Gastrointestinal And Colorectal Anesthesia

by Kumar; Chandra M.

• ISBN13: 9780849340734
• ISBN10: 084934073X
• Edition: 1st
• Format: Hardcover
• Copyright: 2006-09-18
• Publisher: CRC Press

Summary

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.

Table of Contents

Foreword	iii
Brian J. Pollard
Preface	v
Contributors	xvii
Physiology of the Gastrointestinal Tract Including Splanchnic Blood Flow and Tonometry	1	(12)
Gareth L. Ackland
Monty G. Mythen
Introduction	1	(1)
Hepatosplanchnic Circulation	1	(2)
Gastrointestinal Microvasculature	3	(2)
Neural Control of the Gastrointestinal Tract	5	(2)
Neurotransmitters	7	(1)
Central Nervous System Control of the Gastrointestinal System	8	(1)
Neuroimmune Interactions	9	(1)
Metabolic Interactions	10	(1)
Clinical Measurement of Splanchnic Blood Flow	10	(2)
Clinical Studies	12	(1)
Summary	12	(1)
References	12	(1)
Surgical Considerations in Upper Gastrointestinal Surgery	13	(12)
Bussa R. Gopinath
Peter A. Davis
Chandra M. Kumar
Introduction	13	(1)
Esophagectomy	13	(2)
Surgery for Gastric Neoplasm	15	(2)
Gastroesophageal Reflux Surgery	17	(2)
Laparotomy for Perforated Peptic Ulcer	19	(1)
Laparotomy for Gastroduodenal Bleeding	20	(1)
Cholecystectomy	21	(1)
References	22	(3)
Surgical Considerations in Lower Gastrointestinal Surgery	25	(8)
Tim Brown
Al Windsor
Introduction	25	(1)
Preoperative Fasting	25	(1)
Laparoscopic Lower Gastrointestinal Surgery	26	(3)
Bowel Preparation	29	(1)
Conclusion	30	(1)
References	30	(3)
Stress Response During Surgery	33	(12)
Grainne Nicholson
George M. Hall
Introduction	33	(1)
Hormonal Aspects of the Stress Response	33	(4)
Cytokines	37	(1)
Metabolic Consequences	37	(2)
Modifying the Stress Response	39	(2)
References	41	(4)
Measurement and Prediction of Surgical Outcomes	45	(14)
Graham P. Copeland
Introduction	45	(1)
Techniques for Assessing Outcome	46	(5)
Using Predictive Models of Surgical Outcome	51	(5)
References	56	(3)
Reducing Morbidity After Colorectal Surgery: Surgical Perspectives	59	(22)
Anil Reddy
Vikram Garoud
Robert Wilson
Introduction	59	(1)
Preoperative Evaluation	60	(1)
Physiologic Monitoring of Surgical Patients	61	(1)
Nutritional and Metabolic Support	61	(1)
Thermoregulation	62	(1)
Patient Factors	63	(1)
Deep Vein Thrombosis Prophylaxis	63	(1)
Antibiotic Prophylaxis	64	(1)
Nasogastric Tubes	64	(1)
Mechanical Bowel Preparation	65	(1)
Incisions	66	(1)
Anastomotic Techniques	67	(1)
The Role of Stomas	68	(1)
Drains and Colorectal Surgery	69	(1)
Prevention of Postoperative Ileus	70	(1)
Prevention of Postoperative Adhesions and Internal Hernia	70	(1)
Prevention of GI Bleeding	71	(1)
Prevention of Postoperative GI Fistulae	71	(1)
Postoperative Care and Early Recognition of Complications	72	(1)
Specialization in Colorectal Surgery	72	(1)
Blood Transfusion	73	(1)
Conclusion	73	(1)
References	74	(7)
Preoperative Assessment	81	(16)
Heinz E. Schulenburg
Stuart D. Murdoch
Hamish A. McLure
Introduction	81	(1)
Systems Review	82	(5)
Investigations	87	(2)
Specific Medical Conditions	89	(3)
Premedication	92	(1)
Consent	93	(1)
Summary	94	(1)
References	94	(3)
Perioperative Fluid Management and Optimization	97	(14)
Korat Farooq
R. Jonathan
T. Wilson
Introduction	97	(1)
Fluid Compartment Homeostasis	97	(2)
Intravenous Replacement Fluids	99	(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