Handbook of Clinical Anaesthesia 3E 3rd Edition

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This book is dedicated to my three children, Kathryn, Christine and Alexander.
They are my future.
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 Contents
Contributors
Preface

Part 1: Patient Conditions

Section 1: Central nervous system Martin Smith 3
• Autonomic dysfunction and autonomic dysreflexia Katharine Hunt and Sandeep Sharma 4
• Brainstem death Paul Murphy 6
• Diseases of the neuromuscular junction David Brealey and Nicholas Hirsch 9
• Epilepsy Ian Appleby 12
• Head injury Rashan Haniffa and Jeremy Radcliffe 16
• Inflammatory brain disease Rohit Juneja and Jeremy Radcliffe 20
• Multiple sclerosis Ian Appleby 23
• Parkinson disease Chris Taylor 26
• Peripheral neuropathy David Brealey and Nicholas Hirsch 29
• Primary neuromuscular disease David Brealey and Nicholas Hirsch 33
• Spinal cord injury Katharine Hunt 36
• Subarachnoid haemorrhage Tamsin Gregory and Sally Wilson 39
Section 2: Endocrine system Thomas A Crozier 43
• Acromegaly Thomas A Crozier 44
• Adrenocortical insufficiency Thomas A Crozier 46
• Carcinoid syndrome Brian J Pollard 50
• Conn syndrome Thomas A Crozier 53
• Cushing syndrome (hypercortisolism) Thomas A Crozier 55
• Diabetes insipidus Thomas A Crozier 58
• Diabetes mellitus Brian J Pollard 60
• Hyperparathyroidism Thomas A Crozier 64
• Hyperthyroidism Thomas A Crozier 66
• Hypothyroidism Thomas A Crozier 70
• Iatrogenic adrenocortical suppression Thomas A Crozier 72
• Muscular dystrophies Brian J Pollard 74
• Myotonia Brian J Pollard 76
• Pituitary disorders and hypopituitarism Thomas A Crozier 78
• Syndrome of inappropriate antidiuretic hormone hypersecretion Thomas A Crozier 81
• Uncommon endocrine tumours Brian J Pollard 82
Section 3: Respiratory system Neil Soni 85
• Anaesthesia and bronchogenic carcinoma Suveer Singh and Neil Soni 86
• Anaesthesia and chronic obstructive pulmonary disease Suveer Singh and Neil Soni 91
• Anaesthesia and sleep apnoea syndrome Suveer Singh and Neil Soni 98
• Asthma Suveer Singh and Neil Soni 105
• Bronchiectasis Rick Keays and Neil Soni 109
• Cystic fibrosis Rick Keays and Neil Soni 111
• Restrictive lung disease Suveer Singh and Neil Soni 114
• Sarcoidosis Rick Keays and Neil Soni 118
• Smoking and anaesthesia Rick Keays and Neil Soni 120
Q Contents Section 4: Cardiovascular system Stefan De Hert 123
• General considerations Stefan De Hert 124
• Aortic valve disease Jan Fräbdorf 126
• Atrial septal defect Susanne Eberl 129
• Cardiac conduction defects Peter Meijer 132
• Cardiomyopathy Stefan De Hert 136
• Children with congenital heart disease for non-cardiac surgery Susanne Eberl 138
• Congenital heart disease in adult life Veronika Evers 141
• Coronary artery disease Quanhong Zhou and Stefan De Hert 146
• Hypertension Peter Meijer 151
• Ischaemia–reperfusion injury Stefan De Hert and Benedikt Preckel 154
• Mitral valve disease Jan Fräbdorf 156
• Patients with heart failure Quanhong Zhou and Stefan De Hert 159
