Description
In recent years anesthesiologists have developed a more active role in the entire peri-operative period-from the decision for surgery, through recovery, discharge and beyond. In addition, the core training curriculum of anesthesiology has changed significantly to now include many non-operating room anesthesia rotations.General anesthesiology texts include varying degrees of perioperative management information, and a few titles are devoted specifically to the area. However, none combines a problem-based approach with review questions and answers with explanations.Following the format of the Anesthesiology Problem-Based Learning Approach series, each chapter in Perioperative Medicine describes a specific condition or situation and a virtual case presented through a series of questions and answers. With 48 chapters covering a broad array of conundrums encountered in clinical perioperative medicine, the text focuses on preoperative optimization of patients with different comorbidities, such as coronary artery disease, heart failure, chronic obstructive pulmonary disease, obstructive sleep apnea, diabetes mellitus, cirrhosis, substance use disorder, and anemia. Sections on how to choose preoperative tests, medication management, and handling ethical issues, like informed consent, DNR, and uncomfortable conversations with patients, are discussed in detail.Perioperative Medicine: A Problem-Based Learning Approach provides an up-to-date compendium of topics commonly presenting in daily practice and serves as a unique learning opportunity for the busy perioperative clinician approaching a new case and for clinicians in training who need to learn the basics.
Table of Contents
General1. This patient has 17 allergies - including “general anesthesia” 2. Choosing a preoperative process3. Perioperative surgical home care model - utopia or bureaucracy Preoperative Assessment4. Choosing wisely: how to advise the patient on preoperative testing5. My 79 year old patient for right inguinal hernia repair has no labs on file 6. Medication management - Drug eluting stent 2 months ago 7. Medication management - Substance use disorder 8. Indications for preoperative C-spine imaging for elective procedures9. Prehabilitation before total hip replacement 10. Cardiopulmonary exercise testing (CPET)Age11. Ex-premie for interval hernia repair at 11 weeks 12. Geriatric assessment - “the get up and go, got up and left”Organ SystemsCardiac 13. AHA guidelines application14. Perioperative atrial fibrillation and anticoagulation management15. Severe aortic stenosis - candidate for a surgicenter?16. Does your cataract surgeon know you were admitted for heart failure last week?17. Echo shows elevated pulmonary artery pressurePulmonary18. COPD - still smoking, still wheezing19. Severe OSA in the ambulatory setting20. Covid-19Gastrointestinal21. Cirrhosis and truly elective major surgeryNeurological22. Patient has seizures and needs “clearance”23. Clinical Application of Perioperative Brain Health 24. Restrictive lung disease from Parkinson's disease rigidity - is it real? 25. 56 year old with a recent CVA for elective surgery - how soon is too soon?Renal26. Avoiding exacerbation of chronic kidney diseaseHematology27. Preoperative anemia management - evaluation and treatment28. Prolonged PTT in a healthy patientEndocrine29. Elevated glucose on admission fingerstick - how high can we go? 30. Pheochromocytoma and MEN syndromes Other Comorbidities31. Pregnant patient for non-obstetric surgery32. Older primigravida with twin pregnancy for elective cesarean delivery33. Shoulder replacement in patient who had a heart - lung transplantSurgical Considerations34. Minimally invasive surgery and other elements of enhanced recovery protocol35. Blood conservation Ethics & Shared Decision making36. When DNR stands in the OR37. Informed consent - do we really do this correctly? 38. Can I refuse to anesthetize this patient? 39. Difficult conversationsMiscellaneous40. Non-verbal autistic 30 year old for full mouth dental rehabilitation with MH41. Patient with AAA with implanted spinal cord (neuro) stimulator 42. Patient with pacemaker dependent ICD for renal cryoablation43. My friend's son requests surgery for gynecomastia - caused by the drugs he uses for bodybuilding44. Perioperative care of the cancer patientPACU45. Discharge criteria in developmentally disabled patient with OSA 46. My patient is twitching like a fish out of water 47. My patient in the PACU is not making any sense 48. The HR monitor is alarming in the PACU
