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Essentials of Anesthesia & Critical Care Anshul Jain

SECTION 1: ANESTHESIA
UNIT I:Basics of Anesthesia
- ROLE OF AN ANESTHESIOLOGIST
- INTRAOPERATIVE ANESTHESIA
- EMERGENCY MEDICINE
- CRITICAL CARE UNIT
- PAIN MEDICINE
CHAPTER 2:History of Anesthesia
- INTRODUCTION
- INHALATION ANESTHESIA
- LOCAL AND REGIONAL ANESTHESIA
- INTRAVENOUS ANESTHESIA
- STAGES OF ANESTHESIA
- MUSCLE RELAXANTS
CHAPTER 3:Respiratory Physiology
- INTRODUCTION
- ANATOMY
- BREATHING MECHANICS
  - Mechanics of Respiration
- LUNG VOLUMES (TABLE 3.3 AND FIG. 3.3)
- DEAD SPACE AND UNEVEN VENTILATION
  - Effect of Anesthetics on Dead Space
- VENTILATION-PERFUSION RELATIONSHIP (Fig. 3.4)
- REGULATION OF RESPIRATION
  - Pontine and Vagal Influences
  - Effects of Anesthetics on Respiratory Drive
- MEASURING LUNG FUNCTION
- FITNESS FOR ANESTHESIA
CHAPTER 4:Oxygen and Carbon Dioxide Transport
- OXYGEN CASCADE
- OXYGEN TRANSPORT
  - Reaction of Hemoglobin and Oxygen
  - Dissolved Oxygen
- OXYGEN-HEMOGLOBIN DISSOCIATION CURVE (Fig. 4.2)
- CARBON DIOXIDE TRANSPORT
CHAPTER 5:Operation Theater
- LOCATION
- NUMBER OF OPERATION THEATERS
- DESIGN
- LAYOUT
- OPERATION ROOM ASEPSIS
CHAPTER 6:Anesthesia Machineand Vaporizers
- INTRODUCTION
- STANDARDS FOR AN ANESTHESIA MACHINE
- ANATOMY OF AN ANESTHESIA MACHINE
- TESTING ANESTHESIA MACHINE
  - High-Pressure System and Intermediate System
  - Low-Pressure System
- VAPORIZERS
- SAFETY FEATUREs IN AN ANESTHESIA MACHINE
  - Safety Features of a Vaporizer
CHAPTER 7:Anesthesia Breathing System
- PROPERTIES OF AN IDEAL BREATHING SYSTEM
- CLASSIFICATION OF BREATHING SYSTEM
- MAPLESON SYSTEMS
- ABSORBER BREATHING SYSTEM (CLOSED SYSTEM)
  - To-and-Fro System (Water’s System) (Fig. 7.5)
  - Circle System
- CARBON DIOXIDE ABSORBENT
- OTHER OXYGEN DELIVERY DEVICES
CHAPTER 8:Airway Management
- INTRODUCTION
- AIRWAY ASSESSMENT
- EQUIPMENT FOR AIRWAY MANAGEMENT
- TECHNIQUES OF DIRECT LARYNGOSCOPY AND INTUBATION
- Emergency Airway Management (Flow chart 8.1)
- RAPID SEQUENCE INDUCTION AND INTUBATION
  - Steps
CHAPTER 9:Preanesthetic Evaluation
- INTRODUCTION
- GENERAL PRINCIPLES
- IMPLEMENTATION of PREANESTHETIC ASSESSMENT
- STEPS OF ASSESSMENT
- EFFECT OF PRE-EXISTING DRUG THERAPY ON ANESTHETIC MANAGEMENT AND MODIFICATIONS REQUIRED
- PREMEDICATION
  - Drugs Used for Premedication
UNIT II:Anesthesia Pharmacology
- INTRODUCTION
  - Classification
- MECHANISM OF INHALATIONAL ANESTHESIA
  - Site of Action
- MINIMUM ALVEOLAR CONCENTRATION
- GENERAL PRINCIPLES OF INHALATIONAL ANESTHESIA
- RECOVERY FROM INHALATIONAL ANESTHESIA
  - Diffusion Hypoxia (Fink Effect)Q
- METABOLISM OF INHALED ANESTHETICS
- ORGAN SYSTEM EFFECTS AND TOXICITIES
- METABOLIC EFFECT
- OTHER EFFECTS
- INDIVIDUAL ANESTHETIC AGENTS
- AGENTS NO LONGER USED
- NONANESTHETIC GASES IN ANESTHESIA
CHAPTER 11:Intravenous Anesthetics
- BARBITURATES
- METHOHEXITONE
- PROPOFOL
- KETAMINE
- BENZODIAZEPINES
- FLUMAZENIL
  - Side Effects and Contraindications
