Acute Pain Management
2. Spinal modulation that results in augmentation of pain pathways is a consequence of neuronal plasticity. The phenomenon of “wind-up” is an example of central plasticity that results from repetitive…
Trauma and Burns
B. Full Stomach. A full stomach is a background condition in acute trauma. (Urgency of securing the airway often does not permit adequate time for pharmacologic measures to reduce gastric…
Peripheral Nerve Blockade
FIGURE 35-1. Schematic of the cervical plexus, which arises from the anterior primary rami of C2–C4. The motor branches (including the phrenic nerve) curl anteriorly around the anterior scalene muscle…
Inhaled Anesthetics
C. Physical Characteristics of Inhaled Anesthetics (Tables 17-1 and 17-2) 1. The goal of delivering inhaled anesthetics is to produce the anesthetic state by establishing a specific concentration (partial pressure)…
Anesthesia and Obesity
1. Lifestyle counseling is still the most effective tool for long-term weight loss, but it can be combined with the use of medications. 2. Currently, the only antiobesity medications approved…
Neuromuscular Blocking Agents
2. Propagation of the action potential initiates release of calcium from the sarcoplasmic reticulum, where activation of myosin adenosine triphosphate leads to excitation–contraction coupling of the myofilaments. 3. ACh is…
Epidural and Spinal Anesthesia
B. Ligaments 1. The vertebral bodies are stabilized by five ligaments that increase in size between the cervical and lumbar vertebrae (see Fig. 34-1). 2. The ligamentum flavum is thickest…
Hemostasis and Transfusion Medicine
FIGURE 16-2. Summary of secondary hemostasis and the intrinsic, extrinsic, and common coagulation pathways. TF = tissue factor; TFPI = tissue factor pathway inhibitor; vWF = von Willebrand factor. b….
Anesthesia for Neurosurgery
II. NEUROPHYSIOLOGY A. Cerebral metabolism is directly related to the number and frequency of neuron depolarizations (activity or stimulation increases the metabolic rate). Cerebral blood flow (CBF) is tightly coupled…
Cardiopulmonary Resuscitation
A. Airway Management. The techniques used for airway maintenance during anesthesia are also applicable to cardiac arrest victims (Table 58-2). 1. Foreign body airway obstruction must be considered in any…
