Perioperative Medicine A Problem-Based Learning Approach

In recent years anesthesiologists have developed a more active role in the entire peri-operative period-from the decision for surgery, through recovery, discharge and beyond. In addition, the core training curriculum of anesthesiology has changed significantly to now include many non-operating room anesthesia rotations.General anesthesiology texts include varying degrees of perioperative management information, and a few titles are devoted specifically to the area. However, none combines a problem-based approach with review questions and answers with explanations. Following the format of the Anesthesiology Problem-Based Learning Approach series, each chapter in Perioperative Medicine describes a specific condition or situation and a virtual case presented through a series of questions and answers. With 48 chapters covering a broad array of conundrums encountered in clinical perioperative medicine, the text focuses on preoperative optimization of patients with different comorbidities, such as coronary artery disease, heart failure, chronic obstructive pulmonary disease, obstructive sleep apnea, diabetes mellitus, cirrhosis, substance use disorder, and anemia. Sections on how to choose preoperative tests, medication management, and handling ethical issues, like informed consent, DNR, and uncomfortable conversations with patients, are discussed in detail. Perioperative Medicine: A Problem-Based Learning Approach provides an up-to-date compendium of topics commonly presenting in daily practice and serves as a unique learning opportunity for the busy perioperative clinician approaching a new case and for clinicians in training who need to learn the basics.

1 - Preoperative Process: Phone Triage, Preoperative Clinic, or Virtual Patient Visits
2 - Perioperative Surgical Home Care Model: Utopia or Bureaucracy?
3 - Choosing Wisely: How to Advise the Patient on Preoperative Testing
4 - My 79-Year-Old Patient for Right Inguinal Hernia Repair Has No Labs on File
5 - Medication Management: Drug-Eluting Stent 2 Months Ago
6 - Perioperative Management of Medications for Substance Use Disorders
7 - Indications for Preoperative C-Spine Imaging for Elective Procedures
8 - Prehabilitation Before Total Hip Replacement
9 - Cardiopulmonary Exercise Testing
10 - Ex-Premie for Interval Hernia Repair at 11 Weeks
11 - Geriatric Assessment: "The Get Up and Go, Got Up and Left"
12 - AHA Guidelines Application
13 - Perioperative Atrial Fibrillation and Anticoagulation Management
14 - Severe Aortic Stenosis: Candidate for a Surgicenter?
15 - Does Your Cataract Surgeon Know You Were Admitted for Heart Failure Last Week?
16 - Echo Shows Elevated Pulmonary Artery Pressure
17 - Shoulder Replacement in Patient Who Had a Heart and Lung Transplant
18 - COPD: Still Smoking, Still Wheezing
19 - Severe OSA in the Ambulatory Setting
20 - COVID-19
21 - Cirrhosis and Truly Elective Major Surgery
22 - Patient Has Seizures and Needs "Clearance"
23 - Clinical Application of Perioperative Brain Health
24 - Restrictive Lung Disease from Parkinson's Disease Rigidity: Is It Real?
25 - A 56-Year-Old with a Recent CVA for Elective Surgery: How Soon Is Too Soon? 291
26 - Avoiding Exacerbation of Chronic Kidney Disease
27 - Preoperative Anemia Management: Evaluation and Treatment
28 - Prolonged PTT in a Healthy Patient
29 - Elevated Glucose on Admission Fingerstick: How High Can We Go?
30 - Pheochromocytoma and MEN Syndromes
31 - Pregnant Patient for Non-Obstetric Surgery
32 - Older Primigravida with Twin Pregnancy for Elective Cesarean Delivery
33 - Minimally Invasive Surgery and Other Elements of Enhanced Recovery Protocols
34 - Blood Conservation
35 - When DNR Stands in the OR: Who Benefits? Who Decides?
36 - Informed Consent: Do We Really Do This Correctly?
37 - Can I Refuse to Anesthetize This Patient?
38 - Difficult Conversations
39 - This Patient Has 17 Allergies: Including "General Anesthesia"
40 - Nonverbal Autistic 30-Year-Old for Full Mouth Dental Rehabilitation with Malignant Hyperthermia
41 - Patient with AAA with Implanted Spinal Cord (Neuro) Stimulator
42 - Patient with Pacemaker-Dependent ICD for Renal Cryoablation
43 - My Friend's Son Requests Surgery for Gynecomastia Caused by the Drugs He Uses for Bodybuilding
44 - Perioperative Care of the Cancer Patient
45 - Discharge Criteria in Developmentally Disabled Patient with OSA
46 - My Patient Is Twitching Like a Fish Out of Water: Avoiding the Risks of Residual Paralysis
47 - My Patient in the PACU Is Not Making Any Sense
48 - The HR Monitor Is Alarming in the PACU: Postoperative Arrhythmias

Deborah C. Richman, MBChB, FFA(SA) trained at the University of Cape Town, South Africa. Subsequently she was on the faculty of the Technion in Haifa, Israel - at Ha'Emek hospital in Afula. She started one of the first pre-operative clinics in Israel. Currently, as associate professor of clinical anesthesiology at Renaissance School of Medicine, Stony Brook, her roles include: medical director of Pre-Operative Services since 2006, member of the Institutional Ethics Committee and ACLS instructor. Deborah is past president of SPAQI (Society for Perioperative Assessment and Quality Improvement); and serves on their board of governors. Debra Pulley, MD is Professor of Anesthesiology at Washington University School of Medicine in St. Louis, MO. She first became intrigue with medicine while working as an environmental engineer managing disposal of hazardous waste and learning the effect industrial toxics can have on the human body. After medical school, she chose to specialize in anesthesiology. Several years into providing anesthetic care to patients, Debra recognized the need for multidisciplinary involvement in optimizing perioperative care of patients. She has served as president of the Society of Perioperative Assessment and Quality Improvement (SPAQI) and is currently on the Board of Governors. Adriana D. Oprea, MD is Associate Professor of Anesthesiology at Yale School of Medicine After completing a residency program in Internal Medicine, she worked as a hospitalist at Yale New Haven Hospital and retrained in Anesthesiology. She is dual board certified in internal medicine and anesthesiology and her area of academic and clinical interest is preoperative optimization, especially for patients with endocrine and hematologic disorders. She serves on multiple national committees on Perioperative Medicine and is part of the executive and guidelines committees for the Society for Perioperative Assessment and Quality Improvement (SPAQI).