Table Of ContentANAESTHESIA
DATABOOK
A Perioperative and Peripartum Manual
3RD EDITION
To Chris, without whom the writing of this book would not have been possible. In affectionate memory of
the late H Stuart Winsey FRCS, an anaesthetist’s surgeon, and the late Ritabrata Bose (Bosie) FRCA,
who valued books.
ANAESTHESIA
DATABOOK
A Perioperative and Peripartum Manual
3RD EDITION
Rosemary Mason MB ChB DObst RCOG FRCA
Consultant Anaesthetist
Swansea NHS Trust
Singleton Hospital
Swansea SA2 8QA
UK
© 2001
Greenwich Medical Media Limited
137 Euston Road
London
NW1 2AA
ISBN 1 84110067 6
First published 2001
Apart from any fair dealing for the purposes of research or private study, or
criticism or review, as permitted under the UK Copyright Designs and Patents
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be sent to the publishers at the London address printed above.
The right of Rosemary Mason to be identified as editor of this work has been
asserted by her in accordance with the Copyright Designs and Patents Act 1988.
The publisher makes no representation, express or implied, with regard to the
accuracy of the information contained in this book and cannot accept any legal
responsibility or liability for any errors or omissions that may be made.
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SECTION 1
Medical disorders and
anaesthetic problems
A
Achalasia of the oesophagus 3
Achondroplasia 5
Acromegaly 8
Addiction 12
Addison’s disease; adrenocortical
insufficiency 14
AIDS; acquired immunodeficiency
syndrome 17
Air embolism; see section 2 525
Alcoholism 23
Aldosteronism, Primary 26
Alkaptonuria 26
Alveolar proteinosis, pulmonary 27
Amniotic fluid embolism 29
Amphetamine abuse 29
Amyloidosis 32
Amyotrophic lateral sclerosis 36
Ankylosing spondylitis 36
Antiphospholipid syndrome (Hughes’
syndrome) 40
Aortic regurgitation 43
Aortic stenosis 46
Arnold Chiari (and other Chiari)
malformations 49
Arthrogryposis multiplex congenita 51
Asthma 54
Athletic heart syndrome 59
Automatic implantable cardioverter
defibrillators 62
Autonomic failure 66
B
Becker muscular dystrophy 70
Beckwith-Wiedmann syndrome 71
Budd-Chiari syndrome 73
Buerger’s disease 74
C
Carcinoid syndrome 76
Cardiac tamponade 79
Cardiomyopathies; dilated, hypertrophic,
restrictive 82
Carnitine palmitoyl transferase deficiency 88
Carotid body tumour 90
Central core disease 91
C1 esterase inhibitor deficiency; acquired 93
Charcot-Marie-Tooth disease (peroneal
muscular atrophy) 95
Charge association 96
Cherubism 98
Christmas disease (haemophilia B) 99
Churg-Strauss syndrome 99
Coarctation of the aorta, adult 100
Cocaine abuse 102
Cockayne syndrome 106
Conn’s syndrome (primary aldosteronism) 107
Creutzfeldt-Jakob disease 109
Cri du Chat syndrome 111
Cushing’s syndrome & Cushing’s disease 112
Cystic fibrosis 114
Cystic hygroma (lymphangioma) 119
D
Dandy-Walker syndrome 122
Demyelinating diseases 123
Dermatomyositis/polymyositis complex 125
Diabetes insipidus 127
Diabetes mellitus 129
Diffuse idiopathic skeletal hyperostosis 134
Down’s syndrome 136
Drowning and near drowning 139
Duchenne muscular dystrophy 142
v
Contents
Dystrophica myotonica; and other
myotonic syndromes 147
E
Eaton-Lambert syndrome (Lambert-Eaton
or myasthenic syndrome) 153
Ebstein’s anomaly 155
Eclampsia and severe preeclampsia 156
Ehlers-Danlos syndrome 162
Eisenmenger’s syndrome 166
Emery-Dreifuss muscular dystrophy 169
Epidermolysis bullosa (recessive dystrophic) 170
Epiglottitis 172
Epilepsy 176
F
Fabry’s disease 182
Fallot’s tetralogy 183
Familial dysautonomia (Riley-Day
