Morgan and Mikhail's Clinical Anesthesiology pdf

Morgan and Mikhail's Clinical Anesthesiology – Hailed as the best primer on the topic,Morgan & Mikhail's Clinical Anesthesiology has remained true to its stated goal: "to provide a concise, consistent presentation of the basic principles essential to the modern practice of anesthesia."  This trusted classic delivers comprehensive coverage of the field's must-know basic science and clinical topics in a clear, easy-to-understand presentation. At the same time it has retained its value for coursework, review, or as a clinical refresher.

This Edition has been extensively revised to reflect a greater emphasis on critical care medicine, enhanced recovery, and ultrasound in anesthesia practice.

Key features that make it easier to understand complex topics:
•Rich full-color art work combined with a modern, user-friendly design make information easy to find and remember
•Case discussions promote application of concepts in real-world clinical practice
•Boxed Key Concepts at the beginning of each chapter identify important issues and facts that underlie the specialty
•Numerous tables and figures encapsulate important information and facilitate recall
•Up-to-date discussion of all relevant areas of anesthesiology, including equipment and monitors, pharmacology,     pathophysiology, regional anesthesia, pain management, and critical care
•URLs for societies, guidelines, and practice advisories

Table of Contents

  • 1 Notice – Morgan and Mikhail's Clinical Anesthesiology
  • 2 Content
  • 3 The History of Anesthesia
    • 3.1 INHALATION ANESTHESIA
    • 3.2 Contributors – Morgan and Mikhail's Clinical Anesthesiology
  • 4 Foreword – Morgan and Mikhail's Clinical Anesthesiology
  • 5 Preface

Notice – Morgan and Mikhail's Clinical Anesthesiology

Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The authors and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the authors nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources.

For example and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. In this publication we use the terms "female" and "male" in accordance with the guidelines established by the World Health Organization. Specifically, references to female and male are based on the anatomy of the reproductive systems, which define humans as biologically female or male.

Content

The practice of anesthesiology —
Anesthetic equipment & monitors —
The operating room environment —
Breathing systems —
The anesthesia workstation —
Cardiovascular monitoring —
Noncardiovascular monitoring —
Clinical pharmacology —
Pharmacological principles —
Inhalation anesthetics —
Intravenous anesthetics —
Analgesic agents —
Neuromuscular blocking agents —
Cholinesterase inhibitors & other pharmacologic antagonists to neuromuscular blocking agents —
Anticholinergic drugs —
Adrenergic agonists & antagonists —
Hypotensive agents —
Local anesthetics —
Adjuncts to anesthesia —
Anesthetic Management —
Preoperative assessment, premedication, & perioperative documentation —
Airway management —
Cardiovascular physiology & anesthesia —
Anesthesia for patients with cardiovascular disease —
Anesthesia for cardiovascular surgery —
Respiratory physiology & anesthesia —
Anesthesia for patients with respiratory disease —
Anesthesia for thoracic surgery —
Neurophysiology & anesthesia —
Anesthesia for neurosurgery —
Anesthesia for patients with neurological & psychiatric diseases —
Anesthesia for patients with neuromuscular disease —
Kidney physiology & anesthesia —
Anesthesia for patients with kidney disease —
Anesthesia for genitourinary surgery —
Hepatic physiology & anesthesia —
Anesthresia for patients with liver disease —
Anesthesia for patients with endocrine disease —
Anesthesia for ophthalmic surgery —
Anesthesia for otolaryngology- head & neck surgery —
Anesthesia for orthopedic surgery —
Anesthesia for trauma & emergency surgery —
Maternal & fetal physiology & anesthesia —
Obstretric anesthesia —
Pediatric anesthesia —
Geriatric anesthesia —
Ambulatory & non-operating room anesthesia —
Regional anesthesia & pain management —
Spinal, epidural, & caudal blocks —
Peripheral nerve blocks —
Chronic pain management —
Enhanced recovery protocols & optimization of perioperative outcomes —
Perioperative & critical care medicine —
Management of patients with fluid & electrolyte disturbances —
Acid-base management —
Fluid management & blood component therapy —
Thermoregulation, hypothermia, & malignant hyperthermia —
Nutrition in perioperative & critical care —
Anesthetic complications —
Cardiopulminary resuscitation —
Postanesthesia care —
Common clinical concerns in critical care medicine —
Inhalation therapy & mechanical ventilation in the PACU & ICU —
Safety, quality, & performance improvement.

