Front Matter| Volume 38, Pxiii-xviii, December 2020


        Associate Editors vii
        Contributors ix

        Preface xix

        Laurence C. Torsher, Richard P. Dutton, Thomas M. McLoughlin Jr, and Francis V. Salinas

        The Meaning of Consent and Its Implications for Anesthesiologists 1

        Elizabeth H. Wilson and Christopher M. Burkle
         Introduction 1
         History of informed consent 2
         Discussion 4
        Elements of informed consent 4
        Type and amount of information to be provided 6
        Separate anesthesia informed consent 6
        Written versus verbal informed consent 7
        Patient do-not-resuscitate orders and informed consent during the perioperative period 7
        Informed consent in unique anesthesia practice settings 8
         Summary 17
        Disclosure 18

        Anesthetic Choices for Intrapartum Cesarean Delivery in Patients with Epidural Labor Analgesia 23

        Unyime Ituk and Cynthia A. Wong
         Introduction 23
         Epidural anesthesia: conversion from epidural labor analgesia 24
        Choice of local anesthetic agents for extension of epidural labor analgesia to surgical anesthesia 26
        Analgesic adjuvants for epidural anesthesia 28
        Predictors of failure to extend epidural labor analgesia for cesarean delivery 29
        Management of failed epidural anesthesia 29
        Practical tips for converting epidural labor analgesia to surgical anesthesia 32
         General anesthesia for intrapartum cesarean delivery 36
         Spinal or combined spinal-epidural for intrapartum cesarean delivery 37
         Summary 37
        Disclosure 38

        Foundations for Success in the Transition to Private Practice 41

        Richard P. Dutton and Robert Koehler
         Introduction 41
         Knowledge 42
        How the work is done 42
        Where the money comes from 44
        How you will get paid, and why it matters 46
        What local knowledge do I need? 48
         Intangibles 54
        What is different on day 1? 54
        All settled now; how do I get involved? 56
        What if I still want to teach or do research? 58
        What if I get it wrong? 59
         Summary 60
        Disclosure 60

        Anesthetic Considerations for Endovascular Neurologic, Vascular, and Cardiac Procedures 63

        Kamilla Esfahani, Brittany A. Bunker, Scott J. Heller, Edward G. O’Connor, Susan M. Walters, and Amanda M. Kleiman
         General endovascular procedural considerations 63
        Anticoagulation 64
        Contrast 64
        Positioning 64
        Anesthetic considerations 65
         Neurologic endovascular procedures 65
        Preoperative assessment 65
         Endovascular vascular procedures 72
        Preoperative assessment 72
         Endovascular cardiac procedures 80
        Preoperative assessment 80
         Summary 91
        Disclosure 91
        Conflicts of interest 91

        Update on Ketamine 97

        Jon Y. Zhou, Perry Hamilton, Stephen Macres, Matthew Peña, and Schirin Tang
         Introduction 97
         Pharmacology and mechanisms of action 98
        Pharmacokinetics 99
        Pharmacodynamics 99
         Ketamine and acute perioperative pain management 100
        Dosing 100
        Patient selection/indications 101
        Contraindications/adverse effects 101
        Monitoring/supervision guidelines 102
        Emergency room use of ketamine 102
         Ketamine for chronic pain 103
        ketamine 103
        Oral ketamine 104
        Intranasal ketamine 104
        Transdermal ketamine 104
         Ketamine and sedation 105
         Ketamine and major depressive disorder 107
         Abuse potential and regulations 110
         Summary 110
        Disclosure 110

        Whole Blood in Modern Anesthesia Practice 115

        Christopher T. Stephens, Johanna B. de Haan, Srikar Jonna, and Srikanth Sridhar
         Military whole-blood experience 116
         US civilian trauma center experience 117
         Prehospital whole-blood experience 118
         Obstetric whole-blood experience 119
         Whole blood in other clinical settings 120
         Considerations with whole-blood use 121
         Immunologic concerns 122
         ABO typing and compatibility 123
         Hemolysis and surveillance after whole blood administration 123
         Rh incompatibility 124
         Circulatory overload 126
         Summary and future directions 126
         Care points 127
        Disclosure 127

        The Anesthesiologist’s Role in Teaching Airway Management to Nonanesthesiologists: Who, Where, and How 131

        Thomas E. Grissom and Ron E. Samet
         Introduction 131
         What does it mean to be proficient in airway management? 133
         Where should this take place and who should be teaching? 141
         Do you need to teach direct laryngoscopy, video laryngoscopy, or both? 145
         What is the role of simulation? 145
         What is on the horizon for airway management training? 148
         Summary 150
         Care Points 151
        Disclosure 151

        The Effect of Analgesia and Anesthesia on Postpartum Depression 157

        Philip Heesen, Sharon Orbach-Zinger, Sophie Grigoriadis, Stephen Halpern, and Leonid A. Eidelman
         Introduction 157
        Definition and diagnosis 158
        Neuraxial analgesia and postpartum depression 160
        Screening 162
         Summary 162
        Disclosure 163

        Cannabinoids-based Medicine Pharmacology, Drug Interactions, and Perioperative Management of Surgical Patients 167

