Decision Making in Anesthesiology An Algorithmic Approach
Decision Making in Anesthesiology An Algorithmic Approach
5th Edition
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Decision Making in Anesthesiology: An Algorithmic Approach
First Edition: 1987 (B. C. Decker)
Fifth Edition: 2020
9789351529453
Printed at
- Nathon C Allred MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Carlo J Alphonso MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Tyler A Anderegg MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- J Jeffrey Andrews MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Ferdinand K Bacomo DO FACP
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Naumit S Bhandari MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Stephen C Bird DO
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Daniel M Bitner MS MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Scott Blackwell MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Melissa Wilcox Blasko MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Joseph G Boice DMD MD
- Department of Oral and Maxillofacial Surgery
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Brian T Boies MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Kurt R Bolin MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Michael C Bowman MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Adam C Braden MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Lois L Bready MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Erin Brockway MD
- Department of Anesthesiology
- Vanderbilt University Medical Center
- Nashville, Tennessee, USA
- Jared Brown MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Julia Bustamante MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Carol E Campbell MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Dale C Capener MD
- Department of Anesthesia & Operative Services
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Paulina Cardenas MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Mark A Cheney MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Yvonne I Claflin MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- David Clanton MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Paige Cohick MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Sally Combest MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Adrienne K Cummings MD
- Department of Anesthesiology
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Jonathan M Deeth MD
- Department of Anesthesiology
- Evans Army Community Hospital
- Fort Carson, Colorado, USA
- Dimitar Dentchev MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Britta DeVolder BSN, MBA
- University Health System
- San Antonio, Texas, USA
- Vincent A Diaz MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Michael A DiMeola MD
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Department of Anesthesia & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Casey Drawert MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Joshua S DuBois MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Maxim S Eckmann MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Bryant S Edwards DO
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Rafael Elenes MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Tim Farris MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Emily M Fischer MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Brian M Fitzgerald MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Bryce Foster MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Samir J Gandhi MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Maria A Garcia MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Kelly A Gardner MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Rudy Garza III MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- James A Gill MBBS MSc
- Department of Anesthesia
- King's College Hospital
- London, England, United Kingdom
- Bonny Carter Gillis MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Leah E Gross MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Matthew C Gummerson MD FAAP
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Brooke G Harden MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Joshua M Hauser MD MPH
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Matt Hermansen MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Braden J Hestermann MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Rosemary Hickey MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Heather L Higgins MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Joseph R Holahan MD
- South Texas Oncology and Hematology
- San Antonio, Texas, USA
- Nancy G Hoover MD
- Department of Anesthesia
- Evans Army Community Hospital
- Fort Carson, Colorado, USA
- Garett E Jackson MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Adriaan T Jansse JD
- Attorney, Cavaretta, Kaona, & Leighner, PLLC
- San Antonio, Texas, USA
- Wendy B Kang MD JD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Scott Kaser MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Asif Khan MD
- Department of Anesthesiology and Pain Management
- University of Texas Southwestern
- Dallas, Texas, USA
- Andrea L King MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Gregory P Kraus MD
- Department of Anesthesiology
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Major Daun J Lai MD
- US Army Institute of Surgical Research
- San Antonio, Texas, USA
- David Langdon MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Veronica F Lao MD
- Assistant Professor
- Department of Anesthesiology
- University of Texas, San Antonio
- San Antonio, Texas, USA
- Rene A Larrieu MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Karl A Lautenschlager MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Melanie T Lawinger MD
- Department of Anesthesia & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- David A Layer DO
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Hong N Le MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Deborah Jo Levine MD
- Department of Medicine
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Deena R Liles MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Steven Lindauer MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Michael B Little MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Luis Llamas MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- David R Lowery MD
- Department of Anesthesiology
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Lauren M Lyons MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Christopher V Maani MD
- Department of Anesthesia
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Elizabeth V Maani MD
- Department of Radiation Oncology University of Texas Health Science Center
- San Antonio, Texas, USA