The History of Anesthesia

The specialty of anesthesia began in the mid-
nineteenth century and became firmly established
less than six decades ago. Ancient civilizations had
used opium poppy, coca leaves, mandrake root,

alcohol, and even phlebotomy (to the point of uncon-
sciousness) to allow surgeons to operate. Ancient
Egyptians used the combination of opium poppy
(containing morphine) and hyoscyamus (contain-
ing scopolamine); a similar combination, morphine
and scopolamine, has been used parenterally for
premedication. What passed for regional anesthesia
in ancient times consisted of compression of nerve
trunks (nerve ischemia) or the application of cold
(cryoanalgesia). The Incas may have practiced local
anesthesia as their surgeons chewed coca leaves and
applied them to operative wounds, particularly prior
to trephining for headache.

The evolution of modern surgery was hampered
not only by a poor understanding of disease pro-
cesses, anatomy, and surgical asepsis but also by the
lack of reliable and safe anesthetic techniques. These
techniques evolved first with inhalation anesthesia,
followed by local and regional anesthesia, and finally
intravenous anesthesia. The development of surgical
anesthesia is considered one of the most important
discoveries in human history.

INHALATION ANESTHESIA

Because the hypodermic needle was not invented
until 1855, the first general anesthetics were des-
tined to be inhalation agents. Diethyl ether (known
at the time as "sulfuric ether" because it was pro-
duced by a simple chemical reaction between ethyl
alcohol and sulfuric acid) was originally prepared in
1540 by Valerius Cordus. Ether was used for
frivolous purposes ("ether frolics"), but not as
an anesthetic agent in humans until 1842, when
Crawford W. Long and William E. Clark indepen-
dently used it on patients for surgery and dental
extraction, respectively. However, they did not pub-
licize their discovery. Four years later, in Boston, on
October 16, 1846, William T.G. Morton conducted
the first publicized demonstration of general anes-
thesia for surgical operation using ether. The dra-
matic success of that exhibition led the operating
surgeon to exclaim to a skeptical audience: "Gentle-
men, this is no humbug!"

Chloroform was independently prepared by
von Leibig, Guthrie, and Soubeiran in 1831.
Although first used by Holmes Coote in 1847,

Contributors – Morgan and Mikhail's Clinical Anesthesiology

Kallol Chaudhuri, MD, PhD

Professor

Department of Anesthesia

West Virginia University School of Medicine

Morgantown, West Virginia

Swapna Chaudhuri, MD, PhD

Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Lydia Conlay, MD

Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Johannes De Riese, MD

Assistant Professor

Department of Anesthesiology

Texas Tech University Health Sciences Center

Lubbock, Texas

Suzanne N. Northcutt, MD

Associate Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Aschraf N. Farag, MD

Assistant Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Pranav Shah, MD

Assistant Professor

Department of Anesthesiology

VCU School of Medicine

Richmond, Virginia

Robert Johnston, MD

Associate Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Sabry Khalil, MD

Assistant Professor – Morgan and Mikhail's Clinical Anesthesiology

Department of Anesthesiology

Texas Tech University Health Sciences Center

Lubbock, Texas

Sanford Littwin, MD

Assistant Professor

Department of Anesthesiology

St. Luke's Roosevelt Hospital Center and Columbia University College of Physicians and Surgeons