        Samer Narouze, Natalie Strand, and Priodarshi Roychoudhury
         Introduction 168
         Cannabis and cannabinoids 168
        Δ9-Tetrahydrocannabinol 168
        Cannabidiol 171
         Perioperative management of patients on cannabinoids 173
        Physiologic effects of cannabis 173
        Cannabis products and route of administration 175
        Cannabis drug interactions 176
        Specific considerations for perioperative management 176
        Cannabis intoxication 180
        Cannabis intoxication delirium 181
        Acute neurocognitive impairment 181

        Motor-Sparing Peripheral Nerve Blocks for Shoulder, Knee, and Hip Surgery 189

        Sebastián Layera, Mohammed Saadawi, De Q. Tran, and Francis V. Salinas
         Introduction 190
         Diaphragm-sparing nerve blocks for shoulder surgery 191
        Sensory innervation of the shoulder joint and overlying cutaneous area 191
        Strategies to minimize hemidiaphragmatic paresis after interscalene brachial plexus block 191
        C7 nerve root block 192
        Supraclavicular brachial plexus approach 192
        Upper (superior) trunk block 192
        Suprascapular nerve block 193
        Costoclavicular brachial plexus block approach 195
        Summary of hemidiaphragmatic paresis-sparing strategies for shoulder surgery 195
         Motor-sparing nerve blocks for total knee replacement 196
        Introduction and sensory innervation of the knee 196
        Topographic distribution of the peripheral nerves supplying the anteromedial knee 196
        Femoral triangle block versus adductor canal block 197
        Femoral triangle block versus placebo 197
        Femoral triangle block versus periarticular local anesthetic infiltration analgesia 198
        Combined femoral triangle block with local anesthetic infiltration analgesia versus local anesthetic infiltration analgesia alone 199
        Single-injection versus continuous femoral triangle block 199
        Summary of anatomic and clinical evidence of femoral triangle blocks and adductor canal blocks 199
        Obturator nerve block 200
        Infiltration between the popliteal artery and the capsule of the posterior knee block 200
        Popliteal plexus block 201
        Summary of evidence for obturator nerve, infiltration between the popliteal artery and the capsule of the posterior knee, and popliteal plexus blocks 201
         Motor-sparing nerve blocks for hip surgery 202
        Summary 202

        Emergency Anesthesia in Resource-Limited Areas 209

        Seung Lee, Azuka Onye, and Asad Latif
         Introduction 209
         General considerations for working in resource-limited areas 210
        Overall Considerations and Constraints in Resource-Limited Areas 210
        Disaster Relief Efforts in Resource-Limited Areas 213
        Role of the Anesthesia Provider Outside the Operating Room 214
         Anesthetic technique and perioperative care 215
        Preoperative Considerations in Emergency Anesthesia 215
        Intraoperative Considerations in Emergency Anesthesia 217
        Anesthetic Plan 219
        Postoperative Considerations in Emergency Anesthesia 223
         Summary 224
        Disclosure 225

        Anesthesia for Obstetric Disasters 229

        Kristen L. Fardelmann and Aymen Awad Alian
         Maternal mortality 229
         Cardiac arrest in pregnancy 230
         Obstetric complications 231
        Obstetric Hemorrhage 231
        Amniotic Fluid Embolism/Anaphylactoid Syndrome of Pregnancy 236
        Hypertensive Emergency in Pregnancy 237
        HELLP Syndrome 241
         Anesthesia complications 242
        High Neuraxial Anesthesia Blockade 242
        Local Anesthetic Systemic Toxicity 244
        Difficult Airway 244
        Disclosure 247

        Anesthesia for the Patient with Severe Liver Failure 251

        Aidan Spring, Jagroop S. Saran, Sinead McCarthy, and Stuart A. McCluskey
         Introduction 251
         Cause of liver disease 253
         Risk stratification 254
         Assessment and investigations 255
         Preoptimization 257
         Intraoperative management 258
        Monitoring 258
        Anesthetic Medications 258
        Sedative-Hypnotics 258
        Analgesics 259
        Neuromuscular Blockade 259
        Volatile Anesthetics 259
        Coagulation 259
        Postoperative Analgesia 259
         Considerations for specific procedures 260
        Cardiac Surgery 260
         Trauma 261
         Anesthesia for transhepatic portosystemic shunt and minor procedures 262
         Abdominal surgery 262
        Conflicts of Interest 263

        The Future Directions of Research in Cardiac Anesthesiology 269

        Jessica Spence and C. David Mazer
         Knowledge gaps that need to be addressed 270
        Mitigating the Inflammatory Effects of Cardiopulmonary Bypass 270
        Diagnosis and Management of Perioperative Myocardial Infarction after Cardiac Surgery 271
        Neurologic Outcomes of Cardiac Surgery 272
        Transfusion Strategies in Cardiac Surgery 274
        Optimizing the Long-Term Outcomes of Patients after Valve Surgery 274
         New approaches to research in cardiac anesthesia 275
        Novel Analytical Techniques 276
        Pragmatic Trials 277
        Adaptive Trial Designs 279
         Summary 280
        Acknowledgments 280