ANESTHESIA a Comprehensive Review

ANESTHESIA A Comprehensive Review FIFTH EDITION Brian A. Hall, MD Assistant Professor of Anesthesiology College of Medicine, Mayo Clinic Rochester, Minnesota Robert C. Chantigian, MD Associate Professor of Anesthesiology College of Medicine, Mayo Clinic Rochester, Minnesota 1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899 ANESTHESIA: A COMPREHENSIVE REVIEW, FIFTH EDITION ISBN: 978-0-323-28662-6 Copyright © 2015, 2010, 2003, 1997, 1992 by Mayo Foundation for Medical Education and Research, Published by Elsevier Inc. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions poli- cies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notices Knowledge and best practice in this field are constantly changing. As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary. Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein. In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility. With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications. It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions. To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Library of Congress Cataloging-in-Publication Data Hall, Brian A., author. Anesthesia: a comprehensive review / Brian A. Hall, Robert C. Chantigian. -- Fifth edition. p. ; cm. Includes bibliographical references and index. ISBN 978-0-323-28662-6 (pbk. : alk. paper) I. Chantigian, Robert C., author. II. Title. [DNLM: 1. Anesthesia--Examination Questions. WO 218.2] RD82.3 617.9’6076--dc23 2014034662 Executive Content Strategist: William Schmitt Content Development Manager: Katie DeFrancesco Publishing Services Manager: Patricia Tannian Senior Project Manager: Kristine Feeherty Design Direction: Brian Salisbury Printed in the United States of America Last digit is the print number: 9 8 7 6 5 4 3 2 1 Preface The half-life for knowledge and human discovery is shorter now than any time in the history of the modern world. New discoveries in science and new developments in technology occur daily. Medicine in general and anesthesiology in particular are no exceptions. Many anesthetic drugs and techniques, once held as state-of-the-art, are now relegated to the past. Some of these were current for a period of only 1 or 2 years. The authors have removed material from the previous edition that is not useful in the present day, with a few exceptions intended to demonstrate a specific historic learning point. The contributors have strived to provide a learning tool for practitioners just entering the specialty as well as a review source for those with more experience. Question difficulty ranges from basic, entry level concepts to more advanced and challenging problems. Each question has been vetted by two or more reviewers in the various anesthetic sub- specialties. All material has been checked for accuracy and relevance. Similar to the previous editions, the fifth edition is not intended as a substitute for textbooks, but rather as a guide to direct users to areas needing further study. It is hoped that the reader will find this review thought provoking and valuable. Brian A. Hall, MD Robert C. Chantigian, MD v Contributors Kendra Grim, MD Kent Rehfeldt, MD Assistant Professor of Anesthesiology Assistant Professor of Anesthesiology College of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Rochester, Minnesota Rochester, Minnesota Dawit T. Haile, MD C. Thomas Wass, MD Assistant Professor of Anesthesiology Associate Professor of Anesthesiology College of Medicine, Mayo Clinic College of Medicine, Mayo Clinic Rochester, Minnesota Rochester, Minnesota Keith A. Jones, MD Francis X. Whalen, MD Professor and Chairman Assistant Professor of Anesthesiology Department of Anesthesiology Department of Anesthesiology and Critical Care Medicine University of Alabama School of Medicine College of Medicine, Mayo Clinic Birmingham, Alabama Rochester, Minnesota vii Credits Figure 1-1, page 4 Figure 2-12, page 38 From van Genderingen HR et al: Computer-assisted capnogram From Stoelting RK: Pharmacology and Physiology in Anesthetic analysis, J Clin Monit 3:194-200, 1987, with kind permission of Practice, ed 3, Philadelphia, Lippincott Williams & Wilkins, 1999. Kluwer Academic Publishers. Figure 2-15, page 41 Figure 1-2, page 8 From Stoelting RK, Dierdorf SF: Anesthesia