• Patients with pacemakers and implantable defibrillators Benedikt Preckel 161
• Pulmonary hypertension Benedikt Preckel 164
• Surgery after heart transplantation Stefan De Hert 167
• Tetralogy of Fallot Veronika Evers 169
Section 5: Gastrointestinal tract Brian J Pollard 173
• Chronic liver disease Brian J Pollard 174
• Disorders of the oesophagus and of swallowing Brian J Pollard 177
• The full stomach Brian J Pollard 179
• Hiatus hernia Brian J Pollard 181
• The jaundiced patient Brian J Pollard 183
• Malnutrition Brian J Pollard 186
• Obesity Brian J Pollard 189
• Previous liver transplant Brian J Pollard 192
Section 6: Genitourinary tract Denise McCarthy and George Shorten 195
• Acute kidney injury Denise McCarthy and George Shorten 196
• Assessment of renal function Denise McCarthy and George Shorten 199
• Chronic kidney disease Denise McCarthy and George Shorten 203
• Goodpasture syndrome Denise McCarthy and George Shorten 207
• Haemolytic uraemic syndrome Denise McCarthy and George Shorten 209
• Nephrotic syndrome Denise McCarthy and George Shorten 211
• Patient with a transplant Denise McCarthy and George Shorten 213
Section 7: The blood Charles Marc Samama 215
• Anaemia Charles Marc Samama and Jean-François Schved 216
• Disseminated intravascular coagulation Charles Marc Samama and Jean-François Schved 219
• Glucose-6-phosphate dehydrogenase deficiency Charles Marc Samama and Jean-François Schved 222
• Idiopathic thrombocytopenic purpura Charles Marc Samama and Jean-François Schved 224
• Inherited coagulopathies Charles Marc Samama and Jean-François Schved 226
• Massive transfusion, microvascular haemorrhage and thrombocytopenia
Charles Marc Samama and Jean-François Schved 228
• Mastocytosis Charles Marc Samama and Jean-François Schved 231
• Multiple myeloma Charles Marc Samama and Jean-François Schved 234
• Polycythaemia Charles Marc Samama and Jean-François Schved 236
• Sickle cell syndrome Charles Marc Samama and Jean-François Schved 239
• Thalassaemia Charles Marc Samama and Jean-François Schved 241
Section 8: Bones and joints Alain Borgeat 243
• Ankylosing spondylitis Alain Borgeat and José A Aguirre 244
• Dwarfism José A Aguirre and Alain Borgeat 248
• Marfan syndrome José A Aguirre and Alain Borgeat 251
viii • Metabolic and degenerative bone disease José A Aguirre and Alain Borgeat 253
 Q Contents
• Rheumatoid disease José A Aguirre and Alain Borgeat 255
• Scoliosis Alain Borgeat and José A Aguirre 258
Section 9: Connective tissue Brian J Pollard 265
• Bullous and vesicular skin disorders Brian J Pollard 266
• Disorders of epidermal cell kinetics and differentiation Brian J Pollard 269
• Ehlers–Danlos syndrome Brian J Pollard 271
• Epidermolysis bullosa Brian J Pollard 273
• Glycogen storage disease Brian J Pollard 276
• Mucopolysaccharidoses Brian J Pollard 278
• Polyarteritis nodosa Brian J Pollard 281
• Polymyositis and dermatomyositis Brian J Pollard 283
• Pseudoxanthoma elasticum Brian J Pollard 285
• Scleroderma Brian J Pollard 287
• Systemic lupus erythematosus Brian J Pollard 290
• Urticaria and angio-oedema Brian J Pollard 293

