Anesthesia for Thoracic Surgery
Establishing One-Lung Ventilation • A left-sided DLT can be used for most procedures, with the exception of left main bronchus distortion by intra- or extrabronchial mass, compression of left main…
Anesthesia for Cardiovascular Surgery
Persistent Bleeding After Cardiopulmonary Bypass • Reversing heparin effects: Protamine should be used to return ACT to baseline (usually 1 mg per 100 U of heparin is needed with additional…
Anesthesia for Patients with Cardiovascular Disease
!DOCTYPE html PUBLIC “-//W3C//DTD XHTML 1.1//EN” “http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd”> ANESTHESIA FOR PATIENTS WITH CARDIOVASCULAR DISEASE Endocarditis Prophylaxis • The American College of Cardiology (ACC) and American Heart Association (AHA) currently suggest (class…
Noncardiovascular Monitoring
Pulse Oximetry: Clinical Considerations In addition to SpO2, pulse oximeters provide an indication of tissue perfusion (pulse amplitude) and measure heart rate. Because SpO2 is normally close to 100%, only…
Cardiovascular Physiology and Anesthesia
• CI = HR × SV/BSA (normal values are 2.5 – 4.2 L/min/m2) where MAP is mean arterial pressure, CVP is central venous pressure, CI is cardiac index, HR is…
Analgesic Agents
COX Inhibitors: General Concepts Mechanism of Action: Inhibition of cyclooxygenase (COX), the key step in prostaglandin synthesis. COX-1 receptors are widely distributed throughout the body, including gut and…
Adjuncts to Anesthesia
Recommendations from the Society of Ambulatory Anesthesia (SAMBA): 1. Identify patients at risk for PONV. 2. Use management strategies to reduce PONV risk. 3. Use one to two prophylactic…
Preoperative Assessment, Premedication, and Perioperative Documentation
!DOCTYPE html PUBLIC “-//W3C//DTD XHTML 1.1//EN” “http://www.w3.org/TR/xhtml11/DTD/xhtml11.dtd”> PREOPERATIVE ASSESSMENT, PREMEDICATION, AND PERIOPERATIVE DOCUMENTATION The preoperative assessment is extremely important and consists of a physical examination and medical history, which includes…
Anticholinergic Drugs
Atropine Dosage • Premedication (antisialagogue effect): intravenous (IV) or intramuscular (IM) 0.01 to 0.02 mg/kg up to the usual adult dose of 0.4 to 0.6 mg • Severe bradycardia: Larger…
