Chapters authored
Management of Acute Pain in Obese Patients with Sleep Apnea
Perioperative pain management for obese patients is daily challenges for anesthesiologists especially if complex comorbidities such as Obstructive Sleep Apnea and cardiovascular disease coexist. Limitations to effective pain management in this group are multifactorial, that includes technical difficulty with regional techniques, limited expertise, unavailability of standardized guidelines and lack of familiarity with recent multimodal analgesic regimens. Opioid-related complications such as narcotic-induced ventilatory depression in these group of patients poses another critical concern for both trainees and the experienced anesthesiologists. This chapter is intended for residents, fellows, as well as senior perioperative physicians, and will explore various regional and pharmacological options for acute pain management in this special population based on recent advances and available evidence.
Part of the book: Pain Management in Special Circumstances
Airway Management in Full Stomach Conditions
Pulmonary aspiration in the perioperative period is one of the well-known complications under anesthesia and procedural sedation. A full stomach condition either due to non-adherence to fasting guidelines or due to various other factors that delay gastric emptying are the most common causes. Following aspiration, a patient may develop a wide spectrum of clinical sequelae. The key factors in preventing aspiration include proper pre-operative assessment, appropriate premedication and operating room preparations. Rapid sequence induction and intubation is the recommended technique for securing the airway in cases of full stomach. Management of aspiration depends on the nature of the aspirate. Pre-operative fasting guidelines have been established by various medical societies which may be modified in special circumstances of high risk of aspiration. Prediction of difficult airway in certain cases of full stomach necessitates clinical expertise in airway management.
Part of the book: Special Considerations in Human Airway Management