Part 2: Surgical Procedures

Section 10: Neurosurgery Martin Smith 299
• General principles of neuroanaesthesia Michelle Leemans 300
• Anaesthesia for interventional neuroradiological procedures Mary Newton and Robin Kumar 304
• Anaesthesia for intracranial neurovascular surgery Sally Wilson and Tamsin Gregory 308
• Anaesthesia for magnetic resonance imaging Ugan Reddy and Sally Wilson 311
• Anaesthesia for non-craniotomy neurosurgery Shulpa Reddy and Katharine Hunt 315
• Anaesthesia for posterior fossa surgery Ugan Reddy and Katharine Hunt 318
• Anaesthesia for spine surgery Michelle Leemans 322
• Anaesthesia for supratentorial surgery Ian Appleby and Tamsin Gregory 326
• Anaesthesia for trans-sphenoidal hypophysectomy Nicholas Hirsch 332
• Anaesthetic and ICU management of the head-injured patient David Highton and Martin Smith 334
• Neuromonitoring David Highton and Martin Smith 338
Section 11: Ophthalmic surgery Roger M Slater 341
• Cataract surgery Roger M Slater 342
• Corneal transplant Roger M Slater 345
• Intraocular pressure Roger M Slater 347
• Oculoplastic surgery Roger M Slater 350
• Ophthalmic trauma Roger M Slater 352
• Strabismus correction Roger M Slater 354
• Vitreoretinal surgery Roger M Slater 356
Section 12: ENT surgery Craig R Bailey 359
• Laryngoscopy and microsurgery of the larynx Craig R Bailey 360
• Middle ear surgery Craig R Bailey 363
• Oesophagoscopy Craig R Bailey 365
• Operations on the nose Craig R Bailey 367
• Tonsillectomy and adenoidectomy Craig R Bailey 369
• Tracheostomy Craig R Bailey 372

Section 13: Head and neck surgery Gerhard Schwarz 375

• Dental abscess Gerhard Schwarz 376
• Dental surgery Isolde Rötzer 379
• Face and jaw fractures Marianne Hösele 382
• Laryngectomy and radical neck dissection Gerlinde Mausser 384
• Major reconstructive surgery Marianne Hösele 386 ix
Q Contents • Operations on the salivary glands Gerhard Schwarz 390
• Thyroidectomy Andreas Schöpfer 392

Section 14: Plastic surgery Deborah M Nolan 395

• Burns surgery Deborah M Nolan 396
• Cosmetic surgery Deborah M Nolan 398
• Free-flap surgery and related procedures Deborah M Nolan 400
• Paediatric plastic surgery Deborah M Nolan 402
• Peripheral limb surgery Deborah M Nolan 405

Section 15: Thoracic surgery Mark R Patrick 407

• Overview Mark R Patrick 408
• Bronchopleural fistula Mark R Patrick 412
• Inhaled foreign body Mark R Patrick 414
• Lobectomy Mark R Patrick 415
• Mediastinal surgery Mark R Patrick 417
• Pleurectomy and pleurodesis Mark R Patrick 419
• Pneumonectomy Mark R Patrick 420
• Postoperative analgesia Mark R Patrick 421
• Rigid bronchoscopy Mark R Patrick 423

Section 16: Abdominal surgery Mark C Bellamy 425

• Overview Mark C Bellamy 426
• Abdominal trauma Lisa Milligan 429
• Anaesthesia for pancreatic surgery Helen Buglass 433
• Bariatric surgery Brian J Pollard 436
• Colorectal surgery Lisa Milligan 438
• Hernia repair Lisa Milligan 443
• Obstruction or perforation Richard J Harding 447
• Oesophagogastrectomy Richard J Harding 449
• Open and laparoscopic cholecystectomy Helen Buglass 451

Section 17: Gynaecological surgery Giorgio Capogna and Silvia Stirparo 453
• Fertility surgery Giorgio Capogna and Silvia Stirparo 454
• Hysteroscopy and laser surgery Giorgio Capogna and Silvia Stirparo 456
• Laparoscopy Giorgio Capogna and Silvia Stirparo 458
• Minor gynaecological procedures Giorgio Capogna and Silvia Stirparo 460
• Radical cancer surgery Giorgio Capogna and Silvia Stirparo 462

Section 18: Obstetric anaesthesia Giorgio Capogna and Silvia Stirparo 465
• Basic principles of obstetric anaesthesia Giorgio Capogna and Silvia Stirparo 466
• Anaesthesia for elective caesarean section Giorgio Capogna and Silvia Stirparo 468
• Anaesthesia for emergency caesarean section Giorgio Capogna and Silvia Stirparo 472
• Medical problems and obstetric anaesthesia Giorgio Capogna and Silvia Stirparo 474
• Pain relief in labour Giorgio Capogna and Silvia Stirparo 477
• Serious complications of pregnancy Giorgio Capogna and Silvia Stirparo 482

