a LANGE medical book Clinical Anesthesiology Morgan & Mikhail’s F I F T H E D I T I O N John F Butterworth IV, MD Professor and Chairman Department of Anesthesiology Virginia Commonwealth University School of Medicine VCU Health System Richmond, Virginia David C Mackey, MD Professor Department of Anesthesiology and Perioperative Medicine University of Texas M.D Anderson Cancer Center Houston, Texas John D Wasnick, MD, MPH Steven L Berk Endowed Chair for Excellence in Medicine Professor and Chair Department of Anesthesia Texas Tech University Health Sciences Center School of Medicine Lubbock, Texas New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2013, 2006, 2002 by McGraw-Hill Education, LLC All rights reserved Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval 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treatment and drug therapy are required The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work Readers are encouraged to confirm the information contained herein with other sources For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in 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EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE McGraw-Hill Education and its licensors not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom McGraw-Hill Education has no responsibility for the content of any information accessed through the work Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise Contents Chapter Authors v | Contributors vii Research and Review ix | Foreword xi | Preface xiii The Practice of Anesthesiology SECTION I 15 Hypotensive Agents 255 16 Local Anesthetics 263 Anesthetic Equipment & Monitors The Operating Room Environment Charles E Cowles, MD Breathing Systems 29 17 Adjuncts to Anesthesia 277 SECTION III Anesthetic Management The Anesthesia Machine 43 18 Preoperative Assessment, Premedication, & Perioperative Documentation 295 Cardiovascular Monitoring 87 19 Airway Management 309 Noncardiovascular Monitoring 123 20 Cardiovascular Physiology & Anesthesia 343 SECTION II Clinical Pharmacology Pharmacological Principles 143 Inhalation Anesthetics 153 Intravenous Anesthetics 175 21 Anesthesia for Patients with Cardiovascular Disease 375 22 Anesthesia for Cardiovascular Surgery 435 23 Respiratory Physiology & Anesthesia 487 10 Analgesic Agents 189 24 Anesthesia for Patients with Respiratory Disease 527 11 Neuromuscular Blocking Agents 199 25 Anesthesia for Thoracic Surgery 545 12 Cholinesterase Inhibitors & Other Pharmacologic Antagonists to Neuromuscular Blocking Agents 223 26 Neurophysiology & Anesthesia 575 13 Anticholinergic Drugs 233 28 Anesthesia for Patients with Neurologic & Psychiatric Diseases 613 14 Adrenergic Agonists & Antagonists 239 27 Anesthesia for Neurosurgery 593 iii iv CONTENTS 29 Renal Physiology & Anesthesia 631 30 Anesthesia for Patients with Kidney Disease 653 31 Anesthesia for Genitourinary Surgery 671 32 Hepatic Physiology & Anesthesia 691 Michael Ramsay, MD, FRCA 33 Anesthesia for Patients with Liver Disease 707 Michael Ramsay, MD, FRCA 34 Anesthesia for Patients with Endocrine Disease 727 35 Anesthesia for Patients with Neuromuscular Disease 747 36 Anesthesia for Ophthalmic Surgery 759 SECTION IV Regional Anesthesia & Pain Management 45 Spinal, Epidural, & Caudal Blocks 937 46 Peripheral Nerve Blocks 975 Sarah J Madison, MD and Brian M Ilfeld, MD, MS 47 Chronic Pain Management 1023 Richard W Rosenquist, MD and Bruce M Vrooman, MD 48 Perioperative Pain Management & Enhanced Outcomes 1087 Francesco Carli, MD, MPhil and Gabriele Baldini, MD, MSc SECTION V Perioperative & Critical Care Medicine 37 Anesthesia for Otorhinolaryngologic Surgery 773 49 Management of Patients with Fluid & Electrolyte Disturbances 1107 38 Anesthesia for Orthopedic Surgery 789 50 Acid–Base Management 1141 Edward R Mariano, MD, MAS 39 Anesthesia for Trauma & Emergency Surgery 805 Brian P McGlinch, MD 40 Maternal & Fetal Physiology & Anesthesia 825 Michael A Frölich, MD, MS 41 Obstetric Anesthesia 843 Michael A Frölich, MD, MS 42 Pediatric Anesthesia 877 43 Geriatric Anesthesia 907 44 Ambulatory, Nonoperating Room, & Office-Based Anesthesia 919 51 Fluid Management & Blood Component Therapy 1161 52 Thermoregulation, Hypothermia, & Malignant Hyperthermia 1183 53 Nutrition in Perioperative & Critical Care 1193 54 Anesthetic Complications 1199 55 Cardiopulmonary Resuscitation 1231 Martin Giesecke, MD and Srikanth Hosur, MBBS, MD 56 Postanesthesia Care 1257 57 Critical Care 1277 58 Safety, Quality, & Performance Improvement 1325 Index 1331 Chapter Authors Gabriele Baldini, MD, MSc Assistant Professor Department of Anesthesia McGill University Montreal, Quebec John F Butterworth IV, MD Professor and Chairman Department of Anesthesiology Virginia Commonwealth University School of Medicine VCU Health System Richmond, Virginia Francesco Carli, MD, MPhil Professor Department of Anesthesia McGill