Table Of ContentNon–Operating
Room Anesthesia
Mark S. Weiss, MD
Assistant Professor of Anesthesiology and Critical Care
Director of Inpatient Anesthesia Endoscopy Services
Perelman School of Medicine
Hospital of the University of Pennsylvania
Philadelphia, Pennsylvania
Lee A. Fleisher, MD
Robert D. Dripps Professor and Chair of Anesthesiology and Critical Care
Professor of Medicine
Perelman School of Medicine
Senior Fellow, Leonard Davis Institute of Health Economics
University of Pennsylvania
Philadelphia, Pennsylvania
1600 John F. Kennedy Blvd.
Ste 1800
Philadelphia, PA 19103-2899
NON–OPERATING ROOM ANESTHESIA ISBN: 978-1-4557-5415-1
Copyright © 2015 by Saunders, an imprint of Elsevier Inc.
All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any information storage and
retrieval system, without permission in writing from the publisher. Details on how to seek permission,
further information about the Publisher’s permissions policies, and our arrangements with organizations
such as the Copyright Clearance Center and the Copyright Licensing Agency can be found at our website:
www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and experience
broaden our understanding, changes in research methods, professional practices, or medical treatment
may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in evaluating
and using any information, methods, compounds, or experiments described herein. In using such infor-
mation or methods they should be mindful of their own safety and the safety of others, including parties
for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check the most
current information provided (i) on procedures featured or (ii) by the manufacturer of each product to be
administered, to verify the recommended dose or formula, the method and duration of administration,
and contraindications. It is the responsibility of practitioners, relying on their own experience and knowl-
edge of their patients, to make diagnoses, to determine dosages and the best treatment for each individual
patient, and to take all appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors assume
any liability for any injury and/or damage to persons or property as a matter of products liability, neg-
ligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas con-
tained in the material herein.
Library of Congress Cataloging-in-Publication Data
Non–operating room anesthesia / [edited by] Mark S. Weiss, Lee A. Fleisher.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-4557-5415-1 (hardcover)
I. Weiss, Mark S. (Mark Steven), editor. II. Fleisher, Lee A., editor.
[DNLM: 1. Anesthesia--standards. 2. Process Assessment (Health Care)--methods. WO 200]
RD81
617.9’6--dc23
2014014682
Executive Content Strategist: William Schmitt
Content Development Specialist: Lisa Barnes
Publishing Services Manager: Jeff Patterson
Project Manager: Clay S. Broeker
Design Direction: Louis Forgione
Cover Designer: Elaine Kurie
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
This book is dedicated:
to Lee Fleisher for his trust and friendship.
to my aunt, Lillian Brick, who is my sunshine.
to my mother, Minnette Weiss, who has always been so supportive.
to my father, Frederick Weiss, who was always there to guide me.
to my sons, Isaac, Noah, and Henry David.
And this book is dedicated to the love of my life, Paulette Marie Lambert.
MSW
This book is dedicated to my wife, Renee, and my children,
Jessica and Matthew, for supporting me in my career
while ensuring that I understand what is truly important.
LAF
This page intentionally left blank
About the Authors
Mark S. Weiss, MD, is an Assistant Professor of Anesthe- Lee A. Fleisher, MD, is the Robert D. Dripps Professor and
siology and Critical Care at the University of Pennsylva- Chair of Anesthesiology and Critical Care and a Professor
nia’s Perelman School of Medicine. He received his medical of Medicine at the University of Pennsylvania’s Perelman
degree from the University of Cincinnati and completed School of Medicine. He received his medical degree from the
his residency training at Yale University. His focus is on State University of New York at Stony Brook, from which
perioperative management of high-risk patients, with an he received the Distinguished Alumni Award in 2011.
emphasis on non–operating room anesthesia (NORA). He is His research focuses on perioperative cardiovascular risk
currently the director of Inpatient Endoscopy Services at the assessment and reduction and the measurement of qual-
University of Pennsylvania. ity of care, and he has received numerous federal, industry,
and foundation grants related to these subjects. He is Presi-
dent of the Association of University Anesthesiologists. He
is a member of the Consensus Standards Advisory Commit-
tee of the National Quality Forum and of the Administrative
Board of the Council of Faculty and Academic Specialties of
the Association of American Medical Colleges. In 2007, he
was elected to membership of the Institute of Medicine of
the National Academy of Sciences.
