临床麻醉学 英文版PDF电子书下载

1.The Practice of Anesthesiology 1

Case Discussion:Medical Malpractice 10

Ⅰ．ANESTHESIC EQUIPMENT＆MONITORS 15

2.The Operating Room:Medical Gas Systems,Environmental Factors,＆Electrical Safety 15

Case Discussion:Checking Out the Medical Gas System in a New Operating Room 25

3.Breathing Systems 27

Case Discussion:Unexplained Light Anesthesia 37

4.The Anesthesia Machine 40

Case Discussion:Detection of a Leak 56

5.Airway Management 59

Profiles in Anesthetic Practice:Laryngospasm:A Continuing Problem&C.Philip Larson,Jr.,MDCM,MA 78

Case Discussion:Evaluation＆Management of a Difficult Airway 80

6.Patient Monitors 86

Profiles in Anesthetic Practice:If There Were Only One Monitor&Wendell C.Stevens,MD 94

Profiles in Anesthetic Practice:Application of the Basic Physical Examination to Intraoperative Monitoring&John R.Moyers,MD 118

Case Discussion:Monitoring During Magnetic Resonance Imaging 123

Ⅱ．CLINICAL PHARMACOLOGY 127

7.Inhalational Anesthetics 127

Case Discussion:Closed-circuit Anesthesia 146

8.Nonvolatile Anesthetic Agents 151

Profiles in Anesthetic Practice:Rational Administration of Intravenous Anesthesia&J.G.Reves,MD 162

Case Discussion:Premedication of the Surgical Patient 175

9.Neuromuscular Blocking Agents 178

Profiles in Anesthetic Practice:A Current Practice of Relaxation&John J.Savarese,MD 192

Case Discussion:Delayed Recovery from General Anesthesia 197

10.Cholinesterase Inhibitors 199

Case Discussion:Respiratory Failure in the Recovery Room 205

11.Anticholinergic Drugs 207

Case Discussion:Central Anticholinergic Syndrome 210

12.Adrenergic Agonists＆Antagonists 212

Case Discussion:Pheochromocytoma 222

13.Hypotensive Agents 224

Case Discussion:Controlled Hypotension 231

14.Local Anesthetics 233

Case Discussion:Local Anesthetic Overdose 240

15.Adjuncts to Anesthesia 242

Case Discussion:Management of Patients at Risk for Aspiration Pneumonia 250

Ⅲ．REGIONAL ANESTHESIA＆PAIN MANAGEMENT 253

16.Spinal,Epidural,＆Caudal Blocks&Wayne Kleinman,MD 253

Case Discussion:Neuraxial Anesthetia for Lithotripsy 280

17.Peripheral Nerve Blocks 283

Case Discussion:Dyspnea Following Interscalene Block 308

18.Pain Management 309

Profiles in Anesthetic Practice:Should Patients Suffer Because Physicians Are Afraid?&Carl C.Hug,Jr.,MD,PhD 344

Case Discussion:Analgesia Following Thoracoabdominal Surgery 356

Ⅳ．PHYSIOLOGY,PATHOPHYSIOLOGY,＆ANESTHETIC MANAGEMENT 359

19.Cardiovascular Physiology＆Anesthesia 359

Case Discussion:A Patient with a Short P-R Interval 381

20.Anesthesia for Patients with Cardiovascular Disease 386

Case Discussion:Hip Fracture in an Elderly Woman Who Fell 427

21.Anesthesia for Cardiovascular Surgery 433

Case Discussion:A Patient for Cardioversion 472

22.Respiratory Physiology＆Anesthesia 475

Case Discussion:Unilaterally Diminished Breath Sounds during General Anesthesia 509

