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1

Harrison, John Henry, and Magdalena Anitescu. Neuraxial Anesthesia in Coexisting Neurologic Conditions. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0041.

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Some patients who need surgery may have coexisting neurologic disorders like multiple sclerosis, amyotrophic lateral sclerosis, peripheral neuropathies (e.g., Charcot-Marie-Tooth disease or Guillain-Barré syndrome), or muscular dystrophies (e.g., Duchenne’s or myotonic dystrophy). When neuraxial analgesia and anesthesia are indicated, the anesthesiologist should be aware of the risks and benefits of the technique. Neuraxial anesthesia is not absolutely contraindicated in nervous system diseases and there are undeniable benefits to ruling out general anesthesia. In patients with coexisting neur
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2

Ballard, Heather, Ravi Shah, and Santhanam Suresh. Neuraxial Anesthesia and Analgesia for Pediatric Surgery. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0055.

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Neuraxial anesthesia has a long history of use in pediatric surgery. It can be used as a sole anesthetic or as an adjunct to sedation or general anesthesia. Neonatal spinals and single-shot caudal anesthesia are effective for lower abdominal, urological, and lower extremity orthopedic surgeries. When a thoracic, lumbar, or caudal epidural catheter is utilized, postoperative analgesia can also be provided to surgeries involving the chest and upper abdomen. There is renewed interest in neuraxial anesthesia due to concerns of the effect of volatile anesthetics on the developing brain. Though rese
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3

Gloff, Marjorie, Melissa Kreso, and Richard Wissler. Neurologic Complications in Obstetric Anesthesia. Edited by Emma Ciafaloni, Cheryl Bushnell, and Loralei L. Thornburg. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190667351.003.0033.

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Neuraxial analgesia and anesthesia is routinely requested for women in the peripartum and postpartum period. Given that there is widespread knowledge of the benefits of obstetricians, mainstream media, and word-of-mouth communication, many patients expect to receive some form of neuaxial anesthesia during their peripartum experience. Neuraxial anesthesia can provide both pain relief during induction and labor and can provide surgical anesthesia for a variety of surgical procedures in the peripartum and postpartum period. While generally considered safe, neuraxial anesthesia is not without risk
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4

Chin, Ki Jinn. Central Neuraxial Blockade: Ultrasound. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780199908004.003.0022.

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Successful central neuraxial blockade requires entry into the epidural or intrathecal space, and is contingent on the ability to guide a needle into the desired interlaminar space between adjacent vertebrae. Ultrasonography of the spine has been shown to be an effective tool for guiding epidural and spinal anesthesia. The use of ultrasound to central neuraxial blockade can broadly be divided into either preprocedural ultrasound imaging to delineate the underlying anatomy, or real-time ultrasound imaging of the needle as it is advanced toward the target. This chapter focuses only on preprocedur
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5

Urman, Richard, and Alan Kaye. Vascular Anesthesia Procedures. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506073.001.0001.

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This book reviews the practice of vascular anesthesia, which is now increasingly recognized as a subspecialty of anesthesia, and looks at developments and latest evidence in neuraxial, regional, and general anesthesia techniques. It explores essential topics on vascular anatomy, common vascular procedures, and anesthetic techniques in general and regional anesthesia. It also includes subjects relating to complications, perioperative patient monitoring, and post-operative management. The book begins with an analysis of the basic vascular anatomy and physiology, which covers the three components
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6

Grant, Stuart A., and David B. Auyong. Trunk and Spine Ultrasound Guided Regional Anesthesia. Oxford University Press, 2016. http://dx.doi.org/10.1093/med/9780190231804.003.0004.

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This chapter describes the clinical anatomy and outlines the tools and techniques needed to perform thoracic, abdominal and neuraxial ultrasound-guided procedures. The nerve blocks described here include the transversus abdominis plane (TAP), quadratus lumborum, ilioinguinal-iliohypogastric, rectus sheath, intercostal, PECS, serratus plane, paravertebral, and neuraxial spinal and epidural blocks. For each nerve block, the indications, risks, and benefits of the varying approaches are described in detail. The chapter includes step-by-step instructions with illustrations to allow the operator to
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7

Mardini, Issam A., Jiabin Liu, and Nabil Elkassabany. Anticoagulation in Regional Anesthesia. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0046.

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Regional anesthesia and analgesia provide attractive options for patients undergoing major orthopedic procedures. The use of anticoagulation medications in the elderly patient population and in patients with cardiovascular risks is very common. The guidelines from the American Society of Regional Anesthesia and Pain Medicine (ASRA) and other societies have been adopted widely over many years. The guidelines provide a basis for adequate delay intervals between dosing of medications and performing neuraxial or peripheral nerve blocks (PNBs), thus allowing for safer practice of regional anesthesi
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8

Kaye, Alan, and Richard Urman, eds. Thoracic Anesthesia Procedures. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506127.001.0001.

