The seventh volume in the Anesthesiology Problem-Based Learning Approach series, Perioperative Medicine provides an up-to-date and comprehensive review of the perioperative medicine specialty.
In recent years anesthesiologists have developed a more active role in the entire peri-operative period-from the decision for surgery, through recovery, discharge and beyond. In addition, the core training curriculum of anesthesiology has changed significantly to now include many non-operating room anesthesia rotations.General anesthesiology texts include varying degrees of perioperative management information, and a few titles are devoted specifically to the area. However, none combines a problem-based approach with review questions and answers with explanations.
Following the format of the Anesthesiology Problem-Based Learning Approach series, each chapter in Perioperative Medicine describes a specific condition or situation and a virtual case presented through a series of questions and answers. With 48 chapters covering a broad array of conundrums encountered in clinical perioperative medicine, the text focuses on preoperative optimization of patients with different comorbidities, such as coronary artery disease, heart failure, chronic obstructive pulmonary disease, obstructive sleep apnea, diabetes mellitus, cirrhosis, substance use disorder, and anemia. Sections on how to choose preoperative tests, medication management, and handling ethical issues, like informed consent, DNR, and uncomfortable conversations with patients, are discussed in detail.
Perioperative Medicine: A Problem-Based Learning Approach provides an up-to-date compendium of topics commonly presenting in daily practice and serves as a unique learning opportunity for the busy perioperative clinician approaching a new case and for clinicians in training who need to learn the basics.
PART I PREOPERATIVE ASSESSMENT
1: Maureen Keshock and Kenneth Cummings: Preoperative Process: Phone Triage,
Preoperative Clinic, or Virtual Patient Visits
2: Eileen Campbell and Janine Limoncelli: Perioperative Surgical Home Care
Model: Utopia or Bureaucracy?
3: Jay S. Kersh and BobbieJean Sweitzer: Choosing Wisely: How to Advise the
Patient on Preoperative Testing
4: Barbara Rogers and Wiebke Ackermann: My 79-Year-Old Patient for Right
Inguinal Hernia Repair Has No Labs on File
5: Julio Montejano and Angela Selzer: Medication Management: Drug-Eluting
Stent 2 Months Ago
6: Thomas Hickey and Shafik Boyaji: Perioperative Management of Medications
for Substance Use Disorders
7: Deborah C. Richman: Indications for Preoperative C-Spine Imaging for
Elective Procedures
8: Olivia Belloni, Rashwan Gogue, Luigi Beretta, and Enrico Maria Minnella:
Prehabilitation Before Total Hip Replacement
9: Paris Dove, Emily Traer, Hilmy Ismail, and Bernhard Riedel:
Cardiopulmonary Exercise Testing
PART II AGE
10: Joseph P. Resti and Bettina Smallman: Ex-Premie for Interval Hernia
Repair at 11 Weeks
11: Kaitlin Willham and Heather E. Nye: Geriatric Assessment: "The Get Up and
Go, Got Up and Left"
PART III ORGAN SYSTEMS
12: Samuel Papke, Michael Benson, and Joshua Zimmerman: AHA Guidelines
Application
13: Jing Tao and Adriana D. Oprea: Perioperative Atrial Fibrillation and
Anticoagulation Management
14: Elvera L. Baron and Menachem M. Weiner: Severe Aortic Stenosis: Candidate
for a Surgicenter?
15: Michael Curtis, Nathaen Weitzel, and Miklos D. Kertai: Does Your Cataract
Surgeon Know You Were Admitted for Heart Failure Last Week?
16: Debra D. Pulley and Anand Lakshminarasimhachar: Echo Shows Elevated
Pulmonary Artery Pressure
17: Caroline R. Gross and Zdravka Zafirova: Shoulder Replacement in Patient
Who Had a Heart and Lung Transplant
18: Wesley Rajaleelan and Jean Wong: COPD: Still Smoking, Still Wheezing
19: Sean Love, Chelsey Santino, and Tina Tran: Severe OSA in the Ambulatory
Setting
20: Robert Fong: COVID-19
21: Sofia S. Jakab and Adriana D. Oprea: Cirrhosis and Truly Elective Major
Surgery
22: Ramanjot S. Kang, Ashley Mathew, and Shirley Avraham: Patient Has
Seizures and Needs "Clearance"
23: Samuel N. Blacker: Clinical Application of Perioperative Brain Health
24: Shilpa Rao: Restrictive Lung Disease from Parkinson's Disease Rigidity:
Is It Real?
