Essence of Anesthesia Practice

Brain Death

Risk Number of pts awaiting organ transplantation is much greater than the number of available solid organs Medical management affects the viability of organs for transplant Perioperative Risks Cardiovascular collapse Pulmonary edema Endocrine dysfunction Metabolic imbalance Coagulopathy Hypothermia Worry About…

Botulism

Risk Infant botulism. Wound botulism. Foodborne botulism. Adult intestinal toxemia. Injection botulism. Biological warfare/inhalational botulism (Category A biological threat). Incidence In USA, approximately 145 cases are reported each year: infant botulism 65%, wound 20%, and foodborne 15%; adult intestinal colonization…

Blindness

Risk Eye injuries represent 4% of claims analyzed in the ASA Closed Claims Project. Majority of entries in the ASA POVL Registry are associated with cardiac and spine cases, with a reported incidence as high as 4.5% and 0.2%, respectively.…

Bleomycin Sulfate Toxicity

Risk Pts with a history of germ cell tumors, lymphomas, squamous cell carcinomas, Kaposi sarcomas, and cervical cancers treated with BLM Incidence of BLT is 10–40%; mortality is 1–2% Risk of BLT increases with total dose >400 unit, glomerular filtration…

Blebs and Bullae

Risk Prevalence of blebs as high as 6% of young, healthy adults, although spontaneous rupture occurs only in 7.4 to 18 per 100,000. Incidence of ruptured bulla is 26 per 100,000. Increased incidence of primary disease in young males. Increased…

Bipolar Disorder

Risk Lifetime prevalence within USA 4% Vast majority of pts younger than 25 y Suicide rates are 20 times higher than that of general population Perioperative Risks Risk of disregard for self care within manic phases, especially in the setting…

Bilirubinemia of the Newborn

Risk A common problem in neonates. Some types pathologic and some physiologic. Bilirubin may be unconjugated or conjugated; differentiating important for diagnosis. If pathologic, varying effect on management (e.g., sepsis, Rh incompatibility, GI obstruction, Gilbert, AVM, sickle cell, biliary atresia).…

Bernard-Soulier Syndrome

Risk Estimated to be <1 in 1 million persons, but may be higher due to misdiagnosis and underreporting Rare: Approximately 100 cases reported in literature Perioperative Risks Severe hemorrhage out of proportion to plt count Transfusion reactions Worry About Severe…

Behçet Disease

Risk Affects age group between 20–40 y Nations along Silk Route have higher incidence Males and females are equally affected Perioperative Risks Increase in IOP during intubation in pts with uveitis complicated by glaucoma Pulmonary embolism Difficult airway due to…

Beckwith-Wiedemann Syndrome

Risk 1 per 13,700 individuals. No gender predilection, although with monozygotic twins it is seen more in females than males. Conceptions from IVF have a 3–5 times increased risk of BWS. Perioperative Risks Acute airway obstruction; difficult mask ventilation and…