By Barry Friedberg

One significant spinoff of the getting older baby-boom new release is a surging curiosity in plastic surgery. even though strategies like facelifts and abdominoplasties (the 'tummy-tuck') are thought of minimally invasive, the anesthetic protocols and regimens listed below are frequently overly advanced and unnecessarily poisonous. This reference will specialize in the entire tactics that the anesthesiologist should be trained in to properly deal with this team of sufferers. Perioperative care and discomfort administration might be coated for the total spectrum of operations, and there'll be certain emphasis on level-of-consciousness tracking of those sufferers.

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INTRODUCTION EVOLUTION OF PATIENT MONITORING LEVEL-OF-CONSCIOUSNESS MONITORING BISPECTRAL INDEX: THE PROTOTYPE LEVEL-OF-CONSCIOUSNESS MONITOR Bispectral Analysis BIS Algorithm BIS Index VALIDATION OF THE BIS INDEX ASSESSING THE BIS INDEX IN RECOVERY OF CONSCIOUSNESS ASSESSING CONSISTENCY OF BIS INDEX PERFORMANCE FACTORS AFFECTING THE CONSCIOUSNESS-MONITOR VALUES USING CONSCIOUSNESS MONITORS IN ANESTHESIA PRACTICE CONSCIOUSNESS MONITORING DURING TYPICAL GENERAL ANESTHESIA Consciousness Monitoring During the Induction of Anesthesia Consciousness Monitoring During Endotracheal Intubation Consciousness Monitoring During the Maintenance of Anesthesia Maintenance strategies using BIS monitoring Consciousness Monitoring During Emergence from Anesthesia Responding to Consciousness-Monitoring Changes During Anesthesia CONSCIOUSNESS MONITORING AND GLOBAL CNS FUNCTION EEG Variants and EEG Signal Analysis Paradoxical delta phenomenon Small-amplitude EEG Epileptiform activity High-frequency artifacts Pacemakers Medical/surgical devices Electrocautery devices CONSCIOUSNESS MONITORING AND THE “ABNORMAL” BRAIN BIS AND PHARMACOLOGIC RESPONSES Nitrous oxide N 2 O Ketamine Etomidate CLINICAL MANAGEMENT SUMMARY: CLINICAL BENEFITS OF CONSCIOUSNESS MONITORING 23 Cambridge Books Online © Cambridge University Press, 2009 P1: PBU cufx091-03 CUFX091/Friedberg 0 521 87090 9 Feb.

MAC remains a term of exclusion in that it specifically is NOT general or regional anesthesia. 2 BIS-monitored PK MAC or the MIA™ technique falls well within the scope of the definition of IV sedation for an AAAASF Class B facility, except in the (current) regulations of the AAAASF and the state of Florida. The MIA™ technique provides a measure of the level of hypnosis achieved. The MIA™ technique intensifies but does not depress the laryngeal or “life-preserving” reflexes. MINIMAL, MODERATE, DEEP SEDATION & GENERAL ANESTHESIA ∗ Minimal sedation (Anxiolysis) Minimal sedation is a drug-induced state during which patients respond normally to verbal commands.

Balasubramaniam B, Park GR: Sexual hallucinations during and after sedation and anaesthesia. Anaesthesia 58:1149, 2003. Cambridge Books Online © Cambridge University Press, 2009 P1: PBU cufx091-03 CUFX091/Friedberg 3 0 521 87090 9 Feb. 2, 2007 17:30 Level-of-Consciousness Monitoring Scott D. D. INTRODUCTION EVOLUTION OF PATIENT MONITORING LEVEL-OF-CONSCIOUSNESS MONITORING BISPECTRAL INDEX: THE PROTOTYPE LEVEL-OF-CONSCIOUSNESS MONITOR Bispectral Analysis BIS Algorithm BIS Index VALIDATION OF THE BIS INDEX ASSESSING THE BIS INDEX IN RECOVERY OF CONSCIOUSNESS ASSESSING CONSISTENCY OF BIS INDEX PERFORMANCE FACTORS AFFECTING THE CONSCIOUSNESS-MONITOR VALUES USING CONSCIOUSNESS MONITORS IN ANESTHESIA PRACTICE CONSCIOUSNESS MONITORING DURING TYPICAL GENERAL ANESTHESIA Consciousness Monitoring During the Induction of Anesthesia Consciousness Monitoring During Endotracheal Intubation Consciousness Monitoring During the Maintenance of Anesthesia Maintenance strategies using BIS monitoring Consciousness Monitoring During Emergence from Anesthesia Responding to Consciousness-Monitoring Changes During Anesthesia CONSCIOUSNESS MONITORING AND GLOBAL CNS FUNCTION EEG Variants and EEG Signal Analysis Paradoxical delta phenomenon Small-amplitude EEG Epileptiform activity High-frequency artifacts Pacemakers Medical/surgical devices Electrocautery devices CONSCIOUSNESS MONITORING AND THE “ABNORMAL” BRAIN BIS AND PHARMACOLOGIC RESPONSES Nitrous oxide N 2 O Ketamine Etomidate CLINICAL MANAGEMENT SUMMARY: CLINICAL BENEFITS OF CONSCIOUSNESS MONITORING 23 Cambridge Books Online © Cambridge University Press, 2009 P1: PBU cufx091-03 CUFX091/Friedberg 0 521 87090 9 Feb.

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