Smith and Aitkenhead's Textbook of Anaesthesia

Resuscitation

Without intervention, cardiac arrest may lead to permanent neurological injury after just three minutes. The interventions that contribute to a successful outcome after a cardiac arrest can be conceptualised as the ‘chain of survival’ ( Fig. 28.1 ). The four…

Complications arising from anaesthesia

Complications are undesirable events arising from anaesthesia. They occur in approximately 10% of anaesthetics. Only the minority of these complications cause lasting harm to the patient. Death complicates five anaesthetics per million given in the UK (0.0005%). Every complication has…

Regional anaesthetic techniques

Regional anaesthetic techniques are used for both operative anaesthesia and postoperative analgesia. They are becoming more popular as a result of advances in drugs and equipment and improved techniques of anatomical localisation, particularly ultrasonic location. In addition, there is a…

Pain

The experience of pain is much more complex than nociception, where there is a reflex response to a noxious stimulus. The total pain experience is influenced by several factors, as outlined in the biopsychosocial model of pain ( Fig. 24.1…

Airway management

This chapter is divided into four parts: 1. Airway equipment 2. Routine airway management 3. Emergency airway management 4. Difficult airway management It does not cover airway management in paediatric, obstetric or emergency anaesthesia. These are covered in Chapter 33,…

The practical conduct of anaesthesia

The conduct of anaesthesia is planned after obtaining details of the surgical procedure and medical condition of the patient. All patients should be visited preoperatively for anaesthetic assessment, including review of the results of relevant investigations. This is also an…

Consent and information for patients

Whenever we seek consent from a patient before medical examination, investigation or treatment, we demonstrate our respect for the ethical principles of autonomy and the patient's right to self-determination. Consent is always given or withheld by the patient; it is…

Intercurrent disease and anaesthesia

The number of surgical procedures carried out in patients previously considered unfit for surgery is increasing. A growing proportion have significant coexisting medical conditions, are older and may have a limited physiological reserve. These factors influence the conduct of anaesthesia…

Preoperative assessment and premedication

All patients scheduled to undergo surgery should be assessed in advance to ensure optimal preparation and perioperative management. This is a standard of care proposed by the Association of Anaesthetists, RCoA and similar bodies worldwide. It is one mechanism by…