New York, New York

Alina Nicoara, MD

Associate Professor

Department of Anesthesiology

Duke University Medical Center

Durham, North Carolina

Nitin Parikh, MD

Associate Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Cooper W. Phillips, MD

Assistant Professor

Department of Anesthesiology

UT Southwestern Medical Center

Dallas, Texas -Morgan and Mikhail's Clinical Anesthesiology

Elizabeth R. Rivas, MD

Assistant Professor

Department of Anesthesiology

Texas Tech University Health Sciences Center

Lubbock, Texas

Bettina Schmitz, MD, PhD

Associate Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Christiane Vogt-Harenkamp, MD, PhD

Assistant Professor

Department of Anesthesia

Texas Tech University Health Sciences Center

Lubbock, Texas

Denise J. Wedel, MD

Professor of Anesthesiology

Mayo Clinic

Rochester, Minnesota

Foreword – Morgan and Mikhail's Clinical Anesthesiology

When a new residency training program in anesthesia was beginning in Rwanda in 2006, we were looking for a suitable textbook to recommend to the trainees. We chose Clinical Anesthesiology by Morgan and Mikhail. I am happy to state that today, 12 years later, the residents are still making the same choice. Over one third of all copies of the last edition were sold outside of North America thus underlining the popularity of this textbook around the world. Morgan and Mikhail's Clinical Anesthesiology

A major change in editors and authors occurred with the 5th edition and it is clear that they stayed true to the ideals of the original editors. Now in 2018, the 6th edition is presented to us. The text continues to be simple, concise, and easily readable. The use of Key Concepts at the beginning of each chapter is very useful and focuses the reader's attention on the important points. The authors have worked hard not to increase the size of the book but to update the material. Expanded chapters on critical care, on enhanced recovery after anesthesia, and on the use of ultrasound will be very useful to readers. This textbook continues to provide a comprehensive introduction to the art and science of anesthesia.

Congratulations to the authors and editors on their fine work.

Preface

My, how time flies! Can half a decade already have passed since we last edited this textbook? Yet, the time has passed and our field has undergone many changes. We are grateful to the readers of the fifth edition of our textbook. The widespread use of this work have ensured that the time and effort required to produce a sixth edition are justified. Morgan and Mikhail's Clinical Anesthesiology

As was true for the fifth edition, the sixth edition represents a significant revision. A few examples are worth noting:

  • Those familiar with the sequence and grouping of content in the fifth edition will notice that chapters have been reordered and content broken out or consolidated to improve the flow of information and eliminate redundancy.
  • The alert reader will note that the section oncritical care medicine has been expanded, reflecting the increasing number of very sick patients for whom we care.
  • Enhanced recovery after surgery has progressed from an important concept to a commonly used acronym (ERAS), a specialty society, and (soon) standard of care.
  • Ultrasound has never been more important in anesthesia practice, and its use in various procedures is emphasized throughout the textbook.

Some things remain unchanged: Morgan and Mikhail's Clinical Anesthesiology

  • We have not burdened our readers with large numbers of unnecessaryreferences. We hope that long lists of references at the end of textbook chapters will soon go the way of the library card catalog and long-distance telephone charges. We assume that our readers are as fond of (and likely as facile with) Google Scholar and PubMed as are we, and can generate their own lists of references whenever they like. We continue to provide URLs for societies, guidelines, and practice advisories.
  • We continue to emphasizeKey Concepts at the beginning of each chapter that link to the chapter discussion, andcase discussions at the end.
  • We have tried to provideillustrations and images whenever they improve the flow and understanding of the text .

Once again, the goal expressed in the first edition remains unchanged: "to provide a concise, consistent presentation of the basic principles essential to the modern practice of anesthesia." And, once again, despite our best intentions, we fear that errors will be found in our text. We are grateful to the many readers who helped improve the last edition. Please email us at[email protected] when you find errors. This enables us to make corrections in reprints and future editions.

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