MILLER’S ANESTHESIA REVIEW Intentionally left as blank MILLER’S ANESTHESIA REVIEW SECOND EDITION Lorraine M Sdrales, MD Attending Anesthesiologist Cedars-Sinai Medical Center Los Angeles, California Ronald D Miller, MD Professor of Anesthesia and Perioperative Care Department of Anesthesia and Perioperative Care University of California, San Francisco, School of Medicine San Francisco, California 1600 John F Kennedy Blvd Ste 1800 Philadelphia, PA 19103-2899 MILLER’S ANESTHESIA REVIEW 978-1-4377-2793-7 Copyright # 2013 by Saunders, an imprint of Elsevier Inc Copyright # 2001 by Churchill Livingstone, an imprint of Elsevier Inc No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/ permissions This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein) Notices Knowledge and best practice in this field are constantly changing As new research and experience broaden our understanding, changes in research methods, professional practices, or medical treatment may become necessary Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds, or experiments described herein In using such information or methods they should be mindful of their own safety and the safety of others, including parties for whom they have a professional responsibility With respect to any drug or pharmaceutical products identified, readers are advised to check the most current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be administered, to verify the recommended dose or formula, the method and duration of administration, and contraindications It is the responsibility of practitioners, relying on their own experience and knowledge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual patient, and to take all appropriate safety precautions To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors, assume any liability for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein Library of Congress Cataloging-in-Publication Data Sdrales, Lorraine M Miller’s anesthesia review / Lorraine M Sdrales, Ronald D Miller – 2nd ed p ; cm Rev ed of: Anesthesia review : a study guide to Anesthesia, fifth edition and Basics of anesthesia, fourth edition / Lorraine M Sdrales, Ronald D Miller ; consulting editor, Robert K Stoelting c2001 Includes bibliographical references and index ISBN 978-1-4377-2793-7 (pbk : alk paper) I Miller, Ronald D., 1939- II Sdrales, Lorraine M Anesthesia review III Title [DNLM: Anesthesia–Examination Questions WO 218.2] 617.90 6076–dc23 2012009621 Executive Content Strategist: William R Schmitt Content Development Specialist: Julia Bartz Publishing Services Manager: Patricia Tannian Production Manager: Hemamalini Rajendrababu Project Manager: Antony Prince Design Direction: Louis Forgione Printed in United States of America Last digit is the print number: CONTRIBUTORS Meredith C.B Adams, MD Assistant Professor, Departments of Anesthesiology, Psychiatry, and Neurology, University of Florida; Section Chief, Pain Medicine, North Florida/South Georgia Veterans Health System, Gainesville, Florida Dean B Andropoulos, MD, MHCM Chief of Anesthesiology, Department of Pediatric Anesthesiology, Texas Children’s Hospital; Professor, Department of Anesthesiology and Pediatrics, Baylor College of Medicine, Houston, Texas Sheila R Barnett, MD Associate Professor of Anesthesiology, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, Massachusetts Luca M Bigatello, MD Director, Surgical Critical Care, Department of Anesthesiology and Pain Medicine, St Elizabeth’s Medical Center, Boston, Massachusetts Thomas J.J Blanck, MD, PhD Professor and Chairman, Department of Anesthesiology, Professor of Physiology and Neuroscience, New York University Langone Medical Center, New York, New York Lundy Campbell, MD Associate Clinical Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Lydia Cassorla, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Daniel Cole, MD Professor of Anesthesiology, College of Medicine Mayo Clinic; Chair, Department of Anesthesiology, Mayo Clinic Arizona, Phoenix, Arizona Adam Collins, MD Associate Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Anil de Silva, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Ken Drasner, MD Professor of Clinical Anesthesia, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Helge Eilers, MD Associate Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California John Feiner, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Alana Flexman, MD Clinical Assistant Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Charles