Principles of Anesthesia Equipment Yasodananda K Areti, Bhavani Shankar Kodali
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1Principles of Anesthesia Equipment2
3Principles of Anesthesia Equipment
Editors Yasodananda K Areti MD Professor of Anesthesia and Intensive Care DM Programme Coordinator Faculty of Medical Sciences, The University of the West Indies Cave Hill Campus, Barbados, West Indies Bhavani Shankar Kodali MD Vice Chairman of Clinical Affairs epartment of Anesthesiology, Perioperative and Pain Medicine Brigham and Women's Hospital Associate Professor, Harvard Medical School Boston, Massachusetts, USA Foreword Moni AbrahamKuriakose Forewords M Ravishankar DA MD James H Philip ME (E) MD CCE
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Principles of Anesthesia Equipment
First Edition: 2016
9789351529385
Printed at
5Dedicated to
The memory of Professor Phaneendra Nath Thota, a teacher par excellence. His inspiration helped us to embark on this project.
Yasodananda K Areti
Bhavani Shankar Kodali6
7Contributors
  • Archana Areti MD
  • Senior Registrar, Mahatma Gandhi
  • Medical College and Research Institute
  • Puducherry, India
  • Yasodananda K Areti MD
  • Professor of Anesthesia and
  • Intensive Care
  • DM Programme Coordinator
  • Faculty of Medical Sciences
  • University of the West Indies
  • Cave Hill Campus
  • Barbados, West Indies
  • TVS Gopal MD
  • Head of Anesthesiology, Care Hospital
  • Hyderabad, Telangana, India
  • Karisha Hinkson-LaCorbinière DM
  • Associate Lecturer
  • Faculty of Medical Sciences
  • The University of the West Indies
  • Cave Hill Campus
  • Barbados, West Indies
  • Ahalya Kodali MD
  • Department of Anesthesiology
  • and Intensive Care
  • Boston Medical Center
  • Boston University
  • Boston, Massachusetts, USA
  • Bhavani Shankar Kodali MD
  • Vice Chairman of
  • Clinical Affairs
  • Department of Anesthesiology
  • Perioperative and Pain Medicine
  • Brigham and Women's Hospital
  • Associate Professor
  • Harvard Medical School
  • Boston, Massachusetts, USA
  • Akilandeswari Manickam MD
  • Professor
  • Department of Anesthesiology,
  • Critical Care and
  • Pain Medicine
  • Sri Ramachandra University
  • Chennai, Tamil Nadu, India
  • Aruna Parameswari MD DNB
  • Professor and Senior Consultant
  • Department of Anesthesiology,
  • Critical Care and Pain Medicine
  • Sri Ramachandra University
  • Chennai, Tamil Nadu, India
  • Athma Prasanna MD
  • Consultant
  • Anesthesiologist and Pain Specialist
  • Bengaluru, Karnataka, India
  • Hariharan Seetharaman MD
  • Professor
  • Anesthesia and Critical Care
  • Faculty of Medical Sciences
  • The University of the West Indies
  • Trinidad and Tobago
  • Ramkumar Venkateswaran MD
  • Professor of Anesthesiology
  • Kasturba Medical College
  • Manipal Academy of Higher Education
  • Manipal University
  • Manipal, Karnataka, India
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9Foreword
For a long time, there was a felt need for a comprehensive book on anesthesia equipment in our continent, written by Indian authors. This is because the standards differ in different countries. Most books on equipment are based on American standards as there are stringent rules prescribed by ASTM (American Society for Testing and Materials, International) to be followed. Moreover, nomenclature differs from one country to another that raises lot of doubts in the minds of residents. This book has been written predominantly by authors of Indian origin who felt the need for such a book.
The chapters in the book have been logically organized for a better understanding of the subject. Special effort has been taken by the authors to detail the illustrations. The diagram and pictures are laid out to make understanding better. Though it is impossible to cover extensively all the equipment used in anesthesiology, basic principles involved in the design of these equipment are well covered. Most chapters in the book are written by Dr Yasodananda K Areti, whose interest in anesthesia equipment and vision to share the expertise for the benefit of a budding anesthesiologist has resulted in the compilation of this book.
