Gastrointestinal And Colorectal Anesthesia

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ISBN: 9780849340734 | 084934073X
Cover: Hardcover
Copyright: 9/18/2006

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This resource stands as the only authoritative text to specifically focus on developments and best practices in anesthesiology for procedures affecting the gastrointestinal tract and related appendages. This book provides in-depth coverage of topics such as risk assessment, stress response, and scoring, as well as spans anesthetic trends and practices for endoscopic and laparoscopic procedures, as well as a variety of invasive procedures including hepatobiliary, pancreatic, colorectal, colonic, and abdominal surgeries.

Foreword

iii

Brian J. Pollard

Preface

Contributors

xvii

Physiology of the Gastrointestinal Tract Including Splanchnic Blood Flow and Tonometry

(12)

Gareth L. Ackland

Monty G. Mythen

Introduction

(1)

Hepatosplanchnic Circulation

(2)

Gastrointestinal Microvasculature

(2)

Neural Control of the Gastrointestinal Tract

(2)

Neurotransmitters

(1)

Central Nervous System Control of the Gastrointestinal System

(1)

Neuroimmune Interactions

(1)

Metabolic Interactions

(1)

Clinical Measurement of Splanchnic Blood Flow

(2)

Clinical Studies

(1)

Summary

(1)

References

(1)

Surgical Considerations in Upper Gastrointestinal Surgery

(12)

Bussa R. Gopinath

Peter A. Davis

Chandra M. Kumar

Introduction

(1)

Esophagectomy

(2)

Surgery for Gastric Neoplasm

(2)

Gastroesophageal Reflux Surgery

(2)

Laparotomy for Perforated Peptic Ulcer

(1)

Laparotomy for Gastroduodenal Bleeding

(1)

Cholecystectomy

(1)

References

(3)

Surgical Considerations in Lower Gastrointestinal Surgery

(8)

Tim Brown

Al Windsor

Introduction

(1)

Preoperative Fasting

(1)

Laparoscopic Lower Gastrointestinal Surgery

(3)

Bowel Preparation

(1)

Conclusion

(1)

References

(3)

Stress Response During Surgery

(12)

Grainne Nicholson

George M. Hall

Introduction

(1)

Hormonal Aspects of the Stress Response

(4)

Cytokines

(1)

Metabolic Consequences

(2)

Modifying the Stress Response

(2)

References

(4)

Measurement and Prediction of Surgical Outcomes

(14)

Graham P. Copeland

Introduction

(1)

Techniques for Assessing Outcome

(5)

Using Predictive Models of Surgical Outcome

(5)

References

(3)

Reducing Morbidity After Colorectal Surgery: Surgical Perspectives

(22)

Anil Reddy

Vikram Garoud

Robert Wilson

Introduction

(1)

Preoperative Evaluation

(1)

Physiologic Monitoring of Surgical Patients

(1)

Nutritional and Metabolic Support

(1)

Thermoregulation

(1)

Patient Factors

(1)

Deep Vein Thrombosis Prophylaxis

(1)

Antibiotic Prophylaxis

(1)

Nasogastric Tubes

(1)

Mechanical Bowel Preparation

(1)

Incisions

(1)

Anastomotic Techniques

(1)

The Role of Stomas

(1)

Drains and Colorectal Surgery

(1)

Prevention of Postoperative Ileus

(1)

Prevention of Postoperative Adhesions and Internal Hernia

(1)

Prevention of GI Bleeding

(1)

Prevention of Postoperative GI Fistulae

(1)

Postoperative Care and Early Recognition of Complications

(1)

Specialization in Colorectal Surgery

(1)

Blood Transfusion

(1)

Conclusion

(1)

References

(7)

Preoperative Assessment

(16)

Heinz E. Schulenburg

Stuart D. Murdoch

Hamish A. McLure

Introduction

(1)

Systems Review

(5)

Investigations

(2)

Specific Medical Conditions

(3)

Premedication

(1)

Consent

(1)

Summary

(1)

References

(3)

Perioperative Fluid Management and Optimization

(14)

Korat Farooq

R. Jonathan

T. Wilson

Introduction

(1)

Fluid Compartment Homeostasis

(2)

Intravenous Replacement Fluids

(2)

Fluid Homeostasis and Major Surgery

101

(3)

Monitoring the Circulation

104

(1)

Optimizing Oxygen Delivery in the High-Risk Patient

105

(2)

