Repair of broncho–pleural fistula
• Pleurectomy/pleurodesis
• Oesophagectomy
• Chest injury

Chapter 16 Neurosurgery

• Chapter 16 Neurosurgery
• General principles
• Craniotomy
• Ventriculo-peritoneal shunt
• Evacuation of traumatic intracranial haematoma
• Pituitary surgery
• Posterior fossa surgery
• Awake craniotomy
• Vascular lesions
• Complications of aneurysmal subarachnoid haemorrhage (SAH)
• Anaesthesia for vascular lesions
• Arteriovenous malformations (AVMs)
• Venous air embolism (VAE)
• Brainstem death
• Organ retrieval from a beating heart donor

Chapter 17 Vascular surgery

• Chapter 17 Vascular surgery
• General principles
• Aortic aneurysm repair
• Emergency repair of AAA
• Endovascular stenting of elective AAA
• Thoraco-abdominal aortic aneurysm repair
• Carotid endarterectomy
• Peripheral revascularisation operations
• Axillobifemoral bypass
• Amputations
• Thoracoscopic sympathectomy
• First rib resection
• Varicose vein surgery

Chapter 18 Orthopaedic surgery

• Chapter 18 Orthopaedic surgery
• General principles
• Fat embolism syndrome (FES)
• Cement implantation syndrome
• Tourniquets
• Total hip replacement
• Revision of total hip replacement
• Total knee replacement
• Arthroscopic lower limb procedures
• Cruciate ligament repair
• Ankle surgery
• Foot surgery
• Spinal surgery
• Shoulder surgery
• Total shoulder replacement
• Elbow replacement surgery
• Anaesthesia for hand surgery
• Anaesthesia for major trauma
• Cervical spine fracture
• Anaesthesia for repair of cervical spine fracture
• Anaesthesia for limb fractures
• Compartment syndrome
• Anaesthesia for femoral neck fracture
• Procedures for fractured neck of femur

Chapter 19 Plastic surgery

• Chapter 19 Plastic surgery
• General principles
• Breast reduction
• Breast augmentation
• Correction of prominent ears
• Facelift (rhytidectomy)
• Free flap surgery
• Liposuction
• Skin grafting

Chapter 20 General surgery

• Chapter 20 General surgery
• Anaesthesia for elective laparotomy
• Analgesia
• Temperature control
• Fluid management
• The sick laparotomy
• Anaesthesia for laparoscopic surgery
• Anaesthesia for breast surgery
• Laparoscopic cholecystectomy
• Appendicectomy
• Inguinal hernia repair
• Haemorrhoidectomy
• Testicular surgery

Chapter 21 Liver transplantation and resection

• Chapter 21 Liver transplantation and resection
• General principles
• Liver transplantation
• Hepatic resection

Chapter 22 Endocrine surgery

• Chapter 22 Endocrine surgery
• Thyroidectomy
• Parathyroidectomy
• Phaeochromocytoma

Chapter 23 Urological surgery

• Chapter 23 Urological surgery
• Cystoscopic procedures
• Transurethral resection of prostate (TURP)
• TURP syndrome
• Transurethral resection of bladder tumour
• Open (retropubic) prostatectomy
• Radical prostatectomy
• Nephrectomy
• Cystectomy
• Laparoscopic urological surgery
• Percutaneous stone removal
• Extracorporeal shock wave lithotripsy
• Renal transplant
• Other urological procedures

Chapter 24 Gynaecological surgery

• Chapter 24 Gynaecological surgery
• General principles
• Minor gynaecological procedures
• ERPC, STOP (VTOP)
• Laparoscopy/laparoscopic sterilisation
• Tension-free vaginal tape (TVT)
• Abdominal hysterectomy
• Vaginal hysterectomy
• Ectopic pregnancy
• Other gynaecological procedures

