It has been estimated that up to 2% of pregnant women require non-obstetric surgery that may be performed during any trimester of their pregnancy. Depending on the type of surgery and condition of the patient, non-obstetric surgery may be performed using multiple options for anesthetic agents for general anaesthesia (GA) or regional anaesthesia (RA). However, anaesthesia may present risks to both the mother and the fetus by increasing the potential for maternal and fetal hypoxia, adverse impact on fetal development, or loss of pregnancy. For this reason, proper anaesthesia management of the pregnant patient is particularly sensitive. To inform clinical practice decisions, it is important to identify whether certain anaesthetic agents or drugs are safer than others for use during surgery on pregnant patients, particularly during early pregnancy or in cases when the patient does not yet know she is pregnant. The purpose of this report is to review the clinical evidence and evidence-based guidelines regarding the safety of anaesthesia in pregnant women undergoing non-obstetric surgical or endoscopic procedures.

As minimally invasive surgical techniques evolve, the outlook for patients continues to brighten. This is also true for pregnant women experiencing conditions requiring surgical intervention during gestation. A physician’s ability to identify potential risk factors in pregnant patients that present pre-op directly corresponds with their success in monitoring patients in post-op for adverse obstetric outcomes from non-obstetric surgeries. The utilization of laparoscopic techniques during surgery for pregnant patients has decreased the risk of fetal complications and increased the positive outlook for the duration of the pregnancy. This text is designed to present a minimally invasive approach to surgery that is non-obstetrics related and to educate readers on the potential risk factors and negative outcomes on pregnant patients following non-obstetric surgery. The various sections of this book will address issues faced by surgeons who undertake the task of operating on the pregnant patient. When performing non-obstetric surgery on a pregnant patient the ability to identify possible risk factors for adverse obstetric outcomes is important. Risk factors can be maternal-, surgical-, obstetrical-, or disease-associated. Common adverse obstetric outcomes following non-obstetric surgery include preterm delivery, preterm labor without preterm delivery, and miscarriage. Fetal well-being is an additional risk-benefit factor to be considered when weighing options before conducting non-obstetric surgeries on pregnant patients. This book will provide physicians with the knowledge and tools to identify common risk factors and successfully apply evidence-based risk reduction. To date, no comprehensive resource is available for non-obstetric surgery during pregnancy. Types of pregnancies, potential complications, proper use of anesthesia, types of risk factors (maternal-, surgical-, obstetrical-, and disease-associated), etc. will be thoroughly explained and depicted within these pages. All chapters will be written by subject matter experts in their fields. All information communicated will be comprised of the most currently available knowledge

Addresses the challenges of managing critically ill obstetric patients, with chapters authored by intensivists/anesthesiologists and obstetricians/maternal-fetal medicine specialists.

TITLE: Anaesthetic Agents in Pregnant Women Undergoing Non-Obstetric Surgical or Endoscopic Procedures: A Review of the Safety and Guidelines DATE: 8 June 2015 CONTEXT AND POLICY ISSUES It has been estimated that up to 2% of pregnant women require non-obstetric surgery that may be performed during any trimester of their pregnancy.1-4 Depending on the type of surgery and condition of the patient, [...] The purpose of this report is to review the clinical evidence and evidence-based guidelines regarding the safety of anaesthesia in pregnant women undergoing non-obstetric surgical or endoscopic procedures. [...] Critical Appraisal of Individual Studies The included systematic review was critically appraised using AMSTAR,5 the non-randomized study was evaluated using the Downs and Black checklist,6 and the guideline was assessed with the AGREE II instrument.7 Summary scores were not calculated for the included studies; rather, a review of the strengths and limitations of each included study were described [...] The risk of including inevitably nonviable pregnancies in the retrospective chart review was reduced by excluding patients that had a record of pre-surgical vaginal bleeding or an absence of a fetal heartbeat on ultrasonography.9 The ASGE guideline10 is relevant to pregnant women in any trimester of pregnancy and lactating women undergoing gastrointestinal endoscopy. [...] The ASGE guideline10 provides recommendations for the provision of anaesthesia and suggested agents for endoscopy of pregnant and lactating women.

