Key Points ▪ The history and physical examination most accurately predict the risks of anesthesia and the likelihood of required changes in monitoring or therapy. ▪ For diabetic patients, end-organ dysfunction and the degree of glucose control in the perioperative…
Key Points ▪ The anesthesia preoperative evaluation, which is the clinical foundation for guiding perioperative patient management, reduces perioperative morbidity and enhances patient outcome. ▪ The fundamental purpose of preoperative evaluation is to obtain pertinent information regarding the patient’s medical…
Key Points ▪ Perioperative risk is multifactorial and may occur as a result of anesthesia-, surgery-, and/or patient-specific factors. ▪ Anesthesia-related (and surgery-related) risk is typically defined as morbidity and mortality occurring within 30 days of surgery, although events that…
Key Points ▪ Appropriate reversal of a nondepolarizing neuromuscular blockade is essential to avoid adverse patient outcomes. Complete recovery of muscle strength should be present, and the residual effects of neuromuscular blocking drugs (NMBDs) should be fully pharmacologically reversed (or…
Key Points ▪ Two different populations of nicotinic acetylcholine receptors exist at the mammalian neuromuscular junction. In the adult, the nicotinic acetylcholine receptor at the postsynaptic (muscular) membrane is composed of α 2 βδε subunits, while the fetal (immature) receptor…
Key Points ▪ The pharmacokinetics of anesthetic drugs are described by multicompartment models. Accurate intravenous drug delivery requires adjusting the maintenance infusion rates to take into account the accumulation of the drug in the peripheral tissues. ▪ Biophase is the…
Key Points ▪ With a better understanding of pain pathways and mechanisms, it has been recognized that ion channels play an important role in the transduction, transmission, and modulation of nociceptive signals. This opens a new avenue of developing novel…
Key Points ▪ The modern anesthesia workstation has evolved into a complex device with a number of safety features. However, if there is any possibility that the workstation or the breathing circuit is a potential cause of difficulty with ventilation…
Key Points ▪ Inhaled anesthetics affect every part of physiology of the lungs and their pulmonary pharmacology is complex. ▪ Volatile anesthetics produce bronchodilation through decreases in cytoplasmic ionized calcium concentration and/or a reduction in calcium sensitivity of airway smooth…
Key Points ▪ The alveolar anesthetic concentration (F A ) or partial pressure (P alv ) is important because it is the driving force determining anesthetic uptake into blood and target tissues in the central nervous system, and it can…