Goal-Directed Therapy in Practice

107

(1)

Conclusion

108

(1)

References

109

(2)

Regional Anesthesia in Abdominal Surgery

111

(16)

Timothy Jackson

Frank Loughnane

Introduction

111

(1)

Central Neuraxial Techniques

111

(6)

Discrete Nerve Blocks

117

(1)

Special Patient Groups

118

(1)

Summary

119

(1)

References

120

(7)

Sedation for Endoscopic Procedures

127

(12)

Udvitha C. Nandasoma

Mervyn H. Davies

Historical Background

127

(1)

Endoscopic Procedures and Their Associated Risk Factors

127

(2)

Special Patient Groups

129

(1)

Unsedated Endoscopy

129

(1)

Cardiorespiratory Changes During Endoscopy

130

(1)

Topical Pharyngeal Anesthesia

131

(1)

Intravenous Sedation

132

(1)

Choice of Agents

132

(2)

Conclusions

134

(1)

References

134

(5)

Anesthesia for Esophagogastric Surgery

139

(20)

Ian H. Shaw

Introduction

139

(1)

Diseases of the Esophagus

139

(1)

Surgery for Esophagogastric Cancer

140

(2)

Nonoperative Treatment

142

(1)

Anesthesia for Esophageal Surgery

142

(6)

Postoperative Care

148

(3)

Anesthesia in Patient with Previous Esophagectomy

151

(1)

Anesthesia for Nonmalignant Esophageal Surgery

151

(2)

Conclusion

153

(1)

References

153

(6)

Anesthesia for Gastric Surgery

159

(22)

Ian H. Shaw

Ian H. Warnell

Introduction

159

(1)

Anatomy of the Stomach

159

(1)

Lower Esophageal Sphincter

160

(1)

Gastric Aspiration

161

(1)

Gastric Carcinoma

161

(2)

Surgery for Gastric Cancer

163

(1)

Anesthesia for Gastric Cancer Surgery

164

(1)

Anemia and Blood Transfusion in Gastric Surgery

165

(3)

Anesthetic Consideration

168

(3)

Antithromboembolic Prophylaxis

171

(1)

Prophylactic Antibiotic Therapy

172

(1)

Staging Laparoscopy in Gastric Surgery

172

(1)

Analgesia Following Gastric Surgery

172

(1)

Gastrointestinal Hemorrhage

173

(2)

Anesthesia and Massive Gastric Hemorrhage

175

(1)

Conclusion

176

(1)

References

176

(5)

Anesthesia for Bariatric Surgery

181

(18)

Robert Thomas

Mark Bellamy

Introduction

181

(1)

Physiology of Energy Metabolism

181

(2)

Types of Surgery

183

(1)

Complications of Obesity

184

(3)

Preoperative Evaluation

187

(1)

Perioperative Management

188

(4)

Postoperative Care

192

(1)

Conclusion

193

(1)

References

193

(6)

Anesthesia for Antireflux Surgery

199

(14)

Johan Raeder

Introduction

199

(1)

Pathophysiology

199

(1)

Diagnosis

200

(1)

Surgical Procedures

200

(1)

Special Concerns for the Anesthesiologist

201

(5)

Choice of Anesthetic Technique

206

(1)

Considerations in Children

207

(1)

Practical Approach to Anesthesia for Antireflux Surgery in the Adult

208

(1)

References

209

(4)

Anesthesia for Hepatobiliary Surgery

213

(18)

Chris P. Snowden

David M. Cressey

Introduction

213

(1)

Surgical Techniques

213

(3)

Preoperative Assessment

216

(3)

Intraoperative Considerations

219

(5)

Postoperative Care

224

(1)

References

225

(6)

Anesthesia for Pancreatic Surgery

231

(14)

Iain Jones

Andrew Berrill

Anatomy

231

(1)

Functions

231

(1)

General Considerations

231

(1)

Exocrine Tumors

232

(1)

Anesthesia for Pancreatic Carcinoma

232

(1)

Fluid Therapy and Inotropes

233

(1)

Role of Somatostatin Analogues in Pancreatic Surgery

233

(1)

Postoperative Analgesia

233

(1)

Postoperative Care

234

(1)

Complications

234

(1)

Survival After Resection

235

(1)

Palliation of Advanced Pancreatic Cancer

235

(1)

Specialist Centers and the ``Volume-Outcome'' Relationship

235

(1)

Endocrine Tumors

236

(4)