Section 19: Urology Iurie Acalovschi 485

• Cystectomy Iurie Acalovschi 486
• Cystoscopy Iurie Acalovschi 488
• Laser resection of prostate Iurie Acalovschi 490
• Nephrectomy Iurie Acalovschi 492
• Percutaneous nephrolithotomy Iurie Acalovschi 494
• Radical prostatectomy Iurie Acalovschi 496
x • Transurethral resection of prostate Iurie Acalovschi 498
 Q Contents
Section 20: Vascular surgery Andrew J Mortimer and Rachel A Stoeter 501
• Overview Andrew J Mortimer and Rachel A Stoeter 502
• Abdominal aortic reconstruction: elective open repair Rachel A Stoeter
and Andrew J Mortimer 505
• Abdominal aortic reconstruction: emergency repair Rachel A Stoeter
and Andrew J Mortimer 508
• Abdominal aortic reconstruction: endovascular aneurysm repair Rachel A Stoeter and
Andrew J Mortimer 511
• Carotid endarterectomy Rachel A Stoeter and Andrew J Mortimer 513
• Leg revascularization and amputations Rachel A Stoeter and Andrew J Mortimer 516
Section 21: Transplantation Richard Wadsworth 519
• Heart transplantation Andrew Roscoe 520
• Kidney transplantation Swati Karmarkar 522
• Liver transplantation Zoka Milan 527
• Lung and heart–lung transplantation Andrew Roscoe 530
• Pancreas transplantation William R Macnab 533
Section 22: Orthopaedics Stuart White 535
• Overview Stuart White 536
• Arthroscopy Stuart White 538
• Manipulation under anaesthesia Stuart White 540
• Repair of fractured neck of femur Stuart White 541
• Total hip arthroplasty Stuart White 543
Section 23: Endocrine surgery Thomas A Crozier 545
• Parathyroid surgery Brian J Pollard 546
• Phaeochromocytoma Brian J Pollard 547
Section 24: Paediatrics George H Meakin 551
• Overview George H Meakin 552
• Circumcision Davandra Patel 556
• Congenital diaphragmatic hernia Andrew J Charlton 558
• Congenital hypertrophic pyloric stenosis Robert WM Walker 560
• Tracheo-oesophageal fistula and oesophageal atresia Stephen Greenhough 562
Section 25: Cardiac surgery Akbar Vohra 565
• Aortic valve surgery Akbar Vohra 566
• Cardiopulmonary bypass: principles, physiology and biochemistry Akbar Vohra 568
• Cardiopulmonary bypass: sequelae Akbar Vohra 572
• Congenital heart disease: general principles Sally Wilmshurst 574
• Congenital heart disease: management of specific lesions Sally Wilmshurst 577
• Coronary artery bypass grafting Akbar Vohra 580
• Mitral valve surgery Akbar Vohra 583
• Postoperative care of adult patients after cardiopulmonary bypass Akbar Vohra 586
• Postoperative care of paediatric patients after cardiopulmonary bypass Sally Wilmshurst 589
• Regional anaesthesia and cardiac surgery Akbar Vohra 591
• Thoracic aorta surgery Akbar Vohra 593

