Anesthesia for Spine Surgery

✍ Scribed by Ehab Farag

• Publisher: Cambridge University Press
• Year: 2012
• Tongue: English
• Leaves: 475
• Edition: 1
• Category: Library

✦ Synopsis

The increased complexity of spinal surgical procedures in recent years has required more sophisticated anesthetic management of patients undergoing these procedures. Spine surgery anesthesia is now recognized as a distinct sub-specialty, increasingly undertaken by general anesthesiologists as well as neuroanesthesiologists. Anesthesia for Spine Surgery describes the anesthetic management and surgical procedures at every vertebral level in both adult and pediatric patients. The most important related considerations are covered, including: • Postoperative pain management • One lung ventilation during anterior thoracic spine surgery • Intraoperative neuromonitoring • Fluid management Additional chapters review the radiological features of normal and abnormal spines, common complications of spine surgery and ASA closed claims relating to spine surgery anesthesia. Written by highly experienced neuroanesthesiologists and spine surgeons, Anesthesia for Spine Surgery is essential reading for trainee and practising anesthesiologists, neuroanesthesiologists and spine surgeons
A comprehensive guide to anesthesia specifically for spine surgery, explaining procedures from the point of view of both anesthesiologists and surgeons. Cover; Anesthesia for Spine Surgery; Title; Copyright; Dedication; Contents; Contributors; Foreword by Dr. Edward Benzel; Foreword by Dr. David Brown; Preface; Section 1 General considerations; Preoperative assessment of the adult patient; Key points; Introduction; General guidelines; Site of surgery; Cervical and elective surgery; Upper levels; Upper levels; Middle and lower levels; elective surgery; Thoracic levels: elective surgery; Lumbar level: elective surgery; Smoking; Obesity; Pulmonary hypertension; Diabetes mellitus; Drug interactions; Renal impairment; Hematologic disorders. Consent issuesEmergency spine surgery; Acute injury; Clinical features; Diagnosis/treatment; Systems assessment; Respiratory system; Respiratory system; Cardiovascular system; Musculoskeletal system; Genitourinary system; Gastrointestinal system; Hematologic management; Cardiovascular system; Musculoskeletal system; Genitourinary system; Gastrointestinal system; Hematologic management; Conclusion; Fluid management; Key points; Introduction; Pathophysiology of prone position; Endothelial glycocalyx; The important functions of glycocalyx; Perioperative fluid management and glycocalyx. Intravenous fluids commonly used in spine surgeryCrystalloids; Normal saline; Normal saline; Lactated Ringer's; Lactated Ringer's; Colloids; Albumin; Hydroxyethyl starch; Albumin; Hydroxyethyl starch; Goal-directed fluid therapy; Static variables of preload and fluid responsiveness; Cardiac filling pressures; Cardiac filling pressures; Pulmonary artery occlusion pressure; Pulmonary artery occlusion pressure; Global end-diastolic volume obtained by transpulmonary thermodilution; FloTrac/Vigileo; Dynamic variables of fluid responsiveness; Systolic and pulse pressure variation. Systolic and pulse pressure variationStroke volume variation and pulse contour analysis; Limitations of heart-lung interaction as a predictor of fluid responsiveness; Stroke volume variation and pulse contour analysis; Limitations of heart-lung interaction as a predictor of fluid responsiveness; Conclusion; Blood conservation; Key points; Preoperative measures; Antifibrinolytic treatments; Recombinant activated factor VII; Preoperative autodonation; Acute normovolemic hemodilution; Intraoperative red cell salvage; Postoperative cell salvage; Point of care testing; Quality management; Summary. Airway management in spine surgeryKey points; Introduction; Tracheal intubation in patients undergoing spine surgery; Role of the ASA Difficult Airway Algorithm; Prediction of intubation difficulty: intubation difficulty scale; Laryngoscopes; Tracheal intubation in patients with cervical spine instability; Use of succinylcholine in patients undergoing spine surgery; Flexible fiberoptic intubation and awake intubation; Airway edema in spine cases; Spine surgery requiring the use of double-lumen tubes; Management of accidental extubation; Spine surgery under spinal anesthesia

✦ Table of Contents

Blank Page......Page 6
Contents......Page 7
Contributors......Page 9
Foreword by Dr. Edward Benzel......Page 13
Foreword by Dr. David Brown......Page 15
Preface......Page 17
1 - Preoperative assessment of the adult patient......Page 19
2 - Fluid management......Page 43
3 - Blood conservation......Page 61
4 - Airway management in spine surgery......Page 68
5 - Spine imaging......Page 79
6 - Evoked potential monitoring......Page 107
7 - Pharmacology of adjunct anesthetic drugs......Page 124
8 - Surgical techniques......Page 131
9 - Anesthesia for cervical spine surgery......Page 196
10 - Anesthesia for thoracic spine surgery......Page 206
11 - Lung isolation during thoracic spine surgery......Page 222
12 - Anesthesia for lumbar spine surgery......Page 234
13 - Anesthetic management of spinal cord trauma......Page 246
14 - Anesthesia for patients with spinal cord tumors......Page 265
15 - Complications......Page 275
16 - Postoperative care in the PACU......Page 299
17 - Postoperative care in the neuro-intensive care unit......Page 310
18 - Postoperative acute pain......Page 320
19 - Postoperative chronic pain management......Page 339
20 - Pathophysiology of the pediatric patient......Page 365
21 - Preoperative evaluation of the pediatric patient......Page 376
22 - Fluid management and monitoring of the pediatric patient......Page 390
23 - Surgical techniques in the pediatric patient......Page 406
24 - Spinal surgery for patients with congenital heart disease and other associated conditions......Page 423
25 - Postoperative pain control in pediatric patients......Page 438
Index......Page 455