Essence of Anesthesia Practice

Pemphigus

Acknowledgment The authors would like to acknowledge Drs. James M. Sonner and Jeffrey A. Katz for their contribution to this text in the previous edition. Risk Incidence in USA: 0.1–0.5:100,000 per y for pemphigus vulgaris (the most common form of…

Patent Foramen Ovale

Risk Incidence: 25–30% at autopsy. Atrial septal aneurysm (a deformity of the septum that results in deviation of the septum more than 15 mm into either atrium) is associated with at least 50% of PFOs and is considered an additional…

Patent Ductus Arteriosus

Risk Full-term infants: 1:2000 Preterm infants: 8:1000 Highest in preterm and low–birth-weight infants Female-to-male ratio: 2:1 Associated with congenital rubella infection and genetic defects, including trisomy 21, CHARGE, and a familial recurrence rate of 3% Perioperative Risks Surgery: Hemorrhage; hemodynamic…

Paroxysmal Atrial Tachycardia

Risk May be seen in ICU pts and is indistinguishable from paroxysmal SVT Digitalis toxicity, acute lyte or acid-base imbalance Incidence of 2% in the periop period (excluding AF) No racial prevalence and all age groups May be seen with…

Parkinson Disease (Paralysis Agitans)

Risk Advanced age 1% of population >65 y No difference in distribution by gender Perioperative Risks Hemodynamic instability, hypotension, arrhythmias Aspiration and upper airway obstruction from poor coordination of upper airway muscles Laryngospasm Postop confusion and hallucinations Worry About Exacerbation…

Papillomatosis

Risk Incidence of recurrent respiratory papillomatosis (RRP) in USA estimated at 4.3:100,000 among children and 1.8:100,000 among adults. Vertical transmission during delivery is believed to be the major mode of transmission for juvenile-onset recurrent respiratory papillomatosis (JORRP). Case reports show…

Pancreatitis

Risk Incidence of AP varies from 4.9–73.4 cases per 100,000 worldwide. Prevalence of CP has recently been estimated at 12–45 cases per 100,000, although its true prevalence is unknown. Perioperative Risks Most mortality occurs with surgery for complications of severe…

Paget Disease

Risk Second most common bone disorder after osteoporosis. Most common in individuals of Anglo-Saxon descent; men > women Prevalence increases with age and can be as high as 9–15% in people >80 y; average age at diagnosis in USA is…

Pacemakers

Risk In USA, over 3 million people have an implantable cardiac PM, and more than 400,000 PMs are implanted annually. In addition to a right atrial and right ventricular lead, some PM pts with cardiomyopathy also have left ventricular pacing…

Otitis Media

Risk Age: Highest incidence occurs between 6–24 mo of age; incidence subsequently declines, except for an increase at the time of school entry (between 5–6 y of age). Day care attendance. Tobacco smoke and air pollution. Other factors: Poor social/economic…