Awareness During Anesthesia

* First comprehensive source on facts about consciousness while under anesthesia * Includes a detailed pharmacology of drugs * Details techniques for detection and prevention. * Author is leading expert in field

Hypnosis, amnesia, and immobility are three major therapeutic endpoints of general anesthesia. In one to two cases out of a thousand, hypnosis and amnesia are not achieved – often leaving a patient immobile but capable of experiencing and remembering intraoperative events. Awareness during general anesthesia is one of the most dreaded complications of surgery and is feared by patients and clinicians alike. Despite many advances in the field, there are also a number of unresolved questions that persist. Some of the difficulties in the detection and prevention of awareness during anesthesia relate to the underlying complexities of the neuroscientific basis of consciousness. Consciousness, Awareness, and Anesthesia is a multidisciplinary approach to both the scientific problem of consciousness and the clinical problem of awareness during general anesthesia. An international cadre of authors with expertise in anesthesiology, neurobiology, and philosophy provides a cutting-edge perspective. No other book on the subject has drawn from such a breadth of scholarship.

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

Winner, 2017 Mark and Evette Moran Nib Literary Award You know how it is when you go under. The jab, the countdown, the— —and then you wake. This book is about what happens in between. Until a hundred and seventy years ago many people chose death over the ordeal of surgery. Now hundreds of thousands undergo operations every day. Anaesthesia has made it possible. But how much do we really know about what happens to us on the operating table? Can we hear what’s going on around us? Is pain still pain if we are not awake to feel it, or don’t remember it afterwards? How does the unconscious mind deal with the body’s experience of being cut open and ransacked? And how can we help ourselves through it? Haunting, lyrical, sometimes shattering, Anaesthesia leavens science with personal experience to bring an intensely human curiosity to the unknowable realm beyond consciousness. What really happens to us when we are anaesthetised? By this I mean not what happens to the pinging, crackling apparatus of our nerves and spinal cords and brains, but what happens to us—to the person who is me or the person who is you—as doctors go about the messy business of slicing and delving within us? Kate Cole-Adams is a Melbourne writer and journalist. Her non-fiction work Anaesthesia won the Mark and Evette Moran Nib Literary Award, 2017 and the 2017 Australian and New Zealand College of Anaesthetists Media Award. It was shortlisted for the Victorian Premier’s Literary Award for Non-fiction, 2017. Her novel Walking to the Moon is also published by Text. ‘Anaesthesia is mesmerising...This rich and thorough study looks more deeply into questions about the nature of consciousness than many of us who undergo an anaesthetic are likely, or willing, to ponder.’ Australian Book Review ‘A work of splendid richness and depth, driven by a curiosity so intense that it hazards at times the extreme boundaries of the sayable.’ Helen Garner ‘Kate Cole-Adams has been fascinated with our funny non-being during surgery for a long time, and Anaesthesia feels like a book that’s taken over a decade to write, which it is. It also feels like you’re having a decade’s worth of conversations with a dogged, but generous and resourceful thinker, with someone (she is both a journalist and a novelist) who can crack open a complex idea, and then run with it.’ Readings 'An obsessive, mystical, terrifying, and even phantasmagorical exploration of anesthesia’s shadowy terra incognita.’ The New Yorker 'Remarkable in its attention to historical detail and quality of the primary sources...practising anaesthetists should read what has become the single best account of our profession’s most philosophically fragile constructs—consciousness and self... Cole-Adams has distilled and articulated the art of our profession.’ Anaesthesia Intensive Care journal (published by Australian Society of Anaesthetists) ‘Extraordinarily well-researched and delicately structured, this is a book with few parallels. Exceptional writing illuminates a topic that affects most of us, but that few of us understand.’ Judges’ Report, Victorian Premier’s Literary Awards, 2018 ‘Comfortably numb. A close-up look at anaesthesia is equal parts social history, popular science and report on experience.’ NZ Listener ‘Anaesthesia is not just an account of medical research but a poetic exploration of the mysteries of the human mind.’ Australian ‘Should be compulsory reading for all anaesthetists, others responsible for the care of surgical patients, and medical students who wish to achieve a true perspective of today’s anaesthesia.’ medicSA ‘Cole-Adams’s prose is sinuous, at times intoxicating, and witty.’ Sydney Morning Herald ‘A troubling, anxious subject that most of us would rather avoid or deflect with dark humour. Cole-Adams has illuminated it in a memorable way. The book is a gift not of oblivion but of awareness.’ Inside Story ‘For the interested reader, it’s an outline of the science, with an emphasis on the unknown. For the practitioner, it’s a patient experience, eloquently expressed. There’s much more the anaesthesia than meets the eye, and this book provides a glimpse into the depths.’ Conversation ‘A fascinating mix of historical background, moving—sometimes shocking—surgical stories, interviews with experts and case studies. Surprisingly, it seems relatively little is really known about exactly how effective and affective anaesthetic is. Despite that, I found this book an oddly reassuring study.’ North and South NZ ‘Kate Cole-Adams has written a book that defies familiar categories. It is a personal memoir, a history, a scientific study, and a philosophical enquiry into the unconscious, and by drawing all these strands together the author has delivered a masterpiece.’ Jamie Grant, head judge, Waverley Council Nib Literary Awards ‘This is a surprising delight of a book about the invention and use of anaesthetics, but it is also about the concept of consciousness. It is a book about the fear of death, the fear of a lack of control, the fear of an imminent operation, the way a life can be plagued by a general feeling of anxiety and how dreams play a part in this.’ Krissy Kneen, Feminist Writers Festival, Favourite Reads of 2017 ‘Kate Cole-Adams’s Anaesthesia propelled me towards new ways of thinking about thinking itself: experience and consciousness and how we make in and make up this world.’ Ashley Hay, Australian, Books of the Year 2017