Part 3: Anaesthetic Factors

Section 26: Preoperative assessment Brian J Pollard 599
• Cardiopulmonary exercise testing Dougal Atkinson and John A Moore 600
• Day-case surgery Brian J Pollard 604
• The elderly patient Brian J Pollard 607
• Elective surgery Brian J Pollard 610
xi
Q Contents • Emergency surgery Brian J Pollard 613
• Infants and children George H Meakin 615
• Premedication Brian J Pollard 619
• Preoperative assessment of cardiovascular risk in non-cardiac surgery Brian J Pollard 621
• Preoperative assessment of pulmonary risk Brian J Pollard 625
• Psychiatric disorders Brian J Pollard 628
• Substance abuse Brian J Pollard 630
• Water and electrolyte disturbances Brian J Pollard 633
Section 27: Airway Cyprian Mendonca 639
• Airway and aspiration risk Rajneesh Sachdeva 640
• Artificial airways Cyprian Mendonca 642
• Difficult airway: overview Cyprian Mendonca 647
• Difficult airway: management Cyprian Mendonca 651
• Difficult airway: new devices Cyprian Mendonca 660
• Difficult airway: prediction Cyprian Mendonca 664
• Effect of general anaesthesia on the airway/upper alimentary canal Cyprian Mendonca 667
• Hypoxaemia under anaesthesia Payal Kajekar 670
• Paediatric airway Carol Bradbury 675
Section 28: Equipment and monitoring Baha Al-Shaikh 679
• The anaesthetic machine James DA Wood and Baha Al-Shaikh 680
• Breathing systems James DA Wood and Baha Al-Shaikh 683
• Depth of anaesthesia Sarath Varghese and Baha Al-Shaikh 687
• Monitoring Rajesh Pattanayak and Baha Al-Shaikh 690
• Pre-use check procedures for anaesthetic machines Amy Greengrass and Baha Al-Shaikh 693
• Ventilators Mark Snazelle and Baha Al-Shaikh 696
Section 29: Techniques Baha Al-Shaikh 699
• Blind nasal intubation Mark Snazelle and Baha Al-Shaikh 700
• Closed circle anaesthesia James DA Wood and Baha Al-Shaikh 702
• Epidural and spinal anaesthesia Baha Al-Shaikh 707
• Induced hypotension during anaesthesia Rajesh Pattanayak and Baha Al-Shaikh 711
• One-lung anaesthesia R Kadayam Sreenivasan and Simon Stacey 714
• Prolonged anaesthesia Rajesh Pattanayak and Baha Al-Shaikh 717
• Regional anaesthesia techniques Baha Al-Shaikh 719
• Total intravenous anaesthesia Mark Snazelle and Baha Al-Shaikh 722
Section 30: Management problems Brian J Pollard 725
• Allergic reactions Brian J Pollard 727
• Amniotic fluid embolism Brian J Pollard 730
• Awareness Chris JD Pomfrett 733
• Blood transfusion Niall O’Keeffe 735
• Cardiopulmonary resuscitation Paul Knott 738
• Complications of position Brian J Pollard 743
• Electroconvulsive therapy Brian J Pollard 747
• Failure to breathe or wake up postoperatively Brian J Pollard 749
• Fat embolism Arabella P Stevens 751
• Fluid and electrolyte balance Simon Varley 754
• Intraoperative arrhythmias Brian J Pollard 759
• Intraoperative bronchospasm Brian J Pollard 762
• Intraoperative hypertension Brian J Pollard 765
• Local anaesthetic toxicity Brian J Pollard 767
• Malignant hyperthermia: clinical presentation Philip M Hopkins 770
• Masseter muscle spasm Philip M Hopkins 772
• Neuroleptic malignant syndrome Brian J Pollard 774
xii
 Q Contents
• Pacing and anaesthesia Akbar Vohra 777
• Postoperative oliguria Brian J Pollard 779
• Postoperative pain management Chandran Jepegnanam 783
• Pseudocholinesterase deficiency Brian J Pollard 788
• Raised intracranial pressure/cerebral blood flow control Brian J Pollard 791
• Thrombosis and embolism Niall O’Keeffe 793
• Total spinal anaesthesia Brian J Pollard 796
• Transport of the critically ill Brian J Pollard 799
• Trauma Brian J Pollard 801
• Transurethral resection of the prostate syndrome Brian J Pollard 805