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The Thoracic Anesthesia Procedures is a comprehensive summary of all major topics in the field. The book describes thoracic physiology and pathophysiology, airway devices and other equipment, surgical considerations, anesthetic techniques for a variety of simpler and complex procedures, ventilation techniques, postoperative care including pain management, and complications. This is a concise, up-to-date, evidence-based illustrated book for use by both trainees and practicing clinicians as a one-in-all source of evolving knowledge, techniques, and modern technology to provide care safely. The b
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9

Chen, Grace, and Ashley Valentine. Neuraxial Analgesia and Anesthesia in Chronic Opioid Users and Patients with Pre-existing Pain. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190457006.003.0007.

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Neuraxial anesthesia and analgesia are effective modalities for surgery and perioperative pain management, respectively. These techniques may have nonanalgesic benefits as well, including improved 30-day mortality benefit, decreased risk of perioperative pneumonia, decreased risk of persistent postoperative pain, and attenuation of the stress response to surgery with improved survival in certain cancers. Post-operative pain control with epidural can be especially beneficial for opioid tolerant chronic pain patients compared to enteral or parenteral analgesics alone. In patients with previous b
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10

Kaye, Alan, and Richard Urman, eds. Obstetric Anesthesia Practice. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190099824.001.0001.

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Obstetrical Anesthesia Procedures provides timely updates in the field of obstetrical anesthesia and provides a concise, up-to-date, evidence-based and richly illustrated book for students, trainees, and practicing clinicians. The book comprehensively covers a robust list of topics focused to improve understanding in the field with emphasis on recent developments in clinical practices, technology, and procedures. This book describes all the essential topics that are required for the practitioner to quickly assess the patient and risk stratify them, decide on the type of analgesic and anestheti
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11

Clebone, Anna, Barbara Burian, Keith J. Ruskin, and Barbara Burian, eds. Pediatric Anesthesia Procedures. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780190685188.001.0001.

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Pediatric Anesthesiology Procedures is intended as a ready resource of common procedures in Pediatric Anesthesiology for both experts and novices. It will be useful to both those with extensive training and experience as well as beginners and those with distant experience or training. A wealth of knowledge in the human factors of procedure design and use has been applied throughout to ensure that desired information can be easily located, that steps are clearly identified and comprehensible, and that additional information of high relevance to procedure completion is co-located and salient. Th
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12

Richardson, Michael G. STAT Caesarean Delivery. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0043.

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During emergency cesarean delivery (CD), indicated by immediate threat to fetal or maternal life, the anesthesiologist must quickly provide anesthesia that is rapid in onset and safe for both patients. Neuraxial anesthesia using well-functioning in-dwelling epidural catheters is achievable with early enough notification. Still, general anesthesia is often the most expedient method. Advanced airway devices and evolving difficult airway management algorithms have likely contributed to observed reductions maternal morbidity and mortality associated with general anesthesia. Long before the crisis
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13

Waters, Janet. A Woman in Labor with Hypotension and Dyspnea After Epidural Placement. Edited by Angela O’Neal. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190609917.003.0022.

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This chapter discusses neurological complications of the administration of epidural and spinal anesthesia in the obstetric population. It begins with a case report on a patient with a total spinal block, which occurs when large doses of local anesthetic intended for the epidural space are inadvertently injected into the subarachnoid space. The chapter reviews key points in recognizing and treating this potentially fatal complication. It discusses other complications, including epidural hematoma, epidural abscess, spinal cord injury, and meningitis, as well as complications from intravascular i
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14

Elkhateb, Rania, and Jill M. Mhyre. Difficult Airway: Special Considerations in Pregnancy. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0053.

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Pregnant patients are at increased risk of difficult airway management due to both anatomic and physiologic changes that occur with pregnancy and during the process of labor. While the majority of surgical procedures on labor and delivery are performed with neuraxial anesthesia, general anesthesia may be required at any time. As such, all anesthesia professionals must be prepared at all times for unplanned and emergent obstetric airway management, including management of the difficult airway in the parturient. Strategies include assessment of patient risk early in labor, maintaining difficult
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15

Allen, Brian F. S. Local Anesthetic Systemic Toxicity in Pregnancy. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0059.

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Local anesthetic systemic toxicity (LAST) is a concern for all practitioners who administer local anesthetics, including neuraxial and regional analgesia and anesthesia for pregnant patients. Toxicity can manifest as neurologic (e.g., seizure) or cardiac (e.g., dysrhythmia) sequelae and even death. Management of LAST differs from advanced cardiovascular life support (ACLS) in several important ways, and the parturient suffering LAST requires even more specific therapy. This chapter reviews the pathophysiology, assessment, and management of LAST in pregnancy, highlighting key differences from A
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16

Buckenmaier, Chester C., Michael Kent, Jason C. Brookman, Patrick J. Tighe, Edward R. Mariano, and David Edwards, eds. Acute Pain Medicine. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190856649.001.0001.