- ETOMIDATE
- NEUROLEPTANALGESIA(FLOW CHART 11.1)
  - Neuroleptanesthesia
- DROPERIDOL
  - Uses
- OPIOID ANESTHETICS
- clinical pharmacology of important agonists
- AGONIST-ANTAGONIST OPIOIDS
- OPIOID ANTAGONISTS
  - Naloxone
  - Naltrexone
- α2 ADRENERGIC AGONISTS
CHAPTER 12:Local Anesthetics
- INTRODUCTION
- BASIC PHARMACOLOGY
  - Chemistry
  - Structure-Activity Relationships and Physicochemical Properties
    - Lipophilic-Hydrophilic Balance
    - Hydrogen Ion Concentration
- MECHANISM OF ACTION (FIG. 12.1)
  - Few Interesting Facts
- CLINICAL PHARMACOLOGY
- FACTORS INFLUENCING ANESTHETIC ACTIVITY IN HUMANS
- CHOICE OF LOCAL ANESTHETICS
- PHARMACOKINETICS
- TOXICITY
- LOCAL ANESTHETIC FAILURE
  - Inflammation at Site of Application
  - Genetic Variability
- INDIVIDUAL AGENTS (TABLE 12.2)
  - Ester Group
  - Amide Group
- OTHER LOCAL ANESTHETICS NOT IN ANESTHESIA PRACTICE
  - Dibucaine
  - Oxethazaine
- NOVEL LOCAL ANESTHETICS
- STERILIZATION OF LOCAL ANESTHESIA
CHAPTER 13:Muscle Relaxants
- INTRODUCTION
- Mechanism OF ACTION OF NEUROMUSCULAR BLOCKERS AT THE NEUROMUSCULAR JUNCTION
- DEPOLARIZING MUSCLE RELAXANTS
  - Succinylcholine
- Nondepolarizing Neuromuscular Blockers
  - Individual Agents (Table 13.4)
  - Other Agents No Longer Used
- CLINICAL USES
- ADVERSE EFFECTS
- FACTORS AFFECTING RESPONSE TO NEUROMUSCULAR BLOCKERS
- RECOVERY FROM NEUROMUSCULAR BLOCKADE
- ANTAGONISM OF RESIDUAL NEUROMUSCULAR BLOCKADE
- OTHER ANTAGONISTS OF NONDEPO-LARIZING NEUROMUSCULAR BLOCKERS
  - Sugammadex
CHAPTER 14:Additional Drugsin Anesthesia
- SYMPATHOMIMETICS
- ANTIHYPERTENSIVES
- ANTIEMETICS
UNIT III:Perioperative Care
- INTRODUCTION
- CLINICAL MONITORING
- CARDIOVASCULAR MONITORING
- RESPIRATORY MONITORING
  - Stethoscope
  - Oxygen Saturation
    - Co-oximetry
    - Pulse Oximetry
- CAPNOGRAPHY
- ANESTHETIC GAS ANALYSIS
  - Techniques
- BLOOD GAS ANALYSIS
- INTRAOPERATIVE SPIROMETRY AND AIRWAY PRESSURE MONITORING
- NEUROMUSCULAR MONITORING
  - Patterns of Nerve Stimulation (Fig. 15.3)
  - Equipment and Technique (Fig. 15.4)
    - Selection of Nerve
- TEMPERATURE MONITORING
- MONITORING THE DEPTH OF ANESTHESIA
  - Specific Monitors
- MONITORING BLOOD LOSS
- MONITORING COAGULATION
CHAPTER 16:Perioperative Fluid Therapy andBlood Transfusion
- INTRODUCTION
- FLUID COMPARTMENTS(FLOW CHART 16.1)
  - Intracellular Fluid
  - Extracellular Fluid
- INTRAVENOUS FLUIDS
- PERIOPERATIVE FLUID THERAPY
- BLOOD TRANSFUSION
UNIT IV:Regional Anesthesia Techniques and Complications
- INTRODUCTION
- APPLIED ANATOMY (FIGS 17.1 AND 17.2)
  - Vertebral Column
  - Spinal Cord
- CENTRAL NEURAXIAL BLOCKADE
  - Mechanism of Action
- SYSTEMIC EFFECTS OF NEURAXIAL BLOCKADE
- SPINAL ANESTHESIA
- EPIDURAL ANESTHESIA
- CAUDAL ANESTHESIA
CHAPTER 18:Nerve Blocks
- INTRODUCTION
  - Techniques of Localizing Neural Structures
- BLOCKS OF HEAD AND NECK
- LOCAL ANESTHESIA OF THE AIRWAY
  - Superior Laryngeal Nerve Block (Fig. 18.2)
- BLOCKS OF UPPER LIMB