University Montreal, Quebec Charles E Cowles, Jr, MD Assistant Professor Department of Anesthesiology and Perioperative Medicine Chief Safety Officer Perioperative Enterprise University of Texas MD Anderson Cancer Center Houston, Texas Michael A Frölich, MD, MS Associate Professor Department of Anesthesiology University of Alabama at Birmingham Birmingham, Alabama Martin Giesecke, MD M.T “Pepper” Jenkins Professor in Anesthesiology Vice Chair, University Hospitals Department of Anesthesiology and Pain Management University of Texas Southwestern Medical Center Dallas, Texas Srikanth Hosur, MBBS, MD Consultant in Intensive Care QuestCare Intensivists Dallas, Texas Brian M Ilfeld, MD, MS Professor, In Residence Department of Anesthesiology University of California, San Diego San Diego, California David C Mackey, MD Professor Department of Anesthesiology and Perioperative Medicine University of Texas M.D Anderson Cancer Center Houston, Texas Sarah J Madison, MD Assistant Clinical Professor of Anesthesiology Department of Anesthesiology University of California, San Diego San Diego, California Edward R Mariano, MD, MAS (Clinical Research) Associate Professor of Anesthesia Stanford University School of Medicine Chief, Anesthesiology and Perioperative Care Service VA Palo Alto Health Care System Palo Alto, California Brian P McGlinch, MD Associate Professor Department of Anesthesiology Mayo Clinic Rochester, Minnesota Colonel, United States Army Reserve, Medical Corps 452 Combat Support Hospital Fort Snelling, Minnesota v vi CHAPTER AUTHORS Michael Ramsay, MD, FRCA Chairman Department of Anesthesiology and Pain Management Baylor University Medical Center President Baylor Research Institute Clinical Professor University of Texas Southwestern Medical School Dallas, Texas Richard W Rosenquist, MD Chair, Pain Management Department Anesthesiology Institute Cleveland Clinic Cleveland, Ohio Bruce M Vrooman, MD Department of Pain Management Anesthesiology Institute Cleveland Clinic Cleveland, Ohio John D Wasnick, MD, MPH Steven L Berk Endowed Chair for Excellence in Medicine Professor and Chair Department of Anesthesia Texas Tech University Health Sciences Center School of Medicine Lubbock, Texas Contributors Kallol Chaudhuri, MD, PhD Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Robert Johnston, MD Associate Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Swapna Chaudhuri, MD, PhD Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Sanford Littwin, MD Assistant Professor Department of Anesthesiology St Luke’s Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons New York, New York John Emhardt, MD Department of Anesthesia Indiana University School of Medicine Indianapolis, Indiana Suzanne N Escudier, MD Associate Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Aschraf N Farag, MD Assistant Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Herbert Gonzalez, MD Assistant Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Kyle Gunnerson, MD Department of Anesthesiology VCU School of Medicine Richmond, Virginia Alina Nicoara, MD Assistant Professor Department of Anesthesiology Duke University Medical Center Durham, North Carolina Bettina Schmitz, MD, PhD Associate Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Steven L Shafer, MD Department of Anesthesia Stanford University School of Medicine Palo Alto, California Christiane Vogt-Harenkamp, MD, PhD Assistant Professor Department of Anesthesia Texas Tech University Health Sciences Center Lubbock, Texas Gary Zaloga, MD Global Medical Affairs Baxter Healthcare Deerfield, Illinois vii This page intentionally left blank Research and Review Jacqueline E Geier, MD Resident, Department of Anesthesiology St Luke’s Roosevelt Hospital Center New York, New York Cecilia N Pena, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Hospital Lubbock, Texas Brian Hirsch, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Lubbock, Texas Charlotte M Walter, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Lubbock, Texas Shane Huffman, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Lubbock, Texas Karvier Yates, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Lubbock, Texas Rahul K Mishra, MD Resident, Department of Anesthesiology Texas Tech University Medical Center Lubbock, Texas ix ... for the fifth edition of what most of us call “Morgan and Mikhail.” We hope that you the reader will find this new edition as readable and useful as you have found the preceding four editions of... made their way into the fifth edition We will be grateful to readers who report these to us at mm 5edition@ gmail.com so that we can correct them in reprints and future editions John F Butterworth... achievement was the fathering of their texts We could not agree more Now in its fifth edition, the overall stylistic goal of Clinical Anesthesiology remains unchanged: to be written simply enough so that