Personalized Anaesthesia: Targeting Physiological Systems for Optimal Effect / Edition 1

by Pedro L. Gambús, Jan F. A. Hendrickx

Overview

Personalized Anaesthesia presents a modern vision of anaesthesia. Integrating technology and knowledge from leading experts in the field, this book will change the way anaesthesia is both taught and practiced. Modern practice requires the anaesthetist to provide patient-specific management. This is the first resource to be organised by the desired physiological effect, rather than by drug groupings, explaining how physiological changes can be produced and controlled according to the characteristics of each patient and the particular surgical context. The book integrates physiology, pharmacology and technology, and applies these concepts in a systematic manner to each homeostatic system. This will optimise drug titration, effect quantification and decision making in anaesthesia practice to match the needs of the individual patient. Complex mathematical and scientific concepts are explained using accessible text, colour illustrations throughout and graphs. This is an essential text for any consultant or trainee working in anaesthesia.

Product Details

ISBN-13:	9781107579255
Publisher:	Cambridge University Press
Publication date:	02/06/2020
Pages:	400
Product dimensions:	7.44(w) x 9.69(h) x 0.59(d)

About the Author

Pedro Gambus is a consultant anaesthetist at the Hospital CLINIC de Barcelona and Associate Professor of Biomedical Engineering at the Universitat de Barcelona, former postdoctoral fellow at the Department of Anesthesia at Stanford University, California, and Visiting Professor at the Department of Anesthesia and Perioperative Care University of California in San Francisco (UCSF).

Jan Hendrickx is a consultant anaesthetist at Aalst General Hospital and Adjunct Professor at the Department of Anesthesia at Stanford University, California.

Table of Contents

Foreword; Introduction; Part I. Basic Principles: 1. Principles of quantitative clinical pharmacology Pedro L Gambús and Sebastián Jaramillo; 2. Pharmacokinetic and pharmacodynamic modeling in anaesthesia María J. Garrido and Iñaki F. Trocóniz; 3. Drug interactions: additivity and synergy among anaesthetic drugs Jacqueline A. Hannam and Timothy G. Short; 4. Covariate analysis in clinical anaesthesia Luis I. Cortinez and Brian J. Anderson; 5. Signal analysis and response measurement Umberto Melia, Erik W. Jensen and José F. Valencia; 6. Application of PKPD and signal analysis to drug administration in anaesthesia Ross R. Kennedy; Part II. Targeting Effects: 7. Hypnotic effect: inducing unconsciousness and emergence from anaesthesia Sergio Vide, Catarina Nunes and Pedro Amorim; 8. Analgesia: effects on response to nociceptive stimulation Emmanuel Boselli and Mathieu Jeanne; 9. Personalized sedation and analgesia Michael M. Beck, Jeffrey B. Horn and Ken B. Johnson; 10. Respiratory depression Malin Jonsson Fagerlund; 11. Immobility Klaus T. Olkkola and Douglas J. Eleveld; 12. Effects on brain function Neus Fabregas and Adrian W. Gelb; 13. Targeted and individualized perioperative medicine for cognitive dysfunction Pauline Glasman, Alice Jacquens and Vincent Degos; 14. Cardiac and hemodynamic function Kai Kuck, Natalie Silverton and Michael K. Cahalan; 15. Effects of anaesthesia on thermoregulation Oliver Kimberger; 16. Effects of perioperative management on kidney function Xavier Borrat and Jordi Mercadal; 17. Effects on liver function Andre M. De Wolf and Jan F. A. Hendrickx; 18. Effects on fluid balance Robert G. Hahn; 19. Ventilation during general anaesthesia Lluís Gallart; 20. Epilogue: artificial intelligence methods Sebastián Jaramillo, José F. Valencia and Pedro L. Gambús; Index.

Editorial Reviews

Reviewer: Robert R. Gaiser, MD (Yale School of Medicine)
Description: This book describes a tailored approach to anesthesia to achieve various physiological principles. It takes a physiological variable, presents an extensive list and means for monitoring, and then incorporates the monitor in the management of the patient. The book is thorough and does not miss a monitor or physiological variable. While figures are well done, the tables are exceptional, providing an immense amount of information in a single location.
Purpose: The overall purpose of the book is unclear. The stated purpose is to show how various physiological states may be achieved, but the book never addresses why targeting the physiological state is important. The foreword presents an overview and yet lacks an overall goal. The book achieves its stated objective, yet leaves readers with the question, "Why?" The book does a good job of describing various monitors, their limitations, and interpretation of the results.
Audience: The intended audience is unclear. The level of writing and the subject is beyond an introductory book, so it would be of limited use to medical students and residents. The subject may be of interest to practicing anesthesiologists who already have a superficial knowledge in the area. It is unclear from the presentation whether greater depth is needed. The authors come primarily from two institutions and seem to be experts in their areas.
Features: The book begins with a clear and comprehensive review of pharmacological principles. The next section addresses monitors and limitations. With this basis, readers are then presented with various physiological variables and how a specific value may be targeted. Anesthesiologists already know the majority of the material, and the book provides a thorough review of the topic. The book addresses different patient populations such as children and the elderly. It would have been helpful to include the obstetric patient population, as nonobstetric surgery is common.
Assessment: This is a thorough discussion of the basics and advanced methods for targeting a specific depth of anesthesia, temperature, intravascular volume, and blood pressure. The approach is already known by anesthesiologists at greater depth. The figures are clear with interesting legends. The tables are extremely useful in providing a vast amount of information in a format that is easy to read and to understand. The references are relatively current, and the index allows one to explore the book easily. While it may be read cover to cover, most will find the book better as a reference.

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