- BLOCKS OF THORAX/ABDOMEN
- BLOCKS OF LOWER EXTREMITY
UNIT V:Anesthesia and Associated Diseases
- INTRODUCTION
  - Risk Factors for Patients with Cardiac Disease (Table 19.1)
- SYSTEMIC HYPERTENSION
  - Anesthetic Management
  - Postoperative Management
- ISCHEMIC HEART DISEASE
  - Anesthetic Management
- VALVULAR HEART DISEASE
- CONGENITAL HEART DISEASE
  - Acyanotic Lesion
    - Anesthetic Management
  - Cyanotic Disease
    - Management of Anesthesia
CHAPTER 20:Anesthesia for Patients with Respiratory Disease
- INTRODUCTION
- GENERAL CONSIDERATIONS
- SPECIFIC DISEASE
CHAPTER 21:Anesthesia for Patients with Hematological Disorders
- ANEMIA
  - Preoperative PreparationQ
  - Anesthetic Considerations
    - Maximum Allowable Blood Loss
- SICKLE CELL ANEMIA
- PLATELET DISORDERS
- COAGULATION FACTOR DISORDERS
  - Heredity Conditions
    - Preoperative Evaluation
    - Anesthetic Considerations
  - Iatrogenic Conditions
CHAPTER 22:Anesthesia for Patients with Hepatobiliary Disease
- INTRODUCTION
- EFFECT OF ANESTHETIC AGENTS ON HEPATIC FUNCTION
- ANESTHETIC MANAGEMENT
- BILIARY DISORDERS
CHAPTER 23:Anesthesia for Patients with Neuropsychiatric Disease
- INTRODUCTION
- EPILEPSY
  - Preoperative Considerations
  - Intraoperative Management
- CEREBROVASCULAR DISEASE
  - Preoperative Management
  - Intraoperative Management
- DEGENERATIVE AND DEMYELINATING DISEASE
- PSYCHIATRIC DISORDERS
- ANESTHESIA FOR ELECTROCONVULSIVE THERAPY
  - Anesthetic Management
CHAPTER 24:Anesthesia for Patients with Musculoskeletal Disease
- MYASTHENIA GRAVIS
- LAMBERT–EATON MYASTHENIC SYNDROME
  - Anesthetic Considerations
- PERIODIC PARALYSIS (HYPERKALEMIC AND HYPOKALEMIC)
  - Anesthetic Considerations
- MUSCULAR DYSTROPHIES
  - Anesthetic Considerations
  - Anesthetic Considerations in Myotonic Dystrophy
- METABOLIC MYOPATHIES
  - Anesthetic Considerations
- MALIGNANT HYPERTHERMIA
CHAPTER 25:Anesthesia for Patients with Endocrinal Disease
- INTRODUCTION
- DIABETES MELLITUS
- THYROID DISORDERS
  - Hypothyroidism
    - Anesthetic Considerations
  - Hyperthyroidism
    - Anesthetic Considerations
- ADRENAL GLAND
  - Hypercortisolism (Cushing’s Syndrome)
    - Anesthetic Considerations
  - Adrenal Insufficiency
    - Management of Anesthesia
- PHEOCHROMOCYTOMA
  - Anesthetic Considerations
CHAPTER 26:Anesthesia for Patients with Renal Disease
- INTRODUCTION
- EFFECT OF ANESTHETIC AGENT ON RENAL PHYSIOLOGY
- EFFECT OF RENAL DISEASE ON ANESTHETIC AGENTS
- PREOPERATIVE CONSIDERATIONS
- PERIOPERATIVE CONSIDERATIONS
- POSTOPERATIVE MANAGEMENT
CHAPTER 27:Anesthesia for Obese Patients
- INTRODUCTION
- CLASSIFICATION
  - Obesity Hypoventilation Syndrome(Pickwickian Syndrome)
- ANESTHETIC CONSIDERATIONS
UNIT VI:Anesthesia Practice
- INTRODUCTION
- ANESTHETIC MANAGEMENT
  - Anticipated Difficult Airway
  - Management
    - Other Options
- UNANTICIPATED DIFFICULT INTUBATION
  - Cannot Intubate Cannot Ventilate Situation
- AWAKE FIBEROPTIC INTUBATION
