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 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…
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…
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 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…
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…
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…
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…
Quality in healthcare is hard to define. One approach is based around six goals: safety; effectiveness; patient focus; timeliness; efficiency; and equity ( Table 18.1 ). Although errors and incidents are commonly discussed in relation to safety, the same fundamental…
The ability to measure and monitor patients’ physiology is fundamental to modern anaesthetic practice, and a variety of sophisticated instruments are available. It is crucial that the anaesthetist understands not only the data being generated but also the limitations of…