Index

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 Contributors

Q Contributors
Iurie Acalovschi MD PhD FCARCSI(HON) FRCA(HON) Thomas Allen Crozier MScBiol PhD MD
Consultant and Professor Emeritus, Department Department of Anesthesiology, University Medical
of Anesthesia and Intensive Care, Octavian Fodor Center, University of Göttingen, Germany
Emergency Clinical Hospital, Cluj-Napoca, Romania
Stefan De Hert MD PhD
José A Aguirre MD DESRA FMH(Anesthesiology) Professor, Department of Anesthesiology, University
SGNOR(Emergency Medicine) SFG-LNA Hospital Ghent, Belgium
Consultant Anesthetist, Balgrist University Hospital,
Susanne Eberl MD DEAA
Zurich, Switzerland
Department of Anesthesiology, Academic Medical
Baha Al-Shaikh FCARCSI FRCA Center, Amsterdam, The Netherlands
Consultant Anaesthetist and Honorary Senior Lecturer,
Veronika Evers MD MAE
William Harvey Hospital, Ashford, Kent, UK
Department of Anesthesiology, Academic Medical
Ian Appleby FRCA Center, Amsterdam, The Netherlands
National Hospital for Neurology and Neurosurgery,
Jan Fräβdorf DESA MD
University College London Hospitals, London, UK
Staff Anesthesiologist, Department of
Dougal Atkinson MBBS MRCP(UK) FRCA Anaesthesiology, Academic Medical Centre (AMC),
Consultant in Anaesthesia and Critical Care, University of Amsterdam, The Netherlands
Manchester Royal Infirmary, Manchester, UK
Amy Greengrass BM
Craig R Bailey MB BS FRCA Core Trainee in Anaesthesia, William Harvey Hospital,
Consultant Anaesthetist, Guys and St Thomas’ NHS Ashford, Kent, UK
Foundation Trust, London, UK
Stephen Greenhough BSc MB ChB FRCA
Mark C Bellamy BA MBBS MA FRCA Department of Paediatric Anaesthesia, Royal Manchester
Intensive Care Unit, St James’s University Hospital, Children’s Hospital, Oxford Road, Manchester, UK
Leeds, UK
Tamsin Gregory BSc MBBS MRCP FRCA
Alain Borgeat National Hospital for Neurology and Neurosurgery,
Head of the Department of Anesthesiology, University College London Hospitals, London, UK
Orthopedic University Hospital Balgrist, Zurich,
Switzerland Rashan Haniffa FRCA MRCP
Academic Clinical Fellow in Anaesthesia, University
Carol L Bradbury FRCA College London Hospitals, London, UK
Specialist Registrar in Anaesthesia, University
Hospitals Coventry and Warwickshire, Coventry, UK Richard J Harding MBBS BMedSci FRCA
Department of Anaesthesia, St James’s University
David Brealey MRCP PhD FRCA Hospital, Leeds, UK
University College London Hospitals, London, UK
David Highton MBChB FRCA
Helen Buglass MBChB FRCA National Hospital for Neurology and Neurosurgery,
Consultant in Anaesthesia and Critical Care, University College London Hospitals, London, UK
Pinderfields Hospital, Wakefield, UK
Nicholas Hirsch FRCA FRCP
Giorgio Capogna MD Department of Neuroanaesthesia and Neurocritical Care,
Professor of Obstetric Anesthesia, University La The National Hospital for Neurology and Neurosurgery,
Sapienza, Rome; Head of Department of Anesthesia, University College London Hospitals, London, UK
Città di Roma Hospital, Rome, Italy
Philip M Hopkins MB BS MD FRCA
Andrew J Charlton Professor of Anaesthesia, University of Leeds;
Department of Paediatric Anaesthesia, Royal Honorary Consultant Anaesthetist, Leeds Teaching
Manchester Children’s Hospital, Manchester, UK Hospitals NHS Trust, Leeds, UK xv
Q Contributors Marianne Hösele MD George H Meakin ChB MD FRCA
Division of Anesthesiology for Neurosurgical and Consultant and Senior Lecturer, Department of