syndrome) 186
Familial periodic paralyses 188
Fat embolism syndrome 193
Fibrodysplasia (myositis) ossificans
progressiva 196
Fraser syndrome 198
Freeman-Sheldon syndrome 199
Friedreich’s ataxia 200
G
Gaucher’s disease 203
Giant axonal neuropathy 204
Gilbert’s disease (idiopathic unconjugated
hyperbilirubinaemia) 205
Glomus jugulare tumour 205
Glucagonoma 207
Glucose-6-phosphate dehydrogenase
deficiency 208
Glycogen storage diseases 209
Goldenhar’s syndrome 210
Goodpasture’s syndrome 212
Gorham’s syndrome 213
Guillain-Barre syndrome 214
H
Haemoglobinopathies (sickle cell disease) 218
Haemophilias A; and haemophilia B 224
Hallervorden-Spatz disease (neuroaxonal
dystrophy) 228
Heart block 229
HELLP syndrome 235
Hereditary angioneurotic oedema 238
Hereditary haemorrhagic telangiectasia
(Osler-Weber-Rendu disease) 241
Hereditary spherocytosis 245
Hers’ disease (Cori type VI glycogen
storage disease) 246
Homocystinuria 247
Hunter’s syndrome; see Hurler’s and
mucopolysaccharidoses 249
Huntington’s disease 249
Hurler, Hurler-Schie, Schie, and Hunter’s
syndromes 250
Hydatid disease 255
Hypercalcaemia 256
Hyponatraemia 258
Hypothyroidism 262
I
Infectious mononucleosis 267
Insulinoma 269
J
Jehovah’s Witnesses; management for
surgery 272
Juvenile hyaline fibromatosis 277
K
Kawasaki disease (mucocutaneous lymph
node syndrome) 279
Kearns-Sayre syndrome 280
Klippel-Feil syndrome 282
Klippel-Trenaunay-Weber syndrome 284
L
Lambert-Eaton syndrome 287
Laryngeal papillomatosis 287
Latex allergy 290
Lesch-Nyan disease 291
Ludwig’s angina 292
Lysergic acid diethylamide (LSD) abuse 294
M
Malignant hyperthermia 296
Marcus-Gunn jaw winking syndrome 303
Marfan syndrome 303
Maroteaux-Lamy syndrome 307
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Anaesthesia Databook: a perioperative and peripartum manual
Mastocytoses 308
McArdle’s syndrome (myophosphorylase
deficiency) 311
Mediastinal masses 313
Miller’s syndrome 317
Mitochondrial encephalomyopathies 318
Mitral valve disease 321
Morquio’s syndrome
(mucopolysaccharidosis type IV) 328
Motor neurone disease (amyotrophic
lateral sclerosis) 330
Moyamoya disease 332
Mucopolysaccharidoses 335
Multiple endocrine neoplasia 336
Multiple system atrophy (Shy-Drager
syndrome) 337
Muscular dystrophies 339
Myasthenia gravis 340
Myasthenic syndrome 344
Myeloma, multiple 344
Myoglobinuria 345
Myotubular (centronuclear) myopathy 345
Myxoedema 346
Myxoma, cardiac 346
N
Nemaline myopathy 350
Neurofibromatosis (types 1 & 2;
von Recklinghausen’s disease) 351
Neurogenic pulmonary oedema 354
Neuroleptic malignant syndrome 354
Noonan’s syndrome 357
O
Obesity 360
Obstructive sleep apnoea 363
Opiate addiction 368
Opitz-Frias syndrome 370
Osler-Weber-Rendu syndrome 370
Osteogenesis imperfecta 370
P
Pacemakers 375
Paget’s disease 375
Papillomatosis 356
Parkinson’s disease 356
Paroxsysmal nocturnal haemoglobinuria 380
Pemphigus vulgaris and foliaceous 382
Pericardial disease 384
Phaeochromocytoma 384
Phenylketonuria 391
Pierre-Robin syndrome and the Robin
sequence 393
Pituitary apoplexy 397
Plasma cholinesterase abnormalities 399
Polycythaemia vera and secondary
polycythaemias 402
Pompe’s disease; and adult-onset acid
maltase deficiency 405
Porphyria 407
Prader-Willi syndrome 413
Protein C deficiency 415
Protein S deficiency 418
Pulmonary hypertension 419
Pulmonary oedema 423
Q
QT interval syndromes, prolonged 433
R
Relapsing polychondritis 439
Rett syndrome 441
Rhabdomyolysis 442
Rheumatoid arthritis 447
S
Sarcoidosis 452
Schwartz-Jampel syndrome 454
Scleroderma 455
Scoliosis 458