and Co-Existing Dis- From Mark JB: Atlas of Cardiovascular Monitoring, New York, ease, ed 4, New York, Churchill Livingstone, 2002. Churchill Livingstone, 1998, Figure 9-4. Figure 3-1, page 71 Figure 1-3, page 9 From Miller RD: Basics of Anesthesia, ed 6, Philadelphia, Saun- Modified from Willis BA, Pender JW, Mapleson WW: Rebreathing in ders, 2011, Figure 10-3. a T-piece: volunteer and theoretical studies of Jackson-Rees modifica- tion of Ayre’s T-piece during spontaneous respiration, Br J Anaesth Table 3-1, page 62 47:1239–1246, 1975. © The Board of Management and Trustees From Miller RD: Basics of Anesthesia, ed 6, Philadelphia, Saun- of the British Journal of Anaesthesia. Reproduced by permission of ders, 2011, p 151, Table 12-6. Oxford University Press/British Journal of Anaesthesia. Table 3-2, page 64 Figure 1-5, page 11 From Miller RD: Basics of Anesthesia, ed 6, Philadelphia, Saun- Reprinted with permission from Andrews JJ: Understanding anesthe- ders, 2011, p 76, Table 7-3. sia machines. In: 1988 Review Course Lectures, Cleveland, Inter- national Anesthesia Research Society, 1988, p 78. Table 3-3, page 65 From Stoelting RK: Pharmacology and Physiology in Anesthetic Prac- Figure 1-6, page 13 tice, ed 4, Philadelphia, Lippincott Williams & Wilkins, 2006, p 293. Modified from American Society of Anesthesiologists (ASA):Check- out: A Guide for Preoperative Inspection of an Anesthesia Table 3-4, page 67 Machine, Park Ridge, IL, ASA, 1987. A copy of the full text can be From Miller RD: Miller’s Anesthesia, ed 7, Philadelphia, Saunders, obtained from the ASA at 520 N. Northwest Highway, Park Ridge, 2011, p 882, Table 29-11. IL, 60068-2573. Table 3-5, page 73 Figure 1-7, page 16 From Stoelting RK: Pharmacology and Physiology in Anesthetic From Andrews JJ: Understanding your anesthesia machine and ven- Practice, ed 4, Philadelphia, Lippincott Williams & Wilkins, p 462. tilator. In: 1989 Review Course Lectures, Cleveland, International Table 3-6, page 77 Anesthesia Research Society, 1989, p 59. From Stoelting RK, Miller RD: Basics of Anesthesia, ed 5, Philadel- Figure 1-9, page 21 phia, Churchill Livingstone, 2006, p 1794. Courtesy Draeger Medical, Inc., Telford, Pennsylvania. Table 3-7, page 84 Figure 1-10, page 22 From Hines RL: Stoelting’s Anesthesia and Co-Existing Disease, From Azar I, Eisenkraft JB: Waste anesthetic gas spillage and scav- ed 5, Philadelphia, Saunders, 2008, p 371. enging systems. In Ehrenwerth J, Eisenkraft JB, editors: Anesthesia Figure 4-2, page 93 Equipment: Principles and Applications, St Louis, Mosby, 1993, p 128. Modified from Sheffer L, Steffenson JL, Birch AA: Nitrous oxide- induced diffusion hypoxia in patients breathing spontaneously,Anes - Table 1-1, page 12 thesiology 37:436-439, 1972. From Miller RD: Basics of Anesthesia, ed 6, Philadelphia, Saunders, Figure 4-3, page 98 2011, p 201, Table 15-2. From Miller RD: Miller’s Anesthesia, ed 6, Philadelphia, Saunders, Table 1-6, page 27 2005, Figure 5-2. Data from Yasuda N et al: Kinetics of desflurane, Data from Ehrenwerth J, Eisenkraft JB, Berry JM: Anesthesia isoflurane, and halothane in humans,Anesthesiology 74:489-498, Equipment: Principles and Applications, ed 2, Philadelphia, 1991; and Yasuda N et al: Comparison of kinetics of sevoflurane and Saunders, 2013. isoflurane in humans,Anesth Analg 73:316–324, 1991. Figure 2-1, page 30 Figure 4-4, page 101 From Miller RD: Miller’s Anesthesia, ed 7, Philadelphia, Saunders, Modified from Eger EI II, Bahlman SH, Munson ES: Effect of age on 2011, Figure 15-4. Courtesy the editor of the BMJ series: Respiratory the rate of increase of alveolar anesthetic concentration, Anesthesiol- Measurement. ogy 35:365–372, 1971. ix x Credits Figure 4-5, page 106 Figure 9-2, page 217 From Cahalan MK: Hemodynamic Effects of Inhaled Anesthet- From Miller RD: Miller’s Anesthesia, ed 7, Philadelphia, Saunders, ics. Review Courses, Cleveland, International Anesthesia Research 2011, p 2014, Figure 63-11. Society, 1996, pp 14-18. Figure 10-1, page 236 Table 4-4, page 103 Modified from Hebl J:Mayo Clinic Atlas of Regional Anesthesia From Stoelting RK, Miller RD: Basics of Anesthesia, ed 4, New and Ultrasound-Guided Nerve Blockade, New York, Oxford Uni- York, Churchill Livingstone, 2000, p 26.

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