Evidence-Based Practice of Anesthesiology [NOOK Book]


Using an evidence-based approach, this title explores 71 important topics in perioperative management -- discussing the clinical options, examining the relevant clinical research, and presenting expert, evidence-based practice recommendations. Inside, you'll find all of today's most effective approaches for everything from preoperative assessment ... through intraoperative anesthesia administration and monitoring ... to postoperative pain management.
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Evidence-Based Practice of Anesthesiology

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Using an evidence-based approach, this title explores 71 important topics in perioperative management -- discussing the clinical options, examining the relevant clinical research, and presenting expert, evidence-based practice recommendations. Inside, you'll find all of today's most effective approaches for everything from preoperative assessment ... through intraoperative anesthesia administration and monitoring ... to postoperative pain management.
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Editorial Reviews

From The Critics
Reviewer: Jeffrey L Apfelbaum, MD(University of Chicago Pritzker School of Medicine)
Description: In this book the editor takes a unique approach in his attempt to help readers to benefit from a systemic review of the literature to allow them to apply the most effective treatments to common dilemmas in clinical anesthesiology. Rather than using traditional chapters, the editor has chosen a unique structure to educate and inform. Dr. Fleisher has posed some 70 questions of considerable clinical importance and asked the authors to provide a response to each based on their review of the literature and evidentiary conclusions.
Purpose: "The editor has indicated that it was his goal to provide a structured way of looking at a series of clinically important questions. Authors were asked to provide an overall background or introduction to a question, outline the options for treatment, review the evidence, identify areas of uncertainty, outline any available guidelines, and, finally, to provide their own recommendations. The vast majority of authors do a credible, if not excellent, job of accomplishing the editors' goals. Unfortunately, in some cases, the naïve reader may be left with an impression that there is a definitive answer to the question posed at the beginning of a chapter when, in fact, the "evidence" is insufficient to justify the authors' apparent conclusion. "
Audience: As suggested in the foreword, the book is an excellent educational tool for clinical practitioners of anesthesiology, as well as for residents and medical students. It provides an interesting perspective in that the reader is presented not only with a summary of the literature review, but also with the opinion of an expert in the subspecialty area.
Features: After an introduction that addresses evidence-based practice guidelines as approached by the American Society of Anesthesiologists, the book is broken into sections on preoperative preparation, perioperative management, regional anesthesia, cardiovascular anesthesia, neurosurgical anesthesia, obstetrical anesthesia, pediatric anesthesia, and pain. Some 108 authors, many internationally renowned experts in their subspecialty areas, have contributed to answering the 70 questions posed by the editor. References are current, and one of the highlights of each chapter is a unique section entitled "author's recommendations."
Assessment: The book is very well written and is structured in a format that facilitates goal-directed learning. I know of no comparable books in the field. If the reader is inquisitive about any of the 70 questions posed here, the literature review and summaries provided by the expert authors are generally excellent to outstanding. However, shortcomings include the simple fact that the book is limited to the 70 questions and, as previously stated, the presentation may leave the naïve reader with the impression that there is a "definitive" answer when, in fact, the "evidence" is insufficient to justify the apparent conclusion. This book will definitely be a reference in my personal library.
From The Critics
"Lee Fleisher, MD, book editor and the chair of a busy academic department, described the goal for authors as 'to provide the reader with a basis upon which they can formulate thier own perioperative approach to complex literature.' The authors met that goal. It does use an evidence-based approach to explore important and relevant clinical topics in a practical and consistent format. Readers will learn a lot and enjoy it." Anesthesia & Analgesia (Feb. 2005)

"The book by Fleisher is balanced, informative, and useful to clinicians who need to make decisions. [It] provides clear recommendations, which are informed by evidence and experience, to caregivers." -Anesthesiology, July 2005

3 Stars from Doody
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Product Details

  • ISBN-13: 9781455740383
  • Publisher: Elsevier Health Sciences
  • Publication date: 1/15/2013
  • Sold by: Barnes & Noble
  • Format: eBook
  • Edition number: 3
  • Pages: 612
  • Sales rank: 754,299
  • File size: 23 MB
  • Note: This product may take a few minutes to download.