Shy-Drager syndrome 461
Sick sinus syndrome (bradycardia/
tachycardia syndrome) 461
Sipple’s syndrome (MEN 2a) 463
Sjogren’s syndrome 464
Solvent and volatile substance abuse 465
Spinal muscular atrophy 469
Spondyloepiphyseal dysplasia 470
Sturge-Weber syndrome 472
Systemic lupus erythematosus 473
T
Takaysu’s arteritis 477
Tetanus 480
Thalassaemia 484
vii
Contents
Thalidomide-related deformities and
other phocomelias 486
Thyrotoxicosis 487
Torsade de pointes (atypical ventricular
tachycardia) 491
Tracheobronchomegaly 493
Treacher Collins syndrome 494
Tuberous sclerosis 496
Turner syndrome 497
V
Varicella 499
Vipoma 500
Von Gierke’s disease and type 1b
glycogenolysis 502
Von Hippel-Lindau disease 504
Von Recklinghausen’s disease 506
Von Willebrand’s disease 506
W
Wegener’s granulomatosis 510
Werdnig-Hoffman disease 513
Williams syndrome 513
Wolff-Parkinson-White syndrome 516
Z
Zenker’s diverticulum 520
SECTION 2
Emergency conditions arising
during anaesthesia or in the
immediate perioperative
period
A
Addisonian crisis 523
Air embolism 525
Amniotic fluid embolism 531
Anaphylactoid/anaphylactic reactions to
intravenous agents 534
Angioneurotic oedema 542
Aortocaval fistula 543
Arrhythmias 545
B
Bronchospasm 548
C
Carcinoid syndrome 549
Cardiac tamponade 551
Central anticholinergic syndrome 553
D
Glycine absorption syndrome 555
L
Latex allergy 555
Local anaesthetic toxicity 557
M
Malignant hyperthermia 563
Masseter muscle rigidity 566
Methaemoglobinaemia 569
P
Phaeochromocytoma 572
Pituitary apoplexy 576
Pulmonary oedema 577
S
Subdural block, accidental 577
Suxamethonium apnoea 580
T
Thyrotoxic crisis or storm 581
Torsade de pointes 584
Total spinal anaesthesia, accidental 586
TURP syndrome 588
Appendix 594
viii
Anaesthesia Databook: a perioperative and peripartum manual
A
ACE
Angiotensin-converting enzyme
AChE
Acetylcholinesterase
ACLA
Anticardiolipin antibody
ACTH
Adrenocorticotrophic hormone
ADH
Antidiuretic hormone
AF
Atrial fibrillation
AFE
Amniotic fluid embolism
AIDS
Acquired immune deficiency
syndrome
AIP
Acute intermittent porphyria
ALA
d-Aminolaevulinic acid (synthase)
AMP
Adenosine monophosphate
APA
Antiphospholipid antibody
APLS
Antiphospholipid antibody
syndrome
APTT
Activated partial thromboplastin
time
APUD
Amine precursor uptake and
decarboxylation
ARDS
Adult respiratory distress syndrome
ASD
Atrial septal defect
AV
Atrioventricular
A-V
Arteriovenous
AVP
Arginine vasopressin
AZT
Zidovudine (‘Retrovir’)
B
BAL
Bronchoalveolar lavage
BBB
Bundle branch block
bd
Twice per day
BG
Blood glucose
BMR
Basal metabolic rate
BP
Blood pressure
C
C1
First component of complement
C2
Second component of
complement
C4
Fourth component of
complement
CABG
Coronary artery bypass graft
cAMP
Cyclical adenosine
monophosphate
CAPD
Continuous ambulatory peritoneal
dialysis
ChE
Cholinesterase
C1EI
C1 esterase inhibitor
CMV
Cytomegalic virus
CNS
Central nervous system
CPAP
Continuous positive airway
pressure
CPB
Cardiopulmonary bypass
CK
Creatine kinase
CPR
Cardiopulmonary resuscitation
CRF
Corticotrophin-releasing factor
CSF
Cerebrospinal fluid
CT
Computerised tomography
CVP
Central venous pressure
CXR
Chest X-ray
D
DDC
3,5-Dicarbethoxy-1,4-
dihydrocolidine
DDAVP
Desmopressin (1-desamino-8-D-
arginine vasopressin)
DMD
Duchenne muscular dystrophy
DNA
Desoxyribose nucleic acid
DVI
Digital vascular imaging
DVT
Deep venous thrombosis
E
EBV
Epstein-Barr virus
ECF
Extracellular fluid
ECG
Electrocardiogram
ECM
External cardiac massage
ECMO
Extracorporeal membranous
oxygenation
ix
List of abbreviations
