Vascular Anesthesia

"This important manuscript reviews basic vascular anatomy and physiology. The vascular system is part of the cardiovascular system, which maintains blood supply to all organs and tissues to upkeep the human metabolic activities. Vascular system has three components: artery, vein, and capillaries where oxygen, nutrients and metabolites exchange. Vascular wall biology has been a very hot topic for the last decades since it is involved in numerous physiological and pathological processes, yet many aspects remain unknown. There are three layers in the vascular wall: Tunica intima, Tunica media and Tunica adventitia. Adventitia has mainly collagenous and elastic fibers, and its physiological function was mostly unknown till recently it is believed to be involved in the pathogenesis of atherosclerosis. The vascular tone can be altered by neurohumoral and other factors. The brain and the heart and other vital organs have the capability to regulate their blood flow via a phenomenon called "autoregulation", which maintains relatively constant blood flow to vital organs over a wide range of perfusion pressure"--

This comprehensive text delivers cutting-edge scientific knowledge and expert clinical guidance on anesthesia for the vascular surgical patient or the patient with cardiac disease undergoing major noncardiac surgery. It covers cardiovascular anatomy, physiology, and pharmacology; preoperative assessment and management, specific perioperative considerations, and postoperative management. This 2nd Edition features eight completely rewritten chapters and six new chapters. Extensive updates throughout reflect all the new procedures, drugs, techniques, and monitoring modalities that have emerged over the last decade. Delivers cutting-edge scientific knowledge that serves as a basis for clinical practice. Provides comprehensive coverage of anesthesia, including cardiovascular anatomy, physiology, and pharmacology preoperative assessment and management specific perioperative considerations and postoperative management. Integrates recent developments from the fields of anesthesiology, cardiology, cardiovascular pharmacology, vascular surgery, and critical care medicine to present a complete clinical picture Offers fresh perspectives from many new contributors who are leaders in their fields. Explores all the new procedures, drugs, techniques, and monitoring modalities that have emerged over the last decade. Devotes more coverage to regional anesthesia or combined regional and general anesthesia for modification of stress responses, improved pain control, better wound healing, and control of inflammatory/immunomodulatory changes associated with surgery. Places increased emphasis on the physiology, diseases, and surgery of the peripheral vasculature throughout, including a new chapter on The Peripheral Circulation in Patients with Vascular Disease (Chapter 1). Includes a new chapter on Imaging of the Vasculature(Chapter 2), that is completely up to date and easy to read. Covers anesthesia and perioperative care for all of the latest procedures, including new information on minimally invasive techniques and new chapters on Interventional Vascular Radiologic Procedures (Chapter 4) and Choice of Invasive vs. Noninvasive Surgery (Chapter 7). Features expanded material on postoperative care, especially on new techniques for pain management, and includes new chapters on Respiratory Complications and Management (Chapter 18) and Ethical Decisions/End of Life Care in Patients with Vascular Disease (Chapter 20).

Introducing the first text to integrate cardiac, thoracic and vascular anesthesia in one accessible resource. This comprehensive text provides a solid foundation of general principles, including preoperative assessment, cost-benefit effectiveness of preoperative workup, cardiac and pulmonary anatomy and physiology, as well as organ system effects of anesthetics. Expert contributors offer a clinical approach to a special section on postoperative considerations and focus on postoperative management. Also features helpful algorithms for decision making.

Vascular surgery and anaesthesia have changed considerably in recent years and become recognised subspecialties, although non-specialist anaesthetists continue to provide much of the care for emergency vascular surgical patients. Core Topics in Vascular Anaesthesia brings together the clinical expertise of global leaders in the field in a comprehensive review of contemporary practice. Detailed discussion is included on every aspect of clinical management: • Preoperative risk assessment, including cardiopulmonary exercise testing and risk modification using pharmacological and cardiac interventions • Anaesthesia for major vascular operations including carotid endarterectomy, complex endovascular aortic surgery and repair of ruptured aortic aneurysms • Intraoperative management of high risk patients including advanced monitoring techniques, fluid management, blood conservation and transfusion, major haemorrhage and treatment of coagulopathy Practical and well illustrated, Core Topics in Vascular Anaesthesia is essential reading for anaesthetists, intensive care physicians and vascular surgeons.

As the practice of vascular anesthesia becomes increasingly recognized as a major subspecialty of anesthesia, there is a growing need among current practitioners to evolve their neuraxial, regional, and general anesthesia techniques and expand their understanding of the latest evidence. Vascular Anesthesia Procedures will review the essential topics of the field from vascular anatomy to common vascular procedures, anesthetic techniques in general and regional anesthesia, complications, perioperative patient monitoring, and post-operative management. Chapters are concise, up-to-date, evidence-based, and richly illustrated throughout.

Thirteen chapters by anesthesiologists and other doctors discuss cardiac physiology, cardiovascular monitoring, drugs, pacemakers and other devices, cardiopulmonary bypass, ischemic heart disease, valvular heart disease, congenital heart disease, off-pump cardiac surgery, noncardiac surgery, less common diseases, thoracic aortic disease, and vascular surgery. Approximately 100 illustrations, as well as many case studies, support the major points. Annotation : 2004 Book News, Inc., Portland, OR (booknews.com).

In this issue of Anesthesiology Clinics, guest editors Drs. Megan P. Kostibas and Heather K. Hayanga bring their considerable expertise to the topic of Vascular Anesthesia. Top experts in the field cover key topics such arterial hemodynamics and ischemia-reperfusion; preoperative evaluation and cardiac risk assessment; complications of vascular disease; coagulopathy and anticoagulant management: drugs, antiplatelets agents, and thrombolytic agents; and more. Contains 16 relevant, practice-oriented topics including cardiovascular monitoring; abdominal aortic arterial aneurysms; aortic dissection; anesthetic management of open surgical treatment for aneurysms; the unstable carotid plaque; acute limb ischemia; regional anesthesia for vascular surgery and pain management; and more. Provides in-depth clinical reviews on current topics in vascular anesthesia, offering actionable insights for clinical practice. Presents the latest information on this timely, focused topic under the leadership of experienced editors in the field. Authors synthesize and distill the latest research and practice guidelines to create clinically significant, topic-based reviews.

Theodore H. Stanley. M. D. W. Clayton Petty. M. D. Anesthesia. the Heart and the Vascular System contains the Refresher Course manuscripts of the presentations of the 32nd Annual Postgraduate Course in Anesthesiology which took place at the Westin Hotel Utah Convention Center in Salt Lake City. Utah. February 20-24. 1987. The chapters reflect new data and concepts within the general framework of "risk. preoperative evaluation and monitoring. " "cerebral. pulmonary and peripheral vascular disease. " "new agents. their advantages and their problems" and "pediatric. cardiac and non-cardiac surgery. " The purposes of the textbook are to 1) act as a reference for the anesthesiologists attending the meeting. and 2) serve as a vehicle to bring many of the latest concepts in anesthesiology to others within a short time of the formal presentation. Each chapter is a brief but sharply focused glimpse of the interests in anesthesia expressed at the conference. This book and its chapters should not be considered complete treatises on the sub jects addressed but rather attempts to summarize the most salient points. This textbook is the fifth in a continuing series documenting the pro ceedings of the Postgraduate Course in Salt Lake City. We hope that this and the past and future volumes reflect the rapid and continuing evolution of anesthesiology in the late twentieth century. YO TABLE OF CONTENTS Diabetes: Preoperative Evaluation and Intraoperative Management Simon de Lange, M. D. , Ph. D.