Surgery for Acute Pancreatitis

240

(3)

Surgery for Chronic Pancreatic Conditions

243

(1)

Conclusions

243

(1)

References

244

(1)

Anesthesia for Laparoscopic Surgery

245

(8)

John C. Berridge

Introduction

245

(1)

Benefits of Laparoscopic Surgery

245

(1)

Physiological Effects of Laparoscopic Surgery

245

(3)

Anesthesia for Laparoscopic Surgery

248

(1)

Postoperative Pain

249

(1)

Conclusions

250

(1)

References

250

(3)

Anesthesia for the Carcinoid Syndrome

253

(12)

Lennart Christiansson

Introduction

253

(1)

Tumor Biology, Diagnosis, and Treatment

253

(4)

The Carcinoid Syndrome

257

(1)

Anesthetic and Perioperative Aspects

258

(4)

References

262

(3)

Anesthesia for Pheochromocytoma Resection

265

(20)

Lennart Christiansson

Introduction

265

(1)

Tumor Biology, Diagnosis, and Treatment

266

(6)

Anesthetic and Perioperative Aspects

272

(8)

References

280

(5)

Anesthesia for Colorectal Surgery

285

(14)

Stuart D. Murdoch

Introduction

285

(1)

Pathology

285

(1)

Preassessment

286

(1)

Risk Prediction

287

(1)

Preoperative Care

287

(2)

Anesthesia

289

(1)

Perioperative Care

290

(4)

Enhanced Recovery or Fast-Track Surgery

294

(1)

References

295

(4)

Anesthesia for Colorectal Surgery in the Elderly

299

(16)

Dave Murray

Introduction

299

(1)

Aging Process

299

(2)

Preoperative Assessment of Elderly Patient

301

(3)

Perioperative Care

304

(6)

Postoperative Care

310

(1)

Conclusions

310

(1)

References

310

(5)

Rapid Recovery After Major Abdominal Surgery

315

(14)

Susan M. Nimmo

Introduction

315

(1)

Preoperative Issues

316

(2)

Anesthetic Factors

318

(6)

Postoperative Issues

324

(2)

Results of the Application of Multimodal Care Pathways for Rapid Recovery Following Major Surgery

326

(1)

References

327

(2)

Anesthesia for Anorectal Surgery

329

(18)

Irwin Foo

Damien Mantle

Introduction

329

(1)

Anatomy of the Rectum and Anal Canal

329

(3)

Surgical Approaches and Techniques

332

(2)

Positioning of Patients During Surgery

334

(3)

Anesthetic Techniques

337

(5)

Postoperative Complications

342

(1)

Summary

342

(1)

References

343

(4)

Anesthesia for Emergency Exploratory Laparotomy

347

(16)

Elizabeth C. Storey

Andrew B. Lumb

Introduction

347

(1)

Preoperative Assessment and Optimization

347

(1)

Outcome Following Emergency Laparotomy

348

(1)

Preoperative Fluid Management

348

(2)

When to Operate?

350

(1)

Anesthetic Technique

350

(3)

Intraoperative Care

353

(2)

Emergence

355

(1)

Postoperative Care

355

(3)

Postoperative Complications

358

(2)

References

360

(3)

Postoperative Pain Management After Abdominal Surgery

363

(18)

Terry T. Durbin

Introduction

363

(1)

Postoperative Pain and Abdominal Surgery

364

(1)

Management of Postoperative Pain

364

(9)

Pain Management Strategies

373

(3)

References

376

(5)

Postoperative Nausea and Vomiting After Abdominal Surgery

381

(14)

Steven Gayer

Howard Palte

Introduction

381

(1)

Physiology

382

(1)

Risk

383

(1)

Management

383

(4)

Management Strategies

387

(3)

Patient's Perception and PONV

390

(1)

Value and Economics of PONV

390

(1)

The Future

391

(1)

Summary

391

(1)

References

391

(4)

The Role of the Critical Care Unit in Abdominal Surgery

395

(16)

Ian Nesbitt

Introduction

395

(1)

How Does Critical Care Alter Outcomes?

396

(6)

Specific Subspecialties

402

(3)

Distant Organ Support and Care of the Organ Donor

405

(1)

Summary

405

(1)

References

405

(6)

Index

411

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Gastrointestinal And Colorectal Anesthesia

Summary

Table of Contents

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Gastrointestinal And Colorectal Anesthesia

Summary

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