Chapter 25 Ear, nose, and throat surgery

• Chapter 25 Ear, nose, and throat surgery
• General principles
• Preoperative airway obstruction
• Obstructive sleep apnoea
• Grommet insertion
• Tonsillectomy/adenoidectomy: child
• Tonsillectomy in adults
• Myringoplasty
• Stapedectomy/tympanoplasty
• Nasal cavity surgery
• Microlaryngoscopy
• Tracheostomy
• Laryngectomy
• Pharyngectomy
• Radical neck dissection
• Parotidectomy
• Other ENT procedures

Chapter 26 Maxillofacial and dental surgery

• Chapter 26 Maxillofacial and dental surgery
• Oral/maxillofacial surgery
• Surgical extraction of impacted/buried teeth
• Maxillary/mandibular osteotomy
• Fractures of the zygomatic complex
• Mandibular fractures
• Anaesthesia for dentistry
• Simple dental extractions
• Sedation for dentistry

Chapter 27 Ophthalmic surgery

• Chapter 27 Ophthalmic surgery
• General principles
• Local anaesthesia for intraocular surgery
• Ocular block techniques
• General anaesthetic technique
• Cataract extraction and IOL
• Strabismus surgery
• Vitreo-retinal surgery
• Dacrocystorhinostomy (DCR)
• Penetrating eye injury

Chapter 28 Day surgery

• Chapter 28 Day surgery
• Day surgery
• Conduct of anaesthesia

Chapter 29 Laser surgery

• Chapter 29 Laser surgery
• General principles
• Safety aspects

Chapter 30 CT and MRI imaging

• Chapter 30 CT and MRI imaging
• Anaesthesia for CT and MRI scanning
• Anaesthesia for computerised tomography (CT)
• Anaesthesia for magnetic resonance imaging (MRI)

Chapter 31 Anaesthesia for the elderly

• Chapter 31 Anaesthesia for the elderly

Chapter 32 Obstetric anaesthesia and analgesia

• Chapter 32 Obstetric anaesthesia and analgesia
• Physiology and pharmacology
• Analgesia for labour
• Epidural analgesia for labour
• Combined spinal epidural analgesia for labour (CSE)
• Poorly functioning epidural
• Complications of epidural analgesia
• Dural puncture
• Epidural blood patch
• Anaesthesia for Caesarean section
• Caesarean section: epidural
• Caesarean section: spinal
• Caesarean section: combined spinal/epidural (CSE)
• Inadequate anaesthesia
• Preload
• Caesarean section: general anaesthesia
• Antacid prophylaxis
• Postoperative analgesia
• Retained placenta
• Breast feeding and maternal drug exposure
• Placenta praevia and accreta
• Massive obstetric haemorrhage
• Amniotic fluid embolism
• Cardiac disease and pregnancy
• Maternal resuscitation
• Pregnancy induced hypertension, pre-eclampsia, and eclampsia
• Eclampsia
• HELLP syndrome
• Incidental surgery during pregnancy
• Cervical cerclage
• Controversies in obstetric anaesthesia

Chapter 33 Paediatric and neonatal anaesthesia

• Chapter 33 Paediatric and neonatal anaesthesia
• Neonatal/infant physiology
• Fluid resuscitation
• Anaesthetic equipment
• Conduct of anaesthesia
• Postoperative pain relief
• Caudal block
• Epidural/subarachnoid block
• Regional nerve blocks
• Diaphragmatic hernia
• Gastroschisis/exomphalos
• Tracheo-oesophageal fistula
• Patent ductus arteriosus
• Pyloric stenosis
• Intussusception
• Herniotomy
• Circumcision
• Orchidopexy
• Hypospadias
• Cleft lip and palate
• Congenital talipes equinovarus
• Femoral osteotomy
• Inhaled foreign body
• Medical problems
• Sedation

Chapter 34 The critically ill patient

• Chapter 34 The critically ill patient
• Immediate trauma care
• Primary survey and resuscitation
• The secondary survey
• Head injuries
• Chest injuries
• Abdominal injuries
• Pelvic fractures
• Spinal injuries
• Limb injuries
• Burns: early management
• Analgesia for the injured patient
• The multiply injured patient: common dilemmas
• Post cardiac arrest resuscitation care
• Septic shock
• The ICU patient going to theatre
• Transferring the critically ill