CHAPTER 29:Anesthesia for Ophthalmic Surgery
- INTRODUCTION
- ANATOMY OF EYE
  - Blood Supply
  - Nerve Supply
- OCULAR PHYSIOLOGY
  - Intraocular Pressure Dynamics
  - Oculocardiac Reflex
- ANESTHETIC MANAGEMENT
CHAPTER 30:Anesthesia for Ear, Nose and Throat Surgery
- INTRODUCTION
- EAR SURGERY
  - Anesthetic Management
- NASAL SURGERY
  - Preoperative Evaluation
    - Nasal Vasoconstrictors
  - Anesthetic Management
- INTRAORAL SURGERY
  - Tonsillectomy
  - Laryngeal Procedures
    - Preoperative Evaluation
    - Anesthetic Techniques
CHAPTER 31:Anesthesia forOrthopedic Surgery
- INTRODUCTION
- PREOPERATIVE EVALUATION
  - Choice of Anesthesia Technique
- PERIOPERATIVE COMPLICATIONS
- ANESTHETIC MANAGEMENT OF DIFFERENT Procedures
CHAPTER 32:Anesthesia for Genitourinary Surgery
- INTRODUCTION
- ANESTHETIC CONSIDERATIONS
CHAPTER 33:Anesthesia forLaser Surgery
- INTRODUCTION
- LASER HAZARDS
CHAPTER 34:Anesthesia for Laparoscopy
- INTRODUCTION
- ALTERNATIVES TO CO2 PNEUMOPERITONEUM
  - Inert Gases
  - Gasless Laparoscopy
- ANESTHETIC MANAGEMENT
- LAPAROSCOPY IN CHILDRENAND DURING PREGNANCY
CHAPTER 35:Anesthesia for Neurosurgery
- INTRODUCTION
- CEREBRAL PHYSIOLOGY AND PHARMACOLOGY
- ANESTHETIC MANAGEMENT
  - Principles for Safe Anesthesia Management
  - Management of Increased Intracranial Pressure (Flow chart 35.1)
    - Diuretics
    - Steroids
- SPECIFIC CONDITIONS
  - Head Injury
- INTRACRANIAL MASS LESIONS
- POSTERIOR FOSSA PROCEDURES (CRANIOTOMY IN SITTING POSITION)
  - Problem of Posterior Fossa Surgery
    - Obstructive Hydrocephalus
    - Venous Air Embolism
- INTRACRANIAL ANEURYSMS AND ARTERIOVENOUS MALFORMATION
- SEIZURE SURGERY
  - Preoperative Evaluation
  - Intraoperative Management
CHAPTER 36:Anesthesia for Cardiothoracic Surgery
- INTRODUCTION
- CARDIOPULMONARY BYPASS
- ANESTHETIC MANAGEMENT OF CARDIAC SURGERY IN ADULTS
- OFF-PUMP CORONARY ARTERY BYPASS SURGERY
- ANESTHESIA FOR THORACIC SURGERY
- PHYSIOLOGICAL CONSIDERATIONS
- ANESTHETIC MANAGEMENT OF LUNG RESECTION
CHAPTER 37:Geriatric Anesthesia
- INTRODUCTION
- PHYSIOLOGICAL CHANGES WITH AGING
- ANESTHETIC MANAGEMENT
CHAPTER 38:Obstetric Anesthesia
- INTRODUCTION
- PHYSIOLOGICAL CHANGES IN PREGNANCY AND THEIR ANESTHETIC IMPLICATIONS
- PLACENTAL TRANSFER OF ANESTHETIC DRUGS
- EVALUATION OF THE FETUS
- ROLE OF INTRAUTERINE RESUSCITATION
- ANESTHESIA FOR SPONTANEOUS VAGINAL DELIVERY (LABOR ANALGESIA)
  - Techniques for Labor Analgesia
- REGIONAL TECHNIQUES FOR LABOR ANALGESIA
- ANESTHESIA FOR CESAREAN SECTION
- SPECIFIC CONDITIONS
  - Pre-eclampsia and Eclampsia
    - Anesthetic Management
  - Antipartum Hemorrhage
- ANESTHESIA FOR NONOBSTETRIC SURGERY DURING PREGNANCY
- BASIC LIFE SUPPORT IN PREGNANCY
- ANESTHESIA FOR MANUAL REMOVAL OF PLACENTA
CHAPTER 39:Pediatric Anesthesia
- INTRODUCTION
- ANATOMICAL AND PHYSIOLOGICAL DIFFERENCES
- PHARMACOLOGICAL DIFFERENCE
- ANESTHETIC CONSIDERATIONS
  - Preoperative Evaluation
  - Postoperative Care
    - Postoperative Pain Management