Craniofacial Surgery and Intensive Care Medicine, Paediatric Anaesthesia, Royal Manchester Children’s
Medical University of Graz, Graz, Austria Hospital, Manchester, UK
Katharine Hunt FRCA Peter Meijer
Consultant Neuroanaesthetist, National Hospital Department of Anesthesiology, Academic Medical
for Neurology and Neurosurgery, University College Center, Amsterdam, The Netherlands
London Hospitals, London, UK
Cyprian Mendonca MD FRCA
Chandran Jepegnanam FRCA Consultant Anaesthetist and Honorary Senior
Consultant in Anaesthesia and Acute Pain Management, Clinical Lecturer, University Hospitals Coventry and
Department of Anaesthesia, Manchester Royal Infirmary, Warwickshire, Coventry, UK
Central Manchester University Hospitals NHS
Zoka Milan MD MSc PhD
Foundation Trust Hospital, Manchester, UK
Consultant Anaesthetist and Intensivist, St James’s
Rohit Juneja University Hospital, Leeds, UK
National Hospital for Neurology and Neurosurgery,
Lisa Milligan BSc(Hons) MBChB FRCA FFICM
University College London Hospitals, London, UK
Consultant in Anaesthetics and Intensive Care
Payal Kajekar FRCA Medicine, Sherwood Forest Hospitals NHS Foundation
Specialty Registrar in Anaesthesia, University Hospitals Trust, Nottinghamshire, UK
Coventry and Warwickshire, Coventry, UK
John A Moore BSc MBChB FRCA MRCP
Swati Karmarkar MD FRCA Consultant in Anaesthesia and Intensive Care,
Consultant Anaesthetist, Manchester Royal Infirmary, Manchester Royal Infirmary, CMFT, Manchester, UK
Manchester, UK
Andrew J Mortimer BSc(HONS) MD FRCA
Rick Keays MD FRCP FRCA FFPMRCA MEWI
Magill Department of Anaesthetics and Intensive Care, Consultant in Anaesthesia and Intensive Care,
Chelsea & Westminster Hospital, London, UK Department of Anaesthesia, University Hospital
of South Manchester, Wythenshawe Hospital,
Paul Knott RN Dip HE BSc(Hons) PGCE
Manchester, UK
Resuscitation & Simulation Practitioner, Central
Manchester University Hospitals, NHS Foundation Paul Murphy MA(Cantab) MBChB FRCA
Trust, Manchester, UK Neurosciences Critical Care Unit, The General Infirmary
at Leeds, Leeds, UK
Robin Kumar MBBS BSc FRCA
Clinical Fellow in Neuroanaesthesia, National Hospital Mary Newton MB BS FRCA
for Neurology and Neurosurgery, Queen Square, London National Hospital for Neurology and Neurosurgery,
University College London Hospitals, Queen Square,
Michelle Leemans
London, UK
Department of Neuroanaesthesia and Neurocritical Care,
The National Hospital for Neurology and Neurosurgery, Deborah M Nolan MBChB FRCA
University College London Hospitals, Queen Square, Consultant Anaesthetist, University Hospital of South
London, UK Manchester, Manchester, UK
William R Macnab BSc MBChB FRCA Niall O’Keeffe BAO BCh FRCA FICM
Consultant Anaesthetist, Manchester Royal Infirmary, Consultant in Cardiothoracic Anaesthesia and
Manchester, UK Intensive Care, Manchester Royal Infirmary,
Manchester, UK
Gerlinde Mausser MD
Division of Anesthesiology for Neurosurgical and Davandra Patel MBChB FRCA
Craniofacial Surgery and Intensive Care Medicine Consultant Paediatric Anaesthetist, Royal Manchester
Medical University of Graz, Graz, Austria Children’s Hospital, Manchester, UK
Denise McCarthy MB BCh BAO FCARCSI Mark R Patrick BSc FRCA
Specialist Registrar in Anaesthesia, Department of Consultant Cardiothoracic Anaesthetist, University
Anaesthesia and Intensive Care Medicine, Hospital of South Manchester, Wythenshawe Hospital,
Cork University Hospital, Cork, Ireland Manchester, UK
xvi
 Q Contributors
Rajesh Pattanayak FRCA Jean-François Schved MD, PhD
