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Perioperative Medicine for the Junior Clinician


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Table of Contents

Contributors (Online Only) Foreword xxiv Michael (Monty) Mythen Preface xxv Paul Myles Acknowledgements xxvii Abbreviations (Online Only) About the companion website xxxvii Part I Introduction 1 1 The role of the perioperative medicine physician 3 Mike Grocott 2 The role of the preadmission clinic 6 James Tomlinson 3 Consent 11 Justin Burke 4 The early postoperative round 15 Debra Devonshire and Paul Myles 5 Quality improvement and patient safety 18 Stuart Marshall 6 Intraoperative and postoperative monitoring 22 Philip Peyton 7 Drugs used for anaesthesia and sedation 28 Alex Konstantatos 8 The recovery room 33 Arvinder Grover 9 Perioperative genomics 38 Christopher Bain and Andrew Shaw Part II Preoperative risk assessment 43 10 Perioperative medication management 45 Paul Myles 11 The cardiac patient for non ]cardiac surgery 51 Howard Machlin 12 Cardiovascular risk assessment in cardiac surgery 57 Christopher Duffy 13 Preoperative cardiac testing 61 Joshua Martin and Peter Bergin 14 Airway assessment and planning 68 Pierre Bradley and Joel Symons 15 Pulmonary risk assessment 74 David Daly 16 Preoperative cardiopulmonary exercise testing 79 Chris Snowden and Serina Salins 17 Anaemia 85 Amanda Davis and Angus Wong 18 Central nervous system risk assessment 90 Richard Stark 19 Risk assessment for perioperative renal dysfunction 94 David McIlroy 20 Medical futility and end ]of ]life care 98 Mark Shulman and Matthew Richardson 21 The surgical safety checklist 102 Pedro Guio ]Aguilar and Russell Gruen Part III Perioperative investigations 107 22 Preoperative investigations (non ]cardiac surgery) 109 Arvinder Grover 23 Postoperative investigations 114 Arvinder Grover Part IV Specific medication management and prophylaxis 119 24 Thromboprophylaxis 121 Amanda Davis 25 Anticoagulants and antiplatelet agents 128 David Daly 26 Diabetes medication 136 Shane Hamblin 27 Steroid medication 144 Shane Hamblin 28 Opioids and opioid addiction 148 Meena Mittal, Nicholas Christelis and David Lindholm 29 Antibiotic prophylaxis 154 Allen Cheng 30 Antibiotic prophylaxis for endocarditis 158 Denis Spelman Part V Perioperative management of organ dysfunction and specific population groups 163 31 Coronary artery disease and coronary stents 165 Sesto Cairo 32 Hypertension 170 Steven Fowler and Terry Loughnan 33 Arrhythmias 175 Andrew Robinson 34 Pacemakers and implanted defibrillators 182 Andrew Robinson 35 Heart failure 188 Vanessa van Empel and Dion Stub 36 Aortic stenosis 193 Rishi Mehra 37 Pulmonary hypertension 198 Mark Buckland 38 Endocarditis, myocarditis and cardiomyopathy 203 Enjarn Lin 39 Acute lung injury 212 Paul Nixon and David Tuxen 40 Obstructive sleep apnoea 217 Matthew Naughton 41 Asthma 223 Alan Young 42 Chronic obstructive pulmonary disease 229 Jeremy Wrobel and Trevor Williams 43 Non ]small cell lung cancer 235 Robert Stirling 44 Gastrointestinal disease 242 Lauren Beswick and William Kemp 45 Hepatic disease 245 Lauren Beswick and William Kemp 46 Oliguria 249 Paul Myles 47 Acute kidney injury 254 Lloyd Roberts and Owen Roodenburg 48 Renal transplantation 259 Solomon Menahem 49 Diabetes mellitus 264 David Story 50 Thyroid disorders 268 Shane Hamblin 51 Parathyroid disorders 272 Shane Hamblin 52 Adrenal disorders 277 Jonathan Serpell 53 Carcinoid syndrome 281 Alexandra Evans 54 Intracranial surgery 286 Hilary Madder 55 Carotid surgery 292 Matthew Claydon 56 Epilepsy 301 Richard Stark 57 Neuromuscular disease 304 Erik Andersen and Andrew Kornberg 58 Trauma: pretheatre management 309 John Moloney 59 Traumatic brain injury 314 Winifred Burnett 60 Maxillofacial injuries 322 Joel Symons and Charles Baillieu 61 Spinal injuries (excluding cervical spine) 329 Susan Liew 62 Cervical spine injuries 337 Peter Hwang and Jin Tee 63 Chest injuries 343 Silvana Marasco 64 Abdominal injuries 349 Katherine Martin 65 Burns 354 Jamie Smart 66 Bleeding disorders 360 Paul Coughlan 67 Human immunodeficiency virus infection 366 Anna Pierce 68 Exposure to blood ]borne viruses 370 Anna Pierce 69 The patient with psychiatric illness 374 Steven Ellen and James Olver 70 Obstetric patients having non ]obstetric surgery 377 Maggie Wong 71 The elderly patient 382 Yana Sunderland 72 Allergies and anaphylaxis 386 Helen Kolawole 73 Obesity 390 Jennifer Carden 74 Goal ]directed therapy 395 Andrew Toner and Mark Hamilton 75 Fluids and electrolytes 400 David Story 76 Electrolyte abnormalities 404 Lloyd Roberts and Carlos Scheinkestel 77 Blood transfusion 410 Amanda Davis 78 Organ donation 416 Steve Philpot and Joshua Ihle Part VI Early postoperative care 421 79 Postoperative nausea and vomiting 423 Joel Symons 80 Postoperative fluid therapy 430 Dashiell Gantner 81 Ventilation strategies 435 John Botha 82 Sepsis and the inflammatory response to surgery 440 Tomas Corcoran and Kajari Roy 83 Nutritional support 445 Craig Walker 84 Postoperative surgical complications 449 Katherine Martin 85 Postoperative chest pain 453 Shane Nanayakkara and Peter Bergin 86 Postoperative shortness of breath 459 KJ Farley and Deirdre Murphy 87 Postoperative hypotension 467 Steven Fowler 88 Myocardial injury after non ]cardiac surgery 472 Fernando Botto and PJ Devereaux 89 Aspiration 476 Alan Kakos 90 Postoperative delirium and postoperative cognitive dysfunction 480 Brendan Silbert and Lisbeth Evered 91 Postoperative hyperthermia 485 Glenn Downey 92 Perioperative hypothermia 493 John Monagle and Shashikanth Manikappa Part VII Pain management 499 93 Acute pain 501 Alex Konstantatos 94 Neuropathic pain 507 Tim Hucker 95 The chronic pain patient 511 Carolyn Arnold