A practical, symptom-based approach to identifying and managing the common and uncommon post-operative complications encountered in the surgical patient.

This book provides easy to follow guidance on how to manage emergency situations and common problems in obstetric anesthesia. The book provides different anesthetic recipes for obstetric procedures and describes challenges that will be encountered on a day-to-day basis. There are trouble-shooting chapters and ‘what to do lists’ for frequent dilemmas. The book covers obstetric-specific resuscitation and medical emergencies seen on the labor ward. Antenatal and postpartum complications relating to anesthesia are covered as well as issues that may arise during follow up of patients who have had neuraxial anesthesia during delivery. Quick Hits in Obstetric Anesthesia should be used as a cognitive aid for emergency cases and as a decision-making tool for urgent management plans. It is a guide to common problems and provides core knowledge to facilitate anesthesia care on labor wards for all grades of anesthetist.

In recent years our understanding of molecular mechanisms of drug action and interindividual variability in drug response has grown enormously. Meanwhile, the practice of anesthesiology has expanded to the preoperative environment and numerous locations outside the OR. Anesthetic Pharmacology: Basic Principles and Clinical Practice, 2nd edition, is an outstanding therapeutic resource in anesthesia and critical care: Section 1 introduces the principles of drug action, Section 2 presents the molecular, cellular and integrated physiology of the target organ/functional system and Section 3 reviews the pharmacology and toxicology of anesthetic drugs. The new Section 4, Therapeutics of Clinical Practice, provides integrated and comparative pharmacology and the practical application of drugs in daily clinical practice. Edited by three highly acclaimed academic anesthetic pharmacologists, with contributions from an international team of experts, and illustrated in full colour, this is a sophisticated, user-friendly resource for all practitioners providing care in the perioperative period.

This book explores several aspects of the research in the field of general anesthesia, including mechanisms of action of inhaled and intravenous hypnotic agents; the anesthetics-induced neurotoxicity in children and elderly; features and physiopathology of postoperative cognitive side effects; and findings from preclinical research focused on the recognition of potential links between anesthetics and cancer cell biology. Furthermore, chapters in this book cover technical topics such as preoperative monitoring of autonomic nervous activity; EEG based monitoring of general anesthesia; monitoring cerebral oximetry by near infrared spectroscopy; pharmacological issues of anesthesia interest; and optimization of perioperative course through the latest techniques such as the opioid-free anesthesia. Finally, this book offers a comprehensive and up-to-date discussion on the phenomenon of general anesthesia awareness and its potential psychological sequelae. In Neuromethods series style, chapters include the kind of detail and key advice from the specialists needed to get successful results in your laboratory. Cutting-edge and comprehensive, General Anesthesia Research is a valuable resource for novice and expert anesthesiologists who want to learn more about the important advances made in this developing field.