23.Anesthesia for Patients with Respiratory Disease 511

Case Discussion:Laparscopic Surgery 522

24.Anesthesia for Thoracic Surgery 525

Case Discussion:Mediastinal Adenopathy 550

25.Neurophysiology＆Anesthesia 552

Case Discussion:Postoperative Hemiplegia 564

26.Anesthesia for Neurosurgery 567

Profiles in Anesthetic Practice:Anesthesia for Neuronavigation&Robert F.Bedford,MD 570

Case Discussion:Resection of a Pituitary Tumor 581

27.Anesthesia for Patients with Neurologic＆Psychiatric Diseases 583

Case Discussion:Anesthesia for Electroconvulsive Therapy 594

28.Management of Patients with Fluid＆Electrolyte Disturbances 597

Case Discussion:Electrolyte Abnormalities Following Urinary Diversion 624

29.Fluid Management＆Transfusion 626

Case Discussion:A Patient with Sickle Cell Disease 640

30.Acid-Base Balance 644

Case Discussion:A Complex Acid-Base Disturbance 660

31.Renal Physiology＆Anesthesia 662

Case Discussion:Intraoperative Oliguria 677

32.Anesthesia for Patients with Renal Disease 679

Case Discussion:A Patient with Uncontrolled Hypertension 689

33.Anesthesia for Genitourinary Surgery 692

Case Discussion:Hypotension in the Recovery Room 705

34.Hepatic Physiology＆Anesthesia 708

Case Discussion:Coagulopathy in a Patient with Liver Disease 717

35.Anesthesia for Patients with Liver Disease 723

Case Discussion:Liver Transplantation 732

36.Anesthesia for Patients with Endocrine Disease 736

Case Discussion:Multiple Endocrine Neoplasia 750

37.Anesthesia for Patients with Neuromuscular Disease 752

Case Discussion:Anesthesia for Muscle Biopsy 759

38.Anesthesia for Ophthalmic Surgery 761

Case Discussion:An Approach to a Patient with an Open Eye＆a Full Stomach 768

39.Anesthesia for Otorhinolaryngologic Surgery 771

Case Discussion:Bleeding Following Sinus Surgery 779

40.Anesthesia for Orthopedic Surgery 782

Case Discussion:Managing Blood Loss in Jehovah's Witnesses 790

41.Anesthesia for the Trauma Patient 793

Case Discussion:Anesthetic Management of the Burn Patient 801

42.Maternal＆Fetal Physiology＆Anesthesia 804

Case Discussion:Postpartum Tubal Ligation 816

43.Obstetric Anesthesia 819

Case Discussion:Appendicitis in a Pregnant Woman 846

44.Pediatric Anesthesia 849

Profiles in Anesthetic Practice:Heart Rate Response to Surgical Incision in Children&John F.Ryan,MD,MEd 858

Case Discussion:Masseter Spasm＆Malignant Hyperthermia 869

45.Geriatric Anesthesia 875

Case Discussion:The Elderly Patient with a Fractured Hip 880

46.Outpatient Anesthesia&Stuart Ackerman,MD 882

Case Discussion:Monitored Anethesia Care for Eye Surgery 886

Ⅴ．SPECIAL PROBLEMS 889

47.Anesthetic Complications&Joseph T.Nitti,MD,＆Gary J.Nitti,MD 889

Profiles in Anesthetic Practice:The Seated Position——Gone Forever?&M.Jane Matjasko,MD,＆Douglas G.Martz,MD 894

Case Discussion:Unexplained Intraoperative Tachycardia＆Hypertension 909

48.Cardiopulmonary Resuscitation 912

Profiles in Anesthetic Practice:Management of the Difficult Airway by Anesthesiologists&David J.Cullen,MD,MS 914

Case Discussion:Intraoperative Hypotension＆Cardiac Arrest 925

49.Postanesthesia Care 936

Profiles in Anesthetic Practice:Routine Postoperative Suctioning:A Bad Idea&Frederic A.Berry,MD 942

Case Discussion:Fever＆Tachycardia in a Young Adult Male 947

50.Critical Care 951

Case Discussion:An Obtunded Young Woman 990

Index 993