About the Author

Joel Symons Anaesthetist and Head of Perioperative Medicine Education, Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia Paul Myles is Director, Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia Rishi Mehra is Anaesthetist and Senior Lecturer, Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia Christine Ball is Anaesthetist and Adjunct Senior Lecturer, Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital and Monash University, Melbourne, Victoria, Australia


'Perioperative Medicine for the Junior Clinician is a succinct, high-yield entry point into perioperative health. Written primarily by Australian clinicians from a wide number of specialties and institutions, the book provides an overview of key topics in perioperative medicine. whether used as a primary text for medical students on their clinical anesthesia or surgery rotations, or for practicing clinicians as an on-the-fly reference, the book meets its proposed purpose of informing on the assessment of perioperative patient care issues and treatment....In summary, Perioperative Medicine for the Junior Clinician is a concise primer of perioperative medicine, and it provides a practical resource for many clinicians and allied health personnel who care for patients in the surgical pathway.' Anesthesia & Analgesia '...the authors have achieved their aim of delivering an easy-to-read book, covering a diverse range of relevant and interesting topics. Important themes are well covered, and practical advice given with reference to evidence based guidelines and protocols. The chapters are interesting and contain plentiful figures and images to maintain engagement. The text is well-referenced throughout ... there is sufficient breadth to stimulate interest for more senior clinicians. This book will undoubtedly be a useful starting point for any clinician involved in perioperative care.' European Journal of Anaesthesiology (EJA)

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