- Nina Mahnke MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Rachel Maldonado MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Crystal A Manohar MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Luiz Maracaja MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- David Matteson MD MS
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Gina Matteson MD
- Department of Psychiatry
- Baylor Scott and White Health
- Texas A&M Health Science Center College of Medicine
- Temple, Texas, USA
- Patrick J Matthews DO
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Andrew K Matthies DO
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Matthew J Mazurek MD
- Carondelet St. Mary's Hospital
- Tucson, Arizona, USA
- Sara McAlpin MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Matthew L McClure MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Craig C McFarland MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- James McKenny MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Christopher B McLeod DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Carl L McMullen DO
- Department of Anesthesia
- William Beaumont Army Medical Center
- El Paso, Texas, USA
- Sara F McWilliams MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Naveen Mehra MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Arthur R Mielke MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Kimberly D Milhoan MD
- Private Practice
- San Antonio, Texas, USA
- Baker A Mitchell III MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Justin P Moreland DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Daniel Moseley MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Matthew S Murrell MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Ameet Nagpal MD MS MEd
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Christopher J Nagy MD
- Department of Anesthesiology
- Uniformed Services University of the Health Sciences
- Bethesda, Maryland, USA
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Susan H Noorily MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Garrett Norton MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Olabode C Ogunwole MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Michael Patzkowski MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Alison Peterson CRNA
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Milt G Poll MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Cindy Van Praag MD
- Private Practice
- Houston, Texas, USA
- Steven M Prust MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Kathryn Putnam MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Heather L Quintela MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Lee M Ragsdale MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Deborah K Rasch MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Matthew D Read MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Jessica Z Reed MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Bradley A Reel MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- John Richardson MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Nicolas E Rios MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Monica Rivera MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Tyler C Roe DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Jorge Serrato MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Jonathan Sherrod MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Sushrut Shidham MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Rigoberto Luis Sierra-Anderson III MD
- Department of Anesthesiology
- Vanderbilt Medical Center
- Nashville, Tennessee, USA
- Punit Singh MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Mason Singleton MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Katherine Slogic MD
- Department of Anesthesia & Operative Services
- San Antonio Uniformed Services Health Education Consortium
- San Antonio Military Medical Center
- Fort Sam Houston, Texas, USA
- Scott Spendlove DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Adam Spjute MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Garrett Starling MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Jacob Stetler DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Gregory J Stevens MD
- Department of Anesthesiology & Operative Services
- Uniformed Services University of the Health Sciences
- San Antonio Military Medical Center
- San Antonio, Texas, USA
- Samuel H Stevens MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Ashlie R Stowers MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Clint Thome MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Mohamed Tiouririne MD
- Department of Anesthesiology
- University of Virginia
- Charlottesville, Virginia, USA
- Kristi D Urias MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Steven G Venticinque MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Gordon M Verber MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Benjamin J Wallisch DO
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Kristen S Wells MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Justin W Wilson MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Travis D Wilson MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
- Katharine H Zentner MD
- Department of Anesthesiology
- University of Texas Health Science Center
- San Antonio, Texas, USA
I am thrilled to have been associated with the authors and editors of Decision Making in Anesthesiology: An Algorithmic Approach, 5th edition (DMA5) because it provides such a valuable resource to all anesthesia care providers (ACPs). Following in the tradition of prior DMA editions, DMA5 enables going to a single source for immediate availably of dozens of life-saving algorithms which help ACPs make appropriate clinical decisions. This is especially important when answers are needed quickly in high-pressure situations. Adherence to these algorithms should enhance patient safety and lead to better patient outcomes, and in my opinion, these are the two major goals of modern medicine.
Decision Making in Anesthesiology: An Algorithmic Approach, 5th edition represents countless hours of work by 150 authors and 3 editors. Approximately 30 new topics have been introduced (several of which include Transaortic Valve Replacement, Liver Resection, Geriatric Patient, Scleroderma and Osteogenesis Imperfecta). New sections have been added (Administrative Issues) or substantially reorganized so as to be more useful for rapid reference (Perioperative Emergencies).
Decision Making in Anesthesiology: An Algorithmic Approach, 5th edition provides an abundant resource for ACPs to review and refresh their knowledge on a broad range of vital topics, many of which are infrequently encountered clinically and thus more challenging. Large, complicated topics have been condensed to the most essential facts. Thus, each chapter is short but intense—each is packed with information which can be used in real time.
