ANESTHESIA FOR LABOR AND DELIVERY • Nonpharmacologic analgesia choices: Hypnotherapy, hydrotherapy, and transcutaneous electrical nerve stimulation (TENS) • Pharmacologic analgesia: Inhalation analgesia, parenteral opioid analgesia (fentanyl, nalbuphine), pudendal block, paracervical…
(LR, NS, & hetastarch → shown to ↑ neutrophil activation; blood, 7.5% hypertonic saline, & albumin did not have this effect) Figure 9-1. Assessment of volume status. Colloid osmotic pressure (COP)…
• Infant chest wall deforms easily → because of cartilaginous structure • Accessory muscles provide limited support (poor anatomic rib configuration) • Infantile diaphragm contains 20–25% of fatigue-resistant type I…
Initial Diagnosis & Management 1. Examine & stabilize—check Airway, Breathing & Circulation 2. Fluid resuscitate—obtain adequate venous access 3. Review data—patient history, anesthesia record, surgical procedure, estimated blood loss, PACU…
Figure 7-1. The hemoglobin-oxygen (Hb-O2) dissociation curve. NONINVASIVE BLOOD PRESSURE MONITORING (OSCILLOMETRIC SPHYGMOMANOMETRY) Basis: Air cuff inflated around extremity, transducer reads oscillations from systolic pulsation • Inflation pressure raised above systolic…
Sacral cornu (S5) • Thoracic spinous processes—angled caudally (in relation to vertebral bodies) • Lumbar spinous processes—angled horizontally • “S-shape of spinal column”: Thoracic kyphosis (convex) at T4; lumbar lordosis…
Acute pain: 0 to 4–6 wks Subacute pain: 1 to 3 mos Chronic pain: Persistent pain >3 mos without biologic value Figure 29-1. Algorithm for pharmacologic management of chronic pain. LOW…
Hyperthyroidism Anesthesia for Hyperthyroidism • Preop • General: Euthyroid status preferred (risk of thyroid storm), check TFTs, continue antithyroid meds & β-blockers to the day of surgery • Airway: Check…
Shunts Valve Area Coronary Artery Anatomy Figure A-1. Coronary arteries. PULMONARY Dead space = Lung units that are ventilated but not perfused Intrapulmonary shunt = Lung units that are perfused but…
NASCIS Protocol for Steroid Therapy • High-dose methylprednisolone is no longer recommended as standard of care for blunt ASCI. Multiple studies have suggested that the risks of high-dose steroid therapy…
