Chronic pain is a major health issue throughout the world and is an increasingly challenging preoperative issue for anesthesiologists. Throughout the 1990s, the health care system in the United States began to encourage more routine assessment of pain in patients,…
Introduction Cancer is the second leading cause of death in the United States, exceeded only by heart disease. The lifetime risk of developing cancer is estimated to be one in three for both men and women. The lifetime risk of…
Introduction The human immune system is traditionally divided into two pathways: innate immunity and adaptive (also known as acquired) immunity. Each is comprised of a series of unique components, all of which function to protect the host against invading microorganisms.…
Skin diseases Skin disease can have significance for the anesthesiologist due to the skin manifestations itself, the underlying medical condition, or the potential worsening by anesthetic interventions. Examples of skin diseases in which the anesthetic implications are mainly due to…
Disease states related to erythrocytes include anemia and polycythemia. Anemia is characterized by a decrease in the red cell mass, with the main adverse effect being a decrease in the oxygen-carrying capacity of blood. Polycythemia (erythrocytosis) represents an increase in…
Diabetes mellitus Normal glucose physiology requires a balance between glucose utilization and endogenous production or dietary delivery ( Fig. 22.1 ). The liver is the primary source of endogenous glucose production via glycogenolysis and gluconeogenesis. Approximately 70% to 80% of…
Introduction The kidney plays a key homeostatic role in the tight regulation of extracellular fluid volume, blood pressure, solute transport and electrolyte concentrations, pH, and excretion of drug metabolites. Knowledge of how the kidneys perform these important functions aids in…
Alterations of water, osmolal, and electrolyte content and distribution as well as acid-base disturbances are common in the perioperative period and rarely happen in isolation because they are inherently interrelated. They both affect and are affected by the function and…
Malnutrition can be caused by either an insufficient consumption of essential nutrients or an overconsumption of poor nutrients. Currently the most prevalent nutritional disease worldwide is obesity. About two-thirds of the world’s population live in countries where being overweight and…
Inborn errors of metabolism manifest as a variety of metabolic defects that may complicate the management of anesthesia ( Table 18.1 ). In some instances, these defects are clinically asymptomatic and become manifest only in response to specific triggering events,…