THE ANESTHESIA WORKSTATION In the decades after the first public demonstration of ether anesthesia in 1846 the anesthesia delivery system consisted of handheld devices ranging from ether- or chloroform-soaked cloths to more sophisticated inhalers that could regulate the administered dose…
The decision-making process regarding anesthetic technique begins with the proposed surgical procedure and incorporates the patient's coexisting diseases and preferences for care. The ultimate responsibility for anesthetic choice lies with the anesthesia provider. Once the anesthesia type is selected, additional…
High-quality anesthesia care begins with the preoperative evaluation. The goals of preoperative evaluation include understanding the proposed surgery, assessing the risk of coexisting medical conditions, deciding whether additional testing is needed to prepare the patient for the procedure, discussing options…
~~ A major concern within the specialty of anesthesiology is the impact of general anesthesia and sedative drugs on neurodevelopment and cognition across the life span. Although definitive conclusions cannot be made, anesthesia providers should follow the progress of our…
INTRODUCTION Neuromuscular blocking agents (NMBAs) interrupt the usual transmission of nerve impulses at the neuromuscular junction (NMJ) by one of two mechanisms to interfere with neuromuscular transmission and produce paralysis of skeletal muscles. On the basis of differences in their…
ANATOMY OF THE AUTONOMIC NERVOUS SYSTEM The Sympathetic Nervous System The autonomic nervous system (ANS) controls involuntary activities of the body outside consciousness. It is at once the most primitive and among the most essential of control systems—primitive in that…
When it comes to direct, integrated, daily management of cardiac and pulmonary physiology, no specialty compares with anesthesiology. A sound understanding of the separate and integrated fundamentals of cardiorespiratory physiology is essential for an anesthesia provider to rapidly manage both…
The basic principles of pharmacology are a fundamental element of an anesthesia provider's knowledge base. This chapter provides an overview of key principles in clinical pharmacology used to describe anesthetic drug behavior. Box 4.1 lists definitions of some basic pharmacologic…
Clinician well-being has emerged as a critical issue because of widespread clinician burnout. There is growing recognition that a combination of individual strategies and systems-level solutions is required to successfully promote clinician well-being. Interventions to prevent burnout are more effective…
The challenges of learning perioperative anesthesia care have grown considerably as the specialty has evolved. The beginning anesthesia trainee is faced with an ever-increasing quantity of literature and the need for increased knowledge and adequate patient care experiences. Healthcare systems…