Consultant Anaesthetist, William Harvey Hospital, Professor and Chairman, Department of Hematology,
Ashford, Kent, UK Hôpital Saint -Eloi, Montpellier University Hospital,
Montpellier France
Brian J Pollard BPharm MBChB MD
FRCA MEWI Gerhard Schwarz MD
Professor of Anaesthesia, Manchester Medical School, Professor and Chairman, Division of Anesthesiology
Department of Anaesthesia, Manchester Royal for Neurosurgical and Craniofacial Surgery and
Infirmary, Manchester, UK Intensive Care Medicine, Medical University of Graz,
Graz, Austria
Dr Chris JD Pomfrett BSc PhD Clinical Scientist,
Lecturer in Neurophysiology applied to Anaesthesia, Sandeep Sharma BSc MBBS FRCA
Department of Anaesthesia, Manchester Royal National Hospital for Neurology and Neurosurgery,
Infirmary, Manchester, UK University College London Hospitals, London, UK
Benedikt Preckel MD MA DEAA George Shorten FFARCSI FRCA MD PhD
Associate Professor of Anesthesia, Department of Professor of Anaesthesia and Intensive Care Medicine,
Anesthesiology, Academic Medical Center, Amsterdam, Department of Anaesthesia and Intensive Care
The Netherlands Medicine, Dean of Medicine, Cork University Hospital,
University College Cork, Ireland
Jeremy Radcliffe FRCA
Department of Neuroanaesthesia and Neurocritical Suveer Singh BSc MBBS PhD FRC EDIC
Care, The National Hospital for Neurology and DICM FFICM
Neurosurgery, University College London Hospitals, Consultant Intensivist and Respiratory Physician,
Queen Square, London, UK Honorary Senior Lecturer, Chelsea and Westminster
Hospital NHS Foundation Trust, Imperial College
Shilpa Reddy FRCA MRCP
London, UK
Perioperative Research fellow in Anaesthesia,
University College Hospitals, London, UK Roger M Slater MRCP(UK) FRCA
Ugan Reddy BSc MBChB FRCA Consultant Anaesthetist, Department of Anaesthesia,
Consultant in Neuroanaesthesia, The National Manchester Royal Infirmary, Manchester, UK
Hospital for Neurology and Neurosurgery, Martin Smith MBBS FRCA FFICM
University College London Hospitals, Consultant and Honorary Professor in
London, UK Neuroanaesthesia and Neurocritical Care, The
Andrew Roscoe MBChB FRCA National Hospital for Neurology and Neurosurgery,
Assistant Professor, Department of Anaesthesia, University College London Hospitals, London, UK
Toronto General Hospital, University of Toronto, Mark Snazelle MRCP FRCA
Canada Specialist Registrar, William Harvey Hospital,
Isolde Rötzer MD Ashford, Kent, UK
Division of Anesthesiology for Neurosurgical and Neil Soni MBChB FRCA FANZCA FCICM MD
Craniofacial Surgery and Intensive Care Medicine, Consultant in Critical Care and Anaesthesia, Chelsea
Medical University of Graz, Graz, Austria and Westminster Hospital, London, UK
Rajneesh Sachdeva DA FCARCSI R Kadayam Sreenivasan MD FRCA
Specialty Trainee in Anaesthesia, University Hospitals ST5, The Royal London Hospital, London, UK
Coventry and Warwickshire, Coventry, UK
Simon Stacey FRCA
Charles Marc Samama MD PhD FCCP Consultant Anaesthetist, St Bartholomew’s Hospital,
Professor and Chairman, Department of London, UK
Anaesthesiology and Intensive Care, Hotel-Dieu
University Hospital, Paris, France Arabella P Stevens MBChB MRCP FRCA
Locum Consultant Anaesthetist, University Hospital of
Andreas Schöpfer MD South Manchester, Manchester, UK
Division of Anesthesiology for Neurosurgical
and Craniofacial Surgery and Intensive Care Silvia Stirparo MD
Medicine, Medical University of Graz, Graz, Staff Anesthesiologist, Department of Anesthesiology,
Austria Città di Roma Hospital, Rome, Italy
xvii