J Fox, MD Vice Chair for Academics, Department of Anesthesiology, Tulane University Medical Center, New Orleans, Louisiana William R Furman, MD Professor of Anesthesiology and Surgery, Vice Chair for Clinical Affairs, Department of Anesthesiology, Vanderbilt University School of Medicine; Executive Medical Director, Perioperative Services, Vanderbilt University Hospital, Nashville, Tennessee v Contributors Steven Gayer, MD, MBA Professor, Department of Anesthesiology and Ophthalmology, The Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, Florida David B Glick, MD, MBA Associate Professor, Department of Anesthesia and Critical Care, University of Chicago; Medical Director, Pre- and Post-Anesthesia Care Units, University of Chicago, Chicago, Illinois Erin A Gottlieb, MD Assistant Professor, Department of Pediatrics and Anesthesiology, Baylor College of Medicine; Attending Anesthesiologist, Division of Pediatric Cardiovascular Anesthesiology, Texas Children’s Hospital, Houston, Texas Eric Y Lin, MD Assistant Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Lawrence Litt, PhD, MD Emeritus Professor, Departments of Anesthesia and Perioperative Care, and Radiology, University of California, San Francisco, School of Medicine, San Francisco, California Henry Liu, MD Associate Professor of Anesthesiology, Director of Cardiothoracic and Vascular Anesthesia, Tulane University Medical Center, New Orleans, Louisiana Tula Gourdin, MBA Analyst, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Linda Liu, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Michael A Gropper, MD, PhD Professor and Executive Vice Chairman, Department of Anesthesia and Perioperative Care, University of California, San Francisco; Director, Critical Care Medicine, University of California, San Francisco Medical Center, San Francisco, California Jennifer Lucero, MD Assistant Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Jennifer E Hofer, MD Assistant Professor, Department of Anesthesia and Critical Care, The University of Chicago Medical Center, Chicago, Illinois Robert W Hurley, MD, PhD Associate Professor, Departments of Anesthesiology, Neurology, Orthopaedics and Rehabilitation, and Psychiatry, University of Florida; Chief of Pain Medicine, College of Medicine, University of Florida; Medical Director, University of Florida Pain and Spine Center, Gainesville, Florida Steve Hyman, MD, MM Associate Professor of Clinical Anesthesiology, Department of Anesthesiology, Vanderbilt University School of Medicine, Nashville, Tennessee Alan David Kaye, MD, PhD Professor and Chairman, Department of Anesthesiology, Professor, Department of Pharmacology, Louisiana State University School of Medicine-New Orleans, New Orleans, Louisiana Jae-Woo Lee, MD Associate Professor in Residence, Department of Anesthesiology and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California vi Anuj Malhotra, MD Pain Management Fellow, Department of Anesthesia, Stanford University, Palo Alto, California Vinod Malhotra, MD Professor, Department of Anesthesiology and Urology, Vice Chair for Clinical Affairs, Clinical Director of the Operating Rooms, Weill Cornell Medical College and Medical Center, New York, New York Rachel Eshima McKay, MD Clinical Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Pankaj Mehta, MD Faculty of Interventional Pain Medicine, Cleveland Clinic Foundation, Cleveland, Ohio Douglas G Merrill, MD, MBA Professor of Anesthesiology, Dartmouth Medical School; Director, The Center for Perioperative Services; Medical Director, Outpatient Surgery, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire Ronald D Miller, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Contributors Theodora K Nicholau, PhD, MD Clinical Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Howard D Palte, MBChB, FCA(SA) Assistant Professor, Department of Anesthesiology, University of Miami, Miami, Florida Anup Pamnani, MD Assistant Professor, Department of Anesthesiology, Weill Cornell Medical College, New York, New York Siamak Rahman, MD Associate Clinical Professor, Department of Anesthesiology, University of California, Los Angeles, Los Angeles, California James P Rathmell, MD Professor of Anesthesia, Harvard Medical School; Vice Chair and Chief, Division of Pain Medicine, Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts Mark Rollins, MD, PhD Associate Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Andrew D Rosenberg, MD Chief, Department of Anesthesiology, New York