v
This page intentionally left blank
Contributors
Rose Campise-Luther, MD, FAAP Anil Gupta, MD, FRCA, PhD
Assistant Professor Associate Professor
Pediatric Anesthesiology Department of Anesthesiology and Intensive Care
Medical College of Wisconsin Institution for Medicine and Health
Milwaukee, Wisconsin Örebro, Sweden
Thomas Cutter, MD, MAEd Manon Hache, MD
Professor Assistant Professor
Department of Anesthesia and Critical Care Department of Anesthesiology
University of Chicago Columbia University Medical Center
Chicago, Illinois New York, New York
Christina D. Diaz, MD Eric A. Harris, MD, MBA
Assistant Professor Associate Professor of Clinical Anesthesiology
Pediatric Anesthesiology Department of Anesthesiology, Perioperative Medicine,
Medical College of Wisconsin and Pain Management
Milwaukee, Wisconsin University of Miami, Miller School of Medicine
Miami, Florida
Karen B. Domino, MD, MPH
Professor Jennifer E. Hofer, MD
Department of Anesthesiology and Pain Medicine Assistant Professor
University of Washington School of Medicine Department of Anesthesia and Critical Care
Seattle, Washington University of Chicago
Chicago, Illinois
Richard E. Galgon, MD, MS
Assistant Professor E. Heidi Jerome, MD
Department of Anesthesiology Associate Professor
University of Wisconsin School of Medicine and Public Department of Anesthesiology and Pediatrics
Health Columbia University Medical Center
Madison, Wisconsin New York, New York
Esther D. Garazi, MD Max Kanevsky, MD, PhD
Department of Anesthesia Assistant Professor of Anesthesia
Perioperative and Pain Medicine Division of Cardiovascular Anesthesia
Stanford University School of Medicine Stanford University School of Medicine
Stanford, California Stanford, California
Gregory G. Ginsberg Meghan Lane-Fall, MD, MSHP
Professor of Medicine Assistant Professor of Anesthesiology and Critical Care
Director of Endoscopy Department of Anesthesiology and Critical Care
Gastroenterology Division University of Pennsylvania
Hospital of the University of Pennsylvania Philadelphia, Pennsylvania
Philadelphia, Pennsylvania
Kelly Lebak, MD
Basavana G. Goudra, MD, FRCA, FCARCSI Anesthesiologist
Assistant Professor MetroHealth Medical Center
Department of Anesthesiology and Critical Care Medicine University of Wisconsin—Madison
Hospital of the University of Pennsylvania Madison, Wisconsin
Philadelphia, Pennsylvania
Jeffrey Lee, MS, MD
Caitlin J. Guo, MD, MBA Assistant Professor
Assistant Professor Anesthesiology
Department of Anesthesia University of Wisconsin—Madison
New York University Medical Center Madison, Wisconsin
New York, New York
vii
viii Contributors
Mark A. Leibel, MD Mark C. Phillips, MD
Assistant Professor Assistant Professor and Medical Director, Advanced GI
Department of Anesthesiology Endoscopy Anesthesia
University of Wisconsin School of Medicine and Public Department of Anesthesiology
Health University of Alabama at Birmingham School of Medicine
Madison, Wisconsin Birmingham, Alabama
Larry Lindenbaum, MD Christopher D. Press, MD
Assistant Professor Department of Anesthesiology, Perioperative
Department of Anesthesiology and Critical Care Medicine and Pain Medicine
Medical College of Wisconsin Stanford University School of Medicine
Milwaukee, Wisconsin Stanford, California
Alex Macario, MD, MBA Johan Raeder, MD, PhD
Professor Professor
Department of Anesthesiology, Perioperative and Pain Faculty of Medicine
Medicine NOR Consultant
Vice-Chair for Education Department of Anaesthesiology
Program Director, Anesthesia Residency Oslo University Hospital
Stanford University School of Medicine Oslo, Norway
Stanford, California
W. Kirke Rogers, MD
Jeff E. Mandel, MD, MS Associate
Assistant Professor of Anesthesiology and Critical Care Department of Anesthesiology
Perelman School of Medicine The University of Iowa Roy J. and Lucille A. Carver College
University of Pennsylvania of Medicine
Philadelphia, Pennsylvania Iowa City, Iowa
Ramon Martin, MD, PhD Daniel Rubin, MD
Staff Anesthesiologist Assistant Professor
Department of Anesthesiology, Perioperative and Pain Department of Anesthesia and Critical Care
Medicine University of Chicago
Brigham and Women’s Hospital Chicago, Illinois
Assistant Professor
Anesthesia John P. Scott, MD
Harvard Medical School Assistant Professor
Boston, Massachusetts Department of Anesthesiology and Pediatrics
Medical College of Wisconsin
Julia I. Metzner, MD Milwaukee, Wisconsin
Associate Professor
Department of Anesthesiology and Pain Medicine Jack S. Shanewise, MD
University of Washington Professor of Anesthesiology
Seattle, Washington Columbia University Medical Center
New York, New York
Roger A. Moore, MD
Clinical Associate Professor of Anesthesiology and Critical Preet Mohinder Singh, MD
Care Assistant Professor
Chair Emeritus, Deborah Heart and Lung Center Department of Anesthesiology and Critical Care Medicine
Perelman School of Medicine Postgraduate Institute of Medical Education and Research
Hospital of the University of Pennsylvania Chandigarh, India
Philadelphia, Pennsylvania
Scott Springman, MD
Melissa L. Pant, MD Professor
Clinical Associate Anesthesiology
Department of Anesthesia and Critical Care University of Wisconsin—Madison
University of Chicago Madison, Wisconsin
Chicago, Illinois
Lena S. Sun, MD
E.M. Papper Professor of Pediatric Anesthesiology
Department of Anesthesiology and Pediatrics
Columbia University Medical Center
New York, New York