25: Debra D. Pulley: A 56-Year-Old with a Recent CVA for Elective Surgery:
How Soon Is Too Soon? 291
26: Emily Y. Xue, David Moore, and Alexander F. Arriaga: Avoiding
Exacerbation of Chronic Kidney Disease
27: Kenneth Cummings: Preoperative Anemia Management: Evaluation and
Treatment
28: Nicole Verdecchia and Khoa Nguyen: Prolonged PTT in a Healthy Patient
29: Lindsay E. Carafone, Colin E. Bauer, Joshua D. Miller, and Steven D.
Wittlin: Elevated Glucose on Admission Fingerstick: How High Can We Go?
30: Zyad J. Carr, Andrea Farela, and Adriana D. Oprea: Pheochromocytoma and
MEN Syndromes
PART IV WOMEN'S HEALTH
31: Nayema K. Salimi and Kristen L. Fardelmann: Pregnant Patient for
Non-Obstetric Surgery
32: Evan Jin, Sangeeta Kumaraswami, and Garret Weber: Older Primigravida with
Twin Pregnancy for Elective Cesarean Delivery
PART V SURGICAL CONSIDERATIONS
33: Lesley Bennici, Morgane Factor, Sunitha Singh, and Ana Costa: Minimally
Invasive Surgery and Other Elements of Enhanced Recovery Protocols
34: Seth Perelman and Christian Mabry: Blood Conservation
PART VI ETHICS AND SHARED DECISION-MAKING
35: Joseph F. Kras: When DNR Stands in the OR: Who Benefits? Who Decides?
36: Stephen Harden and Nicholas Sadovnikoff: Informed Consent: Do We Really
Do This Correctly?
37: Jeanna D. Blitz: Can I Refuse to Anesthetize This Patient?
38: Laura J. Ostapenko and Katherine A. Hill: Difficult Conversations
PART VII MISCELLANEOUS
39: Debra D. Pulley: This Patient Has 17 Allergies: Including "General
Anesthesia"
40: Jonathan Bacon and Ralph Epstein: Nonverbal Autistic 30-Year-Old for Full
Mouth Dental Rehabilitation with Malignant Hyperthermia
41: Meredith Whitacre and Loreta Grecu: Patient with AAA with Implanted
Spinal Cord (Neuro) Stimulator
42: Paula Trigo Blanco and Adriana D. Oprea: Patient with Pacemaker-Dependent
ICD for Renal Cryoablation
43: Adam Adler and Arvind Chandrakantan: My Friend's Son Requests Surgery for
Gynecomastia Caused by the Drugs He Uses for Bodybuilding
44: Cory W. Helder and Alessia Pedoto: Perioperative Care of the Cancer
Patient
PART VIII PACU
45: Jonathan L. Wong and Mana Saraghi: Discharge Criteria in Developmentally
Disabled Patient with OSA
46: Ramon E. Abola: My Patient Is Twitching Like a Fish Out of Water:
Avoiding the Risks of Residual Paralysis
47: Joy Steadman: My Patient in the PACU Is Not Making Any Sense
48: Avi Dobrusin and Muthuraj Kanakaraj: The HR Monitor Is Alarming in the
PACU: Postoperative Arrhythmias
Deborah C. Richman, MBChB, FFA(SA) trained at the University of Cape Town, South Africa. Subsequently she was on the faculty of the Technion in Haifa, Israel - at Ha'Emek hospital in Afula. She started one of the first pre-operative clinics in Israel. Currently, as associate professor of clinical anesthesiology at Renaissance School of Medicine, Stony Brook, her roles include: medical director of Pre-Operative Services since 2006, member of the Institutional Ethics Committee and ACLS instructor. Deborah is past president of SPAQI (Society for Perioperative Assessment and Quality Improvement); and serves on their board of governors.
Debra Pulley, MD is Professor of Anesthesiology at Washington University School of Medicine in St. Louis, MO. She first became intrigue with medicine while working as an environmental engineer managing disposal of hazardous waste and learning the effect industrial toxics can have on the human body. After medical school, she chose to specialize in anesthesiology.
Several years into providing anesthetic care to patients, Debra recognized the need for multidisciplinary involvement in optimizing perioperative care of patients. She has served as president of the Society of Perioperative Assessment and Quality Improvement (SPAQI) and is currently on the Board of Governors.
Adriana D. Oprea, MD is Associate Professor of Anesthesiology at Yale School of Medicine After completing a residency program in Internal Medicine, she worked as a hospitalist at Yale New Haven Hospital and retrained in Anesthesiology. She is dual board certified in internal medicine and anesthesiology and her area of academic and clinical interest is preoperative optimization, especially for patients with endocrine and hematologic disorders. She serves on multiple national committees on Perioperative Medicine and is part of the executive and guidelines committees for the Society for Perioperative Assessment and Quality Improvement (SPAQI).
