Essence of Anesthesia Practice

Osteoporosis

Risk Most common metabolic bone disease in USA All elderly pts of European descent considered at risk Non-Hispanic white women and Asian women at highest risk Estimate is that over 200 million people worldwide are at risk. Approximately 30% of…

Osteogenesis Imperfecta

Risk Incidence: OI occurs in 1:10,000-20,000 live births. Perioperative Risks Owing to the fragility of bones, caution is needed in positioning or transporting these pts. Excessive neck extension may lead to fracture. Scoliosis may cause difficulty with regional anesthesia. High…

Osteoarthritis

Risk Most common type of arthritis with significant disease burden. Globally, affects 9.6% of men and 18% of women ≥60 y old and is ranked as top 11th cause of disability (global years lived with disability). Common presentations are pain,…

Opitz-Frias Syndrome (The G Syndrome)

Risk Overall incidence not reported Very rare congenital disorder Preoperative Risks Very high risk of recurrent pulm aspiration; hypoplasia of both pulm and vascular components of one lung (pulm hypoplasia) High mortality rate in infancy Worry About NM dysfunction of…

Occlusive Cerebrovascular Disease

Risk Worldwide, 15 million people suffer a stroke each year. Prevalence of stroke in USA: Approximately 3%. Incidence of stroke in USA: 795,000 annually, including 600,000 new cases and 115,000 recurrences. China has the highest rates of mortality (19.9%), followed…

Occipital Encephalocele

Risk Most frequent type of encephalocele in North America and Western Europe Incidence in North America: 1:3000–10,000 live births Worse prognosis compared with frontal encephaloceles Perioperative Risks Seizures Hydrocephalus Cranial nerve deficits Poor feeding Spasticity Blindness Worry About Positioning concerns…

Obsessive-Compulsive Disorder

Risk Lifetime prevalence is 1–3%, with bimodal onset in childhood and late adolescence/early adulthood Males and females affected equally Perioperative Risks Drug interactions, notably risk of serotonin syndrome in pts on serotonergic agents such as SSRIs and clomipramine Anxiety/panic attacks…

Noonan Syndrome

Risk Incidence between 1:1000-2500 live births Incidence consistent worldwide Equal distribution between genders Perioperative Risks Airway Cardiovascular Hematologic Infectious Worry About Difficult airway Cardiovascular complications Bleeding Endocarditis Overview Key features include facial anomalies, neck webbing, short stature, chest deformity, spinal…

Niemann-Pick Disease

Risk Incidence in live births: 1:100,000-120,000 Affects equally males and females of all ethnic groups NP-D type A frequent in the Ashkenazi-Jewish population No curative therapy, although several symptomatic manifestations are treatable Associated with a decrease in life expectancy, although…

Neuroleptic Malignant Syndrome

Risk Incidence of 0.01–0.02% Mortality rate of 10% 2000 cases of NMS diagnosed annually in USA hospitals Pharmacologic: Typical/“first generation” antipsychotic Rapid dose titration/switching agents/abrupt medication withdrawal/high cumulative dose IM depot/IV administration Multiple concurrent antipsychotics or antipsychotic with lithium/carbamazepine Demographic/miscellaneous:…