Chapter 35 Anaesthetic emergencies

• Chapter 35 Anaesthetic emergencies
• Anaesthetic emergencies Introduction
• Adult Basic Life Support (BLS)
• Adult Advanced Life Support (ALS)
• Severe bradycardia
• Atrial fibrillation
• Narrow complex tachycardia
• Broad complex tachycardia
• Severe hypotension in theatre
• Severe hypertension in theatre
• Severe hypoxia in theatre
• Severe laryngospasm
• Air/gas embolism
• Aspiration
• Status asthmaticus
• Pulmonary oedema
• Failed intubation
• Can't intubate … Can't ventilate
• Malignant hyperthermia
• Anaphylaxis
• Intra-arterial injection
• Unsuccessful reversal of neuromuscular blockade
• Paediatric Emergencies: Advanced Lif
• Ventricular fibrillation or pulseless VT
• Paediatric doses and equipment
• Paediatric emergencies: neonatal resuscitation
• Paediatric emergencies: collapsed septic child
• Paediatric emergencies: major trauma
• Paediatric emergencies: acute severe asthma
• Paediatric emergencies: anaphylaxis

Chapter 36 Airway assessment and management

• Chapter 36 Airway assessment and management
• Airway assessment
• Unanticipated difficult airway
• Failed intubation
• Techniques for management of elective difficult intubation
• Can't intubate, can't ventilate
• Management of the obstructed airway
• Rapid sequence induction
• Inhalational induction
• Awake fibre-optic intubation
• Extubation after difficult intubation

Chapter 37 Practical anaesthesia

• Chapter 37 Practical anaesthesia
• Anaphylaxis follow-up
• Latex allergy
• Blood exposure incidents
• Target controlled infusions
• Death on the table
• Dealing with a complaint
• Anaesthesia in difficult circumstances
• Long-term venous access
• Oesophageal Doppler monitoring
• Depth of anaesthesia monitoring
• Cardiopulmonary exercise testing
• Neuromuscular blockers, reversal, and monitoring

Chapter 38 Blood products and fluid therapy

• Chapter 38 Blood products and fluid therapy
• Blood products
• Blood conservation techniques
• Massive transfusion
• Jehovah's witnesses
• Fluid and electrolyte therapy

Chapter 39 Acute pain

• Chapter 39 Acute pain
• Introduction
• Analgesic drugs
• Patient-controlled analgesia
• Epidural analgesia
• Stimulation-produced analgesia: TENS and acupuncture
• The opioid-dependent patient
• The patient with a substance abuse disorder
• Acute neuropathic pain following surgery

Chapter 40 Postoperative nausea and vomiting

• Chapter 40 Postoperative nausea and vomiting
• General principles

Chapter 41 Regional anaesthesia

• Chapter 41 Regional anaesthesia
• Anticoagulation and regional anaesthesia
• Nerve identification
• Characteristics of different local anaesthetic agents
• Local anaesthetic toxicity
• Head and neck blocks
• Upper limb blocks
• Lower limb blocks
• Lateral approach
• Trunk blocks
• Central neuraxial blocks

Chapter 42 Drug formulary

• Chapter 42 Drug formulary
• Infusion regimes
• Mac Values
• Antibiotic prophylaxis

Chapter 43 Anaesthesia data

• Chapter 43 Anaesthesia data
• ASA/CEPOD classifications
• Breathing circuits
• Pulmonary function tests
• Cardiovascular physiology data
• Respiratory physiology data
• Useful equations
• Normal values
• Useful websites
• Checklist for anaesthetic equipment

Disclaimer

Oxford University Press makes no representation, express or implied, that the drug dosages in this book are correct. Readers must therefore always check the product information and clinical procedures with the most up to date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulations. The authors and the publishers do not accept responsibility or legal liability for any errors in the text or for the misuse or misapplication of material in this work.

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