This issue of Anesthesiology Clinics focuses on Preoperative Evaluation.Topics will include: Preoperative Clinics, Consultations,Informed Consent/Shared Decision Making, Preoperative Labs,Evaluation of Major Organ Systems, Special Considerations, and Innovative treatment/preparation programs

The clinical practice of anesthesia has undergone many advances in the past few years, making this the perfect time for a new state-of-the-art anesthesia textbook for practitioners and trainees. The goal of this book is to provide a modern, clinically focused textbook giving rapid access to comprehensive, succinct knowledge from experts in the field. All clinical topics of relevance to anesthesiology are organized into 29 sections consisting of more than 180 chapters. The print version contains 166 chapters that cover all of the essential clinical topics, while an additional 17 chapters on subjects of interest to the more advanced practitioner can be freely accessed at www.cambridge.org/vacanti. Newer techniques such as ultrasound nerve blocks, robotic surgery and transesophageal echocardiography are included, and numerous illustrations and tables assist the reader in rapidly assimilating key information. This authoritative text is edited by distinguished Harvard Medical School faculty, with contributors from many of the leading academic anesthesiology departments in the United States and an introduction from Dr S. R. Mallampati. This book is your essential companion when preparing for board review and recertification exams and in your daily clinical practice.

Offering up-to-date coverage of everything from historical and international perspectives to basic science and today’s clinical practice, Miller's Anesthesia, 10th Edition, remains the #1 reference and trusted learning resource for practitioners and trainees in this complex field. Dr. Michael Gropper leads a team of expert editors and contributing authors who provide current information on the technical, scientific, and clinical issues you face each day—whether you’re managing a challenging patient care situation, preparing for the boards, or studying for recertification. Addresses timely topics alongside foundational basic science for an in-depth and comprehensive understanding of the field. Contains thoroughly up-to-date content, including two new chapters: The Immune System: Implications for Anesthetic Management and Emergency Preparedness in Healthcare. Provides new content in key areas such as sustainability, global health equity, the effect of anesthetics on immune function, anesthesia for special populations, coverage of infectious diseases including COVID-19, and occupational exposure and safety. Offers state-of-the-art coverage of anesthetic drugs, guidelines for anesthetic practice and patient safety, new techniques, step-by-step instructions for patient management, the unique needs of pediatric patients, and much more—all highlighted by more than 1,200 full-color illustrations (300 new to this edition) for enhanced visual clarity. Includes 40+ video clips demonstrating patient positioning, ultrasound, echocardiograms, and other imaging, and anesthetic procedures in real time.

Anesthesia Outside of the Operating Room is a comprehensive, up-to-date textbook that covers all aspects of anesthesia care in OOR settings, from financial considerations to anesthetic techniques to quality assurance. With increasing numbers of procedures such as cardiac catheterization and imaging taking place outside of the main OR, anesthesia providers as well as non-anesthesia members of the patient care team will find this book critical to their understanding of the principles of anesthesia care in unique settings which may have limited physical resources. Topics include patient monitoring techniques, pre-procedure evaluation and post-procedure care, and procedural sedation performed by non-anesthesia providers. The authors address problems of anesthesia that have unique answers in OOR settings, such as patient transport and cardiac arrest, and discuss technological progress and considerations for the future. The text also covers surgical procedures and anesthetic considerations by procedure location, such as radiology, infertility clinics, field and military environments, and pediatric settings, among many others Select guidelines from the American Society of Anesthesiologists (ASA) are provided as well. Edited by the senior faculty from Harvard Medical School and with contributions from other academic institutions, Anesthesia Outside of the Operating Room provides a unique and convenient compendium of expertise and experience.

Using illustrative clinical cases, this volume in the Problem-Based Learning series reviews key topics in Anesthesia frequently encountered in clinical practice and on examinations. It highlights practical issues that arise in the operating room and solutions for them. With real-world clinical cases and discussion questions that guide case progression, this book facilitates both individual and small-group learning. Each case is further broken down to include additional related subtopics for maximum yield. Evidence-based reviews and multiple-choice self-assessment questions follow each case, making this book ideal for continuing education in anesthesia for the generalist and specialist practitioner. Teachers and trainees in anesthesiology will take advantage of this book's features for targeted teaching, learning, and retention.

In the United States, over half of pregnant women receive some form of anesthesia for their deliveries; this translates into well over 2 million anesthetics per year. With this new handbook, anesthesiologists have easy access to step-by-step, to-the-point information on how to manage patients in specific situations. Every aspect of obstetric anesthesia practice is covered, including patient evaluation, anesthesia for labor and delivery, anesthesia for cesarean delivery, management of patients with concurrent medical problems, management of obstetric emergencies, fetal assessment, and neonatal resuscitation. Distilled, synthesized text is complemented by a generous number of tables, charts, figures and flow diagrams, all presented in accessible handbook format. Obstetric Anesthesia is an ideal introduction to the specialty as well as an essential daily guide for obstetric patient care and management.