University Hospital For Joint Diseases; Executive ViceChair, Department of Anesthesiology, New York University School of Medicine, New York, New York Patricia Roth, MD Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Isobel A Russell, MD, PhD, FACC Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine; Chief, Cardiac Anesthesia Services, University of California, San Francisco Medical Center, San Francisco, California David Shimabukuro, MDCM Associate Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Randolph H Steadman, MD Professor and Vice Chair, Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California Greg Stratmann, MD, PhD Associate Professor, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Bobbie Jean Sweitzer, MD Professor, Departments of Anesthesiology and Critical Care and Medicine, University of Chicago; Director, Anesthesia Perioperative Medicine Clinic, University of Chicago Medical Center, Chicago, Illinois Pekka Talke, MD Professor, Chief of Neuroanesthesia, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine, San Francisco, California Arthur W Wallace, MD, PhD Professor in Residence and Vice Chair, Department of Anesthesia and Perioperative Care, University of California, San Francisco, School of Medicine; Chief of Anesthesia, Veterans Affairs Medical Center, San Francisco, California Jeffrey D Wilkinson, MD South County Anesthesia Associates; Chairman, Quality Committee of the Board, St Anthony’s Medical Center, St Louis, Missouri Victor W Xia, MD Associate Clinical Professor, Department of Anesthesiology, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, California vii Intentionally left as blank PREFACE As with all medical disciplines, the practice of anesthesia requires a solid knowledge base as well as clinical competence There are many textbooks that provide the student of anesthesiology with the information needed to practice anesthesia What was lacking was a book that allowed students at every level to actively participate in their learning This study guide lets the reader evaluate his or her own knowledge and formulate answers alone or in groups, and it provides an alternate means of study of the information The format of the book is question and answer It is organized in a logical progression from basic anesthesia principles and concepts to more complex issues These include the delivery of anesthesia in various settings and the administration of anesthesia to patients with organ system dysfunction and disease states All the answers are current, fully formed, and self-explanatory, and the page number references provided at the end of each question refer the reader to the Basics of Anesthesia, Sixth Edition, text where further information on the given topic can be found There are several ways this study guide can be used The first-year anesthesia resident may use it to solidify information read Anesthesia residents at every level may use it to prepare for specific clinical applications that they may face on a subspecialty rotation or with given cases Anesthesia residents can also use this study guide for group study in which they will be required to verbalize answers to questions on given topics Similarly, faculty may use the study guide to quiz residents orally in a coherent, progressive manner in formal or informal settings This question and answer book can be used for self-study for Board examinations, which may be particularly useful to the anesthesiologist who is in practice and is required to register with the ABA MOCA program for recertification every 10 years Finally, anesthesiologists in practice may find the study guide useful to refresh their knowledge base and review old and new information that they may not have been taught during their residencies The multiple uses of this study guide make it an appropriate choice for students, teachers, and clinicians of anesthesiology at every level Lorraine M Sdrales Ronald D Miller ix ...MILLER’S ANESTHESIA REVIEW Intentionally left as blank MILLER’S ANESTHESIA REVIEW SECOND EDITION Lorraine M Sdrales, MD Attending Anesthesiologist... John F Kennedy Blvd Ste 1800 Philadelphia, PA 19103-2899 MILLER’S ANESTHESIA REVIEW 978-1-4377-2793-7 Copyright # 2013 by Saunders, an imprint of Elsevier Inc Copyright # 2001 by Churchill Livingstone,... Cataloging-in-Publication Data Sdrales, Lorraine M Miller’s anesthesia review / Lorraine M Sdrales, Ronald D Miller – 2nd ed p ; cm Rev ed of: Anesthesia review : a study guide to Anesthesia, fifth edition and