So I would like to personally thank the authors and editors for providing the anesthesia community with this valuable reference that can really make a difference in our clinical care. In my opinion, DMA5 is an essential reference for all ACPs—both our colleagues in training as well as those who are more seasoned. I am delighted to endorse this work!
J Jeffrey Andrews MD
Professor and Former Chair
Department of Anesthesiology
University of Texas Health Science Center
San Antonio, Texas, USA
Preface
The purpose of Decision Making in Anesthesiology: An Algorithmic Approach, 5th Edition, is to present the process of anesthetic management during the perioperative period in a decision tree format. Thus, this work is not intended to replace the excellent major anesthesia textbooks currently available, but rather to illustrate how to consider and act on the information they contain. This format encourages the reader to think systematically and to follow a logical sequence through preoperative evaluation and preparation, intraoperative management, and postoperative considerations. Our goal was to construct decision trees that were easy to follow, demonstrated decision points clearly, and were simple but not simplistic. The comments are keyed to designated decision points for further information, supported by references. This format, employed consistently throughout the prior four editions, continues to be most interesting to reformulate and in some cases reorganize our clinical knowledge and experiences in order to construct these algorithms.
Although all who practice clinical anesthesia would like to suppose that our practices are evidence based and cost-effective, many decisions in the “real world” are influenced by patient and surgical preferences, availability of equipment or supplies, and medicolegal considerations, as well as current limitations of the science of anesthesia. Despite these constraints, we all strive daily to balance the oft-times competing imperatives of cost-effectiveness, safety, and optimal outcomes of our patient care, 24×7×365, one patient at a time. We have attempted to ensure that our algorithms are accurate and realistic. In controversial areas they may reflect the preferences and thinking of the individual contributors. In some cases there may be valid alternative approaches and techniques that are not described. We happily anticipate that new and better approaches will continue to evolve as the science of our field progresses.
As educators involved in university training programs, we have consciously targeted this work for our colleagues in training (and new in this edition, have provided space for notes in most chapters). Many have shared their appreciation for the format of prior editions in preparation for certification examinations. In learning the practice of anesthesia as well as in ongoing practice, it is very helpful to have immediate access to an experienced consultant who can suggest a reasonable approach and review special surgical requirements (and potential pitfalls). This is what is proposed in our book—to suggest reasonable anesthetic management schemes and to serve as a clinical reference. Just as advice rendered by the experienced consultant must be individualized for the patient in question, so must our suggestions be considered in light of special patient needs. We hope that anesthesia care providers (ACPs) of all backgrounds and others involved in the perioperative care of surgical patients may also find this a refreshing method of review.
Lois L Bready MD
Susan H Noorily MD
Rosemary Hickey MD
Dedication and Acknowledgments
We are grateful for the many anesthesiology residents with whom we have worked over a combined 100 years of our clinical practices. Working with bright, committed people who genuinely care about their patients, have the situational awareness that is essential to our practice, and are able to rapidly adjust focus from scientific research and population health to individual patient needs and back again, never gets old!
Many thanks to our authors, who shared their clinical expertise generously and tackled this unusual format with enthusiasm. We are especially grateful to our section editors (new with this edition) who performed superb editorial assistance to their chapter authors. Thanks to our editorial assistant, Misty Blaze and administrators Kristi McBrearty and Clarissa Rios, and to special faculty support provided by J Jeffrey Andrews, MD and Steven G Venticinque, MD.
We acknowledge our colleagues from around the world who have reached out to express their appreciation for prior editions. Some have shared how the book helped them to prepare for certification examinations. Others mentioned its help in managing rare cases in medically remote areas. Still others gave us suggestions for new topics and other essential feedback.
We thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director), Mr MS Mani (Group President), Ms Chetna Malhotra Vohra (Associate Director—Content Strategy), Ms Pooja Bhandari (Production Head) and Ms Nedup Denka Bhutia (Development Editor) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, for giving a go-ahead at the very beginning and helping us to bring out this book.
Thank you.
Lois L Bready MD
Susan H Noorily MD
Rosemary Hickey MD