Contents

List of Contributors

Foreword

CHAPTER 1: The Physics of Ultrasound

Sound energy

Generation of the ultrasound wave

Refinements in transducer production

The frequency, wavelength and speed of sound waves

Frequency

Wavelength

Speed

The image

Reduced and distorted images

The probe

Terminology of modes

Doppler shift

The safety of ultrasound

CHAPTER 2: Coronary Artery Stents: Management in Patients Undergoing Noncardiac Surgery

Percutaneous coronary interventions

Radial or femoral access

Antiplatelet and anticoagulant therapy

Coronary artery stenting and noncardiac surgery

Management of complications in patients with stents

Adjunct technology and future developments in coronary stenting

Aspirin and clopidogrel resistance

Conclusions

CHAPTER 3: Anaesthesia and Enhanced Recovery for Colorectal Surgery

Preoperative preparation

Admission

Intraoperative components of ERAS

Postoperative components of ERAS

Discharge

Audit and outcome measurement

Quality Innovation Productivity and Prevention agenda

Summary

CHAPTER 4: The Unanticipated Difficult Airway: The ‘Can’t Intubate, Can’t Ventilate’ Scenario

Why does this scenario occur?

Avoiding the CICV situation

Cricothyroidotomy

Wide bore or narrow bore cannula?

Complications of cricothyroidotomy

Training in cricothyroidotomy

CHAPTER 5: Analgesia for Abdominal Surgery

Epidural analgesia

Spinal anaesthesia

Rectus sheath block

Transversus abdominis plane block

Ilioinguinal and iliohypogastric blocks

Paravertebral block

Summary

CHAPTER 6: Analgesic Regimens for Children

Pain perception

Designing analgesic regimens

Analgesic drugs and techniques

Chronic pain

Postoperative nausea and vomiting (PONV)

CHAPTER 7: The Unstable Cervical Spine

The provision and maintenance of a reliable, patent airway is paramount

Maintenance of spinal cord perfusion is a priority

Airway techniques that minimally displace the alignment of the vertebrae should be used

Normal cervical spine anatomy

Definition of instability

Neurological consequences of instability

Causes of cervical instability

Diagnosis

Conservative management

Surgical management

Anaesthetic management

Airway management

Spinal cord perfusion

CHAPTER 8: Obstetric Haemorrhage

Epidemiology

Antepartum haemorrhage: causes

Postpartum haemorrhage: causes

Major haemorrhage: immediate management

Management in theatre

Options for haemostasis: avoidance of hysterectomy

Emergency anaesthesia

Elective caesarean section: anticipated major haemorrhage

Anaphylactoid syndrome of pregnancy

Cardiac arrest

CHAPTER 9: Anaesthesia for Patients Undergoing Hip Fracture Surgery

Demographics

Preoperative management

The timing of surgery

Intraoperative anaesthetic care

Postoperative care

CHAPTER 10: e-Learning Anaesthesia

The rationale behind e-Learning Anaesthesia

The e-Learning Anaesthesia project

Summary

CHAPTER 11: Consent and the Explanation of Risk in Anaesthesia

Common law of consent

Competence

Patients who lack competence

Children

Teaching, learning and maintaining skills

Research

Data protection

Needlestick injuries

Problems with consent