The delivery of safe paediatric anaesthesia requires an appreciation of the anatomical and physiological characteristics of children at various stages of development, ranging from neonates younger than 44 weeks postconceptional age to infants 1–12 months old to children and young…
Obesity rates have increased from 15% in 1993 to 27% in 2015, and morbid obesity has tripled to affect 2% of men and 4% of women. Figures are projected to rise, with 50% of UK adults expected to be obese…
Increasing numbers of older people are undergoing emergency and elective surgery. This is due to changing demographics, advances in surgical and anaesthetic techniques and changing attitudes and expectations of the older population. Furthermore, degenerative, metabolic and neoplastic conditions, for which…
A high-risk surgical procedure can be considered as one in which there is an accepted postoperative mortality rate of more than 1%. Whether a procedure for a given patient is high risk depends on consideration of the technical hazards of…
In anaesthetic practice the patient is monitored closely and continuously from before induction and throughout the operative procedure. However, many problems associated with anaesthesia and surgery occur in the immediate postoperative period. The 2001 National Confidential Enquiry into Patient Outcome…
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…
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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…