About the Book

An integral component that provides basic recommendations for anesthetic practice.
This is a unique effort by Indian College of Anaesthesiologists (ICA) an academic wing of Indian Society of Anaesthesiologists.
It contains 23 up-to-date topics that cover the current practice guidelines for preoperative preparations, perioperative problems and their management during anesthesia, pain management and intensive care therapy.
The readers would find it beneficial in managing the patients that require anesthetic care, intensive therapy and pain management.
The various chapters include the topics covering preoperative preparations, monitoring, intra- and postoperative problems and their management.
This book is recommended for postgraduate students, trainees, practicing anesthesiologists and those involved in care of critically ill.

About the Author

SK Malhotra MD FICA Editorial Board Member: VP Kumra MD DAc FICA Editorial Board Member: B Radhakrishnan MD MPhil FICA Editorial Board Member: SM Basu MD DA (London) FICA

Table of Contents:
Contents 1. Practice Guidelines for Postanesthesia Care Unit 1 Abdul Qayoom Dar History 1; Managing Pacu Staffing 1; Design and Staffing 2 Outpatient Surgery 12; Pediatric Pacu 14 2. Perioperative Care of Ambulatory Anesthesia 17 Anil Agarwal, Kamal Kishore Preoperative Assessment 18; Perioperative Care 18 Preoperative Preparation 18; Intraoperative Care 18 General Anesthesia 19; Regional Anesthesia 19 Peripheral Nerve block 19; Local Infiltration 19 Intravenous Regional Anesthesia 19 Postoperative Recovery and Discharge 20; Outcome Measures 20 3. Anaphylactic Reactions during Anesthesia 23 Anjan Trikha Anaphylaxis 23; Etiology of Perioperative Anaphylaxis 23 4. Acute Pain Management Guidelines and Protocols: Evidence Based 32 Ashok Kumar Saxena Definition 32; Aims of the Guidelines 33 ASA Task Force’s Recommendations for Providing Postoperative Pain Management 34 5. Monitoring Standards in Anesthesia 45 Gundappa Parameswara Section 1: Professional Standards 47 Section II: Monitoring the Anesthetic Equipment 48 Section III: Perioperative Care and Monitoring 49 Additional Monitoring 50 Section V: Monitoring during Regional Anesthesia, Anesthesia outside the Operation Rooms and Monitored Anesthesia Care 51 Section VI: Monitoring during Transportation 51 Section VII: Monitoring in the Postoperative Ward 51 6. Head Injury: Assessment and Early Management 53 Girija Prasad Rath, Bikash Ranjan Ray Definition and Classification of Head Injury 53 7. Guidelines to Quality Assurance in Anesthesia 60 Jayashree Sood Quality Assurance Cycle 60; Provision of Anesthesia Services 61 Preoperative Examination 62; Preoperative Checklist 63 The Intraoperative Period 63; Records 63 xiv Practice Guidelines in Anesthesia 8. Preanesthetic Evaluation and Investigation 67 JP Sharma, Nidhi Kumar Preanesthetic Evaluation 68; Investigation 70 9. Perioperative Fluid Management in Children 73 LD Mishra, P Ranjan Fluid in Children with Burn Injury 74; Trauma 75 10. Central Venous Catheter Management Guidelines 76 Mahesh Kumar Arora, Dalim Kumar Baidya Preparation of Resource and Training of Staff 76 Selections of Insertion Site and Type of Catheter 76 11. Inadvertent Perioperative Hypothermia 79 BB Mishra Risk Factors 80; Patient Characteristics 81 Anesthesia Factors 81; Surgery Factors 82 Other Risk Factors 82; Gender 82 Surgery Risk Factors 83; Environmental Risk Factors 83 Consequences of Iph 83; Treatment of Hypothermia 84 Guidelines Recommendations 84 12. Practical Guidelines for Ultrasound Guided Nerve Blocks 87 Mridula Pawar Review Basics of Ultrasound 87; Know Your Equipment 87 Anatomical Structures 88; How to Differentiate Tendons from Nerves? 88 How to Differentiate Artery from Vein? 89 Interscalene and Supraclavicular Block 89; Femoral Nerve Block 90 13. Epidural Analgesia: The Practice Guidelines 93 Mritunjay Varma Complications 93; Catheter Insertion 94; Equipment 95 Patient Monitoring 95; Audit and Critical Incidents 97 Education 97 14. Monitored Anesthesia Care 99 Parshotam Lal Gautam Monitoring during Mac 104 15. Management of Local Anesthesia Toxicity 109 Raminder Sehgal General Guidelines 109; Prevention 110 Diagnosis 110; Management of Last 111 16. Interhospital Transfer of Critically Ill Patients 113 Rashmi Datta Transport Triangle 113; Responsibilities of the Transport Triangle 114 Types of Interhospital Transportation Teams 115; Choice of Vehicle 116 xv Accompanying Medications 117; Accompanying Equipment 117 Aeromedical Considerations 119; Legal Issues 121 17. Practice Guidelines for Management of the Difficult Airway 127 SK Malhotra 18. Practice Guidelines in Obstetric Anesthesia 132 Sunanda Gupta, Seema Partani Preanesthetic Requirements 132; Aspiration Prophylaxis 133 Guidelines for Regional Anesthesia in Obstetrics 133 Anesthesia for Cesarean Delivery 134; Removal of Retained Placenta 135 Postpartum Tubal Ligation 135 Management of Obstetric and Anesthetic Emergencies 135 Cardiopulmonary Resuscitation in Obstetric Patients 136 19. Checking Anesthesia Equipment 138 Susheela Taxak Principles 138 Anesthesia Delivery System Checks 138 20. Perioperative Blood Transfusion 143 T Prabhakar, RK Tripathi How Much Hemoglobin is Enough? 144 Blood Component Therapy 144; A Workable Guideline 145 21. Infrastructure Requirements for Operation Theater 148 Naresh Dua, VP Kumra Utilization of Operation Theater 148; Infrastructure of Operation Theater 148 Aim of Planning 148; Requirements for Designing 149 Basic Architecture of the OT 149; Ventilation 151 Electrical 152 22. Preoperative Fasting Guidelines 155 Vinod Kalla 23. Anesthetic Care for MRI 157 Sarla Hooda, Prashant Kumar Basic Physics 157; Specific Issues 158 Preparation and Techniques 158; Monitoring Equipment 158 Anesthesia for MRI 160; Planning and Safety 161 Index 163 Contents