Full Description
There are persistent misunderstandings between internal medicine and anesthesiology in perioperative care. Internists, hospitalists, and subspecialists are often asked to provide perioperative consultation, yet formal training in anesthesiology is limited. This book bridges this gap by explaining why certain intraoperative choices are made, what risks different anesthetic techniques carry, and how internists can best support patient optimization and postoperative recovery. Its purpose is to provide internists with information about anesthesiology's scope, history, pharmacology, and guiding principles to support effective collaboration.
The book is organized into sections reflecting the perioperative continuum. Early chapters introduce anesthesiology's role, safety culture, and monitoring standards. Core chapters address anesthetic pharmacology, types of anesthesia, and perioperative physiology. Special chapters cover postoperative complications, pain management, and opioid stewardship, with attention to patients on buprenorphine, methadone, or illicit opioids. Case-based discussions illustrate common points of tension. The book concludes with a forward-looking chapter on perioperative medicine as a collaborative specialty.
Written in an approachable, clinically relevant style, each chapter includes abstracts, key takeaways, and peer-reviewed references. Tables, clinical pearls, and case-based examples make the text practical for busy clinicians.
Contents
Brief History of Anesthesia Worldwide and in the United States: From Ether to Modern Era.- The Anesthesia Workforce.- Anesthesiology and its Subspecialties.- Why Internists Need to Understand the Basics of Anesthesia Practice.- Dynamics of the Operating and Procedure Room.- Non-Operating Room Anesthesia (NORA): Endoscopy, Catheterization Laboratory, Interventional Radiology and MRI.- Preoperative Assessment and Optimization: History, Risk Stratification and Special Considerations.- The Role of the Internist in Perioperative Medicine.- Perioperative testing from the lens of anesthesiologist.- Monitoring Techniques in Anesthesia.- Core Anesthetic Agents: Intravenous agents, Inhalational Anesthetics and Neuromuscular Blockers.- Pharmacological Adjuncts and Special Medications: Opioids, Dexmedetomidine and Local Anesthetics.- Monitored Anesthesia Care.- Regional Anesthesia: Peripheral Nerve Blocks.- Neuraxial Anesthesia: Spinal, Epidural, and Combined Techniques.- General Anesthesia: Induction, Maintenance and Emergence.- Surgical Positioning: Techniques, Physiologic Implications, and Perioperative Risks.- Post-Anesthesia Care Unit: Structure, Assessment and Discharge Criteria.- Post-operative Delirium, Cognitive Dysfunction, delayed emergence and intraoperative awareness.- Post-operative Cardiac Complications: Myocardial Infarction, Arrhythmias, Heart failure and Tamponade.- Post-operative Pulmonary Complications: Hypoventilation, Atelectasis, Pneumonia, Pulmonary Embolism, and ARDS.- Post-operative renal complications and acute kidney injury.- Post-operative Gastrointestinal and Hepatic Complications.- Post-operative coagulopathy and bleeding.- Post-operative Nausea and Vomiting: Risk, Prevention, and Treatment.- Malignant Hyperthermia: Pathophysiology, Diagnosis, Prevention and Management.- Local Anesthetic Systemic Toxicity: Recognition, Prevention and Management.- Post-operative Pain Management.- Perioperative Consultation: Building an Effective Co-Management Model.- Perioperative Medicine Case Discussions: An Anesthesiologist's Perspective for Internists.- Future Directions: Perioperative Medicine as a Collaborative Specialty.- Epilogue: A Personal Journey from Medical Optimization to Intraoperative Management.