- ANESTHETIC MANAGEMENT OF SPECIFIC DISORDERS
CHAPTER 40:Anesthesia at Remote Locations
- INTRODUCTION
- ANESTHESIA AT HIGH ALTITUDE
- ANESTHESIA AT HIGH PRESSURE (UNDER SEA WATER)
  - Problems and Principles of Anesthetic Management
- ANESTHESIA IN DARK (RADIOLOGICAL PROCEDURES)
CHAPTER 41:Anesthesia for Day Care Surgery
- INTRODUCTION
  - Patients Suitable for Day Care Surgery
- ANESTHETIC MANAGEMENT
CHAPTER 42:Hypotensive Anesthesia
- INTRODUCTION
  - Indications
  - Contraindications
- METHODS FOR INDUCING HYPOTENSION
  - Nonpharmacological
  - Pharmacological
    - Clinical Considerations (Table 42.1)
- OTHER TECHNIQUES TO REDUCE INTRAOPERATIVE BLEEDING
UNIT VII:Pain Management
- INTRODUCTION
- TRANSMISSION OF PAIN
- THEORIES OF PAIN
- CLASSIFICATION OF PAIN (FIG. 43.3)
- EVALUATION OF PAIN
CHAPTER 44:Postoperative Pain Management
- INTRODUCTION
- ASSESSMENT OF PAIN
- METHODS OF POSTOPERATIVE PAIN MANAGEMENT
CHAPTER 45:Chronic Pain and Palliation
- INTRODUCTION
- ASSESSMENT AND MANAGEMENT
- MANAGEMENT ACCORDING TO PAIN TYPES
- COMBINING PAIN MANAGEMENT WITH PALLIATIVE CARE
  - Principles of Palliative Care
SECTION 2: CRITICAL CARE
UNIT VIII:Practice and Management in ICU
- INTRODUCTION
- INTENSIVE CARE UNIT ORGANIZATION
- ASSESSMENT OF SEVERITY OF ILLNESS
- CLINICAL MANAGEMENT
- COMPLICATIONS IN INTENSIVE CARE UNIT
CHAPTER 47:Cardiopulmonary Resuscitation
- INTRODUCTION
- SUDDEN CARDIAC ARREST
- 2010 AMERICAN HEART ASSOCIATION GUIDELINES FOR CPR
  - Conceptual Framework for CPR
    - Rescuer
    - Victim
- BASIC LIFE SUPPORT SEQUENCE (FLOW CHART 47.1)
- ADVANCED CARDIOVASCULAR LIFE SUPPORT
- MONITORING DURING CPR
  - Mechanical Parameters
  - Physiologic Parameters
CHAPTER 48:Principles of Mechanical Ventilation
- INTRODUCTION
- Physiology of Mechanical Ventilation
  - Total Ventilator Controlled Ventilatory Support
  - Partial Patient Controlled Ventilatory Support
- Indication of Mechanical Ventilation
  - Other Indications
- WORKING AND OPERATION OF VENTILATOR
  - Terminology Used (Flow chart 48.1)
- VENTILATOR MODES
- NONINVASIVE VENTILATION
  - Noninvasive Ventilation Modes
    - Limitation of Noninvasive Ventilation
- POSITIVE-END EXPIRATORY PRESSURE
- COMPLICATION OF MECHANICAL VENTILATION
- WEANING FROM VENTILATION
  - Weaning Criteria (Table 48.2)
  - Weaning Procedure
CHAPTER 49:Acid–Base andElectrolyte Imbalance
- INTRODUCTION
- NORMAL ACID–BASE HOMEOSTASIS
- ACID–BASE DISTURBANCES
- ELECTROLYTE DISTURBANCES
CHAPTER 50:Nutritional Support in Intensive Care Unit
- INTRODUCTION
- INDICATION OF NUTRITION SUPPORT (FLOW CHART 50.1)
- NUTRITION REQUIREMENT
- Routes of Nutrition (Flow chart 50.2)
  - Enteral Nutrition
  - Parenteral Nutrition
    - Peripheral Parenteral Nutrition
    - Complications of Parenteral Nutrition
CHAPTER 51:Brain Death
- INTRODUCTION
- MECHANISM OF BRAIN DEATH
  - Criteria and Tests for Determining Brain Death
  - Rule out the Mimics

INDEX

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Chapter Notes