There is a good mix of young as well as experienced anesthesiologists' contribution to the book. It is written in a simple language that makes the reading a pleasure. The chapter on preuse check of anesthesia equipment sticks to one practice guideline and clear. The chapter on sterilization is very informative. The chapters on monitoring, neuraxial blocks and simulation are well illustrated and written.
On the whole, the book is a treasure for anesthesiology residents to learn the basics of the equipment used in anesthesia. I hope the book will have acceptance from all quarters.
M Ravishankar DA MD
Professor of Anesthesiology
Dean, Mahatma Gandhi Medical College
and Research Institute
Puducherry, India10
11Foreword
This book is a treasure trove of facts and detailed information about how things work in anesthesia and the physics, mathematics, and engineering that serve as their basis. Clear, and straightforward figures drawn to show basic principles provide great clarity. Simple language effectively teaches both simple and complex concepts. Nomenclature is different in different countries and this book explains their relationships. Adding to Dr Yasodananda K Areti's teaching in developing countries, Dr Bhavani Shankar Kodali's teaching ventilation monitoring (www.capnography.org; www.capnography.com) based in a well-developed country (USA) for twenty years brings out the latest anesthesia advances.
As I read the book, I found the following to be most striking:
  • Chapter 1 on Applied physics, the relationship of measurement units used in various parts of the world is clearly explained.
  • Chapter 3 on Anesthesia Machine or Workstation describes technological progression from the oldest to the newest technical advances and functionalities by major machine manufacturers including End-Tidal Control of anesthetic agent on GE Aisys, Draeger Zeus and Maquet FLOW-i in many countries.
  • Chapter 5 on Anesthesia Ventilators clearly diagrams and describes modern ventilator capabilities.
  • Chapter 7 on Monitoring Technology beautifully describes and diagrams the numerous technologies available.
  • Chapter 9 on Electrical Safety and Devices succinctly and clearly teaches the basic electronics needed by anesthetists in any country.
This book has great value for anesthetists in all parts of the world. It conveys understanding to those who use the oldest and those who use the newest of the many technologies described.
James H Philip ME(E) MD CCE
Anesthesiologist and Director of Bioengineering
Brigham and Women's Hospital
Professor of Anesthesia
Harvard Medical School
Boston, Massachusetts USA12
13Preface
“Learning gives creativity, Creativity leads to thinking, Thinking provides knowledge, Knowledge makes you great.”
—APJ Abdul Kalam
Applied physics, equipment and clinical monitoring form a major portion of the curriculum for postgraduate students. These topics cover nearly 25% of examination topics. They are quite complicated, and the concepts are difficult to understand for many postgraduate students. We are always challenged with the question as to how much applied physics any anesthesiologist must know. We always opine that if one is armed with knowledge, it will never be regretted. If learning was to be limited, the technological developments in the last five decades would never have been witnessed. Consequently, our specialty and our patients would have been exposed to obsolete technology.
Our aim in producing this postgraduate review is to bring all the essential aspects of applied physics for anesthesiologists into one book and make it simple to understand. One must be able to use equipment safely without placing their patient at risk because of lack of understanding of basic principles. In addition, one must be able to monitor their patients without errors.
We would like to thank all the people who contributed to the preparation of this book, particularly Professor Seetharaman, for his constant assistance. We hope that this venture will be successful in making anesthesiologists acquire the basic knowledge regarding anesthetic equipment.
Yasodananda K Areti MD
Bhavani Shankar Kodali MD14
15Acknowledgments
We wish to acknowledge the University of the West Indies for facilitating this book. We would like to thank Mr Emmerson Haynes and Mr Muralidhar Areti for their assistance with illustrations.
We would also like to thank Mr Jitendar P Vij (Group Chairman), Mr Ankit Vij (Group President), Ms Chetna Malhotra Vohra (Associate Director), Mr Umar Rashid (Development Editor), Ms Geetanjali Singh (Deputy Manager-Production) and Production team of Jaypee Brothers Medical Publishers (P) Ltd., New Delhi, India.16171819