Anaesthesia

Preface

Preface This book is aimed at all those medical and dental students, who have not yet known much about anaesthesia, but would like to learn something about its fundamentals. I t is not meant t o be a manual o f 'ho w to become an anaesthetis t i n ten easy lessons', and i s intende d no t t o replace , bu t rathe r t o supplemen t th e numbe r o f alread y available texts. An attemp t ha s been made to follow a patient abou t t o have a surgica l interven tion , unde r som e for m o f anaesthesia , i n a systemati c manner . Followin g som e historical note s an d a brie f loo k a t pain , th e patien t i s considere d fro m befor e admission to hospital, through various tests, to the period after operation . Some more common drug interactions are mentioned and the patient's progress is followed to the time of recovery. Most agent s used by anaesthetists t o produce anaesthesi a (eithe r genera l or loca l and regional ) ar e include d an d thei r chemica l formulae , action , advantages , dis advantages , complication s an d danger s ar e mentioned . Wher e applicabl e theorie s underlying th e activit y o f thes e substance s an d method s o f us e ar e discusse d wit h references given. Specialized topic s suc h a s malignan t hyperthermia , lif e savin g measures , obstet rical anaesthesia , paediatri c anaesthesia , anaesthesi a fo r EN T an d ey e surgery, im mediate care and other selected topics are also included. The author's long standing contact with medical students and young postgraduates— dating back for over a quarter of a century—helps him to understand and appreciat e the needs of those standing at the bottom of the pyramid o f learning and wishing t o enquire why some things in anaesthesia are done the way they are. The author hope s that this book ca n fulfil thi s 'quest for knowledge' . The autho r i s gratefu l t o th e followin g author s an d thei r publisher s fo r kindl y giving their permission to quote from thei r works: R.S. Atkinson, G.B. Rushman and J. Alfred Lee , A Synopsis of Anaesthesia (Bristol , John Wright and Sons); S.A. Feldman, Muscle Relaxants (Philadelphia , W.B. Saunders); S.A. Feldman and Brian E. Crawley (eds.), Tracheostomy and Artificial Ventilation in the Treatment of Respiratory Failure (London, Edward Arnold); The IMS. Diary (Hon g Kong, I.M.S. Pacific Ltd.); Sir Robert Macintosh, J. Alfred Le e and R.S. Atkinson, Lumbar Puncture and Spinal Analgesia, Intradural and Extradural (Edinburg h & London , Churchil l Livingstone); X Preface J. Spierdijk , S.A . Feldma n an d H . Matti , Anaesthesia and Pharmacology (London , University Press); J.A. Thornto n an d C.J . Levy , Techniques of Anaesthesia, with Management of the Patient and Intensive Care (London, Chapman an d Hall). The following illustrations in this book are from other works and the author wishes to thank their authors for their permission to use: Figs. 3.1 & 3.2, from S.A . Feldma n an d Bria n E . Crawley (eds.), Tracheostomy and Artificial Ventilation in the Treatment of Respiratory Failure', Fig. 9.1 , from J . Spierdijk , S.A . Feldma n an d H . Matti , Anaesthesia and Pharmacology ; Figs. 9.4-9.10, from Sir Robert Macintosh, J. Alfred Le e and R.S. Atkinson, Lumbar Puncture and Spinal Analgesia; Fig. 19.2, supplied by the Grantham Cardiothoracic Hospital, Hong Kong. Courtes y Professor C.K . Mok . The autho r i s also indebte d t o Dr s R.S . Atkinson, G.B . Rushma n an d J . Alfre d Lee for thei r kin d hel p especially wit h Chapte r 2 an d elsewhere ; t o Professo r J.A . Thornton an d D r C.J . Lev y fo r som e pre-operative, obstetrica l an d othe r data ; t o I.M.S. Pacific Ltd . for thei r help with a number of valuable data i n Chapters 3 and the 'Table of Som e Normal Values' ; to M r Jagger S.K . Lau , formerly Chie f Photo grapher , Department of Surgery, University of Hong...