Table of Contents

1 Evidence-based practice guidelines - the American society of anesthesiologists' approach 3
2 Does routine testing affect outcome? 11
3 Should preoperative hemoglobin always be obtained? 15
4 Is routine preoperative pregnancy testing necessary? 18
5 Is a preoperative screening clinic cost-effective? 23
6 Who should have a preoperative 12-lead electrocardiogram? 27
7 When should pulmonary function tests be performed preoperatively? 31
8 Does the airway examination predict difficult intubation? 34
9 What is the optimal evaluation of the patient with obstructive sleep apnea? 47
10 Is ther e an optimal timing for smoking cessation? 57
11 Does prophylactic coronary revascularization reduce cardiac complications? 62
12 Should antihypertensive medications be continued through the perioperative period? 68
13 Should patients with asthma be given preoperative medications including steroids? 77
14 Is autologous predonation cost-effective? 82
15 Does a history of difficult intubation necessitate awake airway management? 91
16 Should regional or general anesthesia be used for cases in which the patient has an anticipated difficult airway? 96
17 Is there an ideal approach to the malignant hyperthermia-susceptible patient? 102
18 What is the optimal perioperative management for latex allergy? 111
19 What reduces the risk of aspiration? 118
20 Is there an optimal treatment for aspiration? 125
21 What is the best strategy to prevent PONV? 130
22 Does the choice of fluid matter in major surgery? 136
23 Does the choice of muscle relaxant affect outcome? 145
24 Maintenance of perioperative normothermia is beneficial 150
25 When should perioperative glucocorticoid replacement be administered? 157
26 Should beta-adrenergic blocking agents be given routinely in noncardiac surgery? 163
27 Are alpha-2 agonists effective in reducing perioperative cardiac complications in noncardiac surgery? 168
28 Does perioperative hyperglycemia increase the risk of postoperative complications? 172
29 What is the best means of preventing perioperative renal dysfunction? 181
30 What works in a patient with acute respiratory distress syndrome? 191
31 Is there an optimal perioperative hemoglobin? 197
32 Is acute normovolemic hemodilution cost-effective? 205
33 What drugs decrease postoperative bleeding? 210
34 Fondaparinux : what is its efficacy and safety in surgical patients? 218
35 Can we prevent recall during anesthesia? 223
36 What actions can be used to prevent peripheral nerve injury? 228
37 Is one general anesthetic technique associated with faster recovery? 236
38 Choice of general anesthetic for ambulatory surgery 241
39 What criteria should be used for discharge after outpatient surgery? 247
40 What is the optimal intraoperative and postoperative management of the obstructive sleep apnea patient 253
41 Do intensive care specialists improve patient outcome? 258
42 Is regional anesthesia superior to general anesthesia for hip surgery? 267
43 Should spinal anesthesia be performed in patients with multiple sclerosis? 270
44 Is regional anesthesia safe in the patient on antiplatelet agents? 277
45 Does intraoperative regional anesthesia decrease perioperative blood loss? 283
46 Should additives be used for peripheral nerve blocks? 287
47 The best approaches to prophylaxis against DVT formation when using a combination of neuraxial anesthesia and heparins 292
48 Vitamin K antagonists and spinal axis anesthesia 305
49 Herbal medications and spinal axis anesthesia 312
50 What is the optimal management of postdural puncture headache? 314
51 When is an epidural blood patch indicated? 318
52 Is regional anesthesia appropriate for outpatient surgery? 323
53 Do pulmonary artery catheters influence outcome in noncardiac surgery? 331
54 Does intraoperative neuromonitoring affect outcome? 336
55 What is the best method of diagnosing perioperative myocardial infarction? 344
56 Is OPCAB superior to CABG? 353
57 Fast-track cardiac anesthesia - is it safe? 359
58 Which should be done first, a CABG or a CEA, or should both be done together? 364
59 Is regional anesthesia superior to general anesthesia for infrainguinal revascularization? 369
60 Is there a difference in perioperative morbidity and mortality in patients undergoing carotid endarterectomy with local versus general anesthesia? 372
61 Timing of surgery after an ischemic stroke 379
62 Is there a best technique in the patient with increased intracranial pressure? 389
63 Does labor epidural analgesia affect labor outcome? 395
64 Anesthesia for cesarean delivery : regional or general? 401
65 Does anesthesia increase the risk to the parturient undergoing non-obstetric surgery? 407
66 Should succinylcholine be used in children? 415
67 How young is the youngest infant for outpatient surgery? 419
68 Should a child with a respiratory tract infection undergo elective surgery? 424
69 Is preemptive analgesia clinically effective 433
70 Is epidural analgesia superior to IV-PCA? 441
71 Optimal postoperative analgesia 449
Index 459
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