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Acute Pain Medicine tackles a large array of diagnostic and treatment consideration across a variety of surgical and nonsurgical acute pain conditions. It reviews a variety of acute pain–modulating factors followed by interventional and pharmacologic treatment options. For each applicable condition, perineural and neuraxial considerations are given when appropriate along with nociceptive anatomic complements. Pharmacologic modalities are described, stressing the use of multimodal analgesia and a variety of opioid-based options if necessary. The book reviews cases that commonly are associated w
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17

Sivak, Erica, Marcus Malek, and Denise Hall-Burton. Hirschsprung Disease. Edited by Kirk Lalwani, Ira Todd Cohen, Ellen Y. Choi, and Vidya T. Raman. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190685157.003.0037.

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Hirschsprung disease is characterized by the absence of ganglion cells in the enteric nervous system. Inability to pass meconium in the neonatal period, enterocolitis, bowel obstruction, or chronic constipation in older infants and children may be the presenting symptoms. Once diagnosed, surgical intervention is always required. Successful resection of all portions of aganglionic intestine may be accomplished through multiple surgical techniques. Depending upon the surgical approach required, regional anesthesia may be indicated to assist with pain control postoperatively. This chapter describ
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18

Anitescu, Magdalena, and Chirag Shah. The Vasovagal Reflex and Neuraxial Techniques. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0042.

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Syncope, or the transient loss of consciousness, is one of the leading causes of emergency department visits. Syncope can be neurally mediated, orthostatic, cardiac, or cerebrovascular. Neurally mediated vasovagal syncope is the most frequent form. Diagnostic modalities are tilt- table testing and implantable loop recorders. Therapeutic options usually begin with supportive measures, such as a fluid bolus or changing patient positioning, but complex cases may require vasoactive agents or placement of a pacemaker. In many situations patients who present to the operating room for various surgeri
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19

Candido, Kenneth D., Teresa M. Kusper, Bora Dinc, and Nebojsa Nick Knezevic. Epidural Blood Patch. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190271787.003.0036.

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Post-dural-puncture headache (PDPH) is a consequence of neuraxial anesthesia, diagnostic lumbar puncture, intrathecal drug delivery systems, or any other technique involving dural trespass. The spinal headache results from a dural puncture that leads to cerebrospinal fluid (CSF) leakage from the subarachnoid space to the epidural space, culminating in intracranial hypotension and development of a low-pressure headache. A key element of PDPH is an increase in pain severity upon a change in position from supine to upright, which corresponds to a gravity-induced influence on CSF pressure dynamics
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20

Peralta, Feyce. High or Total Spinal/Epidural. Edited by Matthew D. McEvoy and Cory M. Furse. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190226459.003.0044.

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High or total spinal/epidural blockade occurs due to excess spread of local anesthetic within the neuraxial space. While this is an infrequent complication, it can cause respiratory and hemodynamic instability in obstetric patients. If high/total spinal/epidural occurs prior to delivery, such derangements may lead to fetal intolerance and need for emergency delivery. Clinicians should suspect risk for high block when patients lose upper extremity motor function and complain of dysphonia or dyspnea. Intubation and respiratory and hemodynamic support along with adequate sedation should be given
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21

Seipel, Catherine P., and Titilopemi A. O. Aina. Tracheoesophageal Fistula Repair. Edited by Erin S. Williams, Olutoyin A. Olutoye, Catherine P. Seipel, and Titilopemi A. O. Aina. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190678333.003.0048.

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Tracheoesophageal fistula (TEF) with esophageal atresia (EA) is a congenital malformation occurring in approximately 1:4,000 live births. TEF/EA is characterized by disrupted continuity of the esophagus. There are five distinct types, but the most common is EA with a distal TEF. Most cases are diagnosed postnatally after an inability to pass a nasogastric tube (NGT), with subsequent radiographic imaging finding the NGT coiled within the esophageal pouch. The anesthetic management of TEF/EA repair can be complicated by the presence of cardiac, renal, and vertebral anomalies. Additionally, venti
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22

McClenahan, Maureen F., and William Beckman. Pain Management Techniques. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190217518.003.0011.

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This chapter provides a broad review of various interventional pain management procedures with a focus on indications, anatomy, and complications. Specific techniques reviewed include transforaminal epidural steroid injection, lumbar sympathetic block, stellate ganglion block, cervical and lumbar radiofrequency ablation, gasserian ganglion block, sacroiliac joint injection, celiac plexus block, lateral femoral cutaneous nerve block, ilioinguinal block, lumbar medial branch block, obturator nerve block, ankle block, occipital nerve block, superior hypogastric plexus block, spinal cord stimulati
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