RT Book, Section
A1 Vernick, William J.
A1 Cheung, Albert T.
A1 Kukafka, Jeremy D.
A1 Savino, Joseph S.
A2 Cohn, Lawrence H.
SR Print(0)
ID 55912914
T1 Chapter 10. Cardiac Anesthesia
T2 Cardiac Surgery in the Adult, 4e
YR 2012
FD 2012
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-163310-9
LK accesssurgery.mhmedical.com/content.aspx?aid=55912914
RD 2024/04/18
AB The  cardiac  anesthesiologist  is  challenged  with  the  requirements  of  maintaining  general  anesthesia  while  also  serving  as  the  patient's  intensivist  and  diagnostician,  facilitating  the  surgery  and  maintaining  vital  organ  function.  The  objectives  of  a  general  anesthetic  are  analgesia,  amnesia,  and  unconsciousness  while  supporting  vital  physiologic  function  and  creating  satisfactory  operating  conditions.  An  effective  general  anesthetic  blunts  the  physiologic  responses  to  surgical  trauma  and  hemodynamic  perturbations  while  permitting  recovery  at  a  predictable  time  after  the  operation.  To  accomplish  this,  the  anesthesiologist  must  act  as  the  patient's  medical  intensivist:  support  life  with  mechanical  ventilation;  control  the  circulation;  and  diagnose  and  treat  acute  emergencies  that  may  occur  during  surgical  incision,  rapid  changes  in  body  temperature,  extracorporeal  circulation,  and  acute  shifts  in  intravascular  volume.  The  cardiac  anesthesiologist  must  provide  complex  diagnostics  in  order  to  facilitate  surgery  by  determining  the  competency  of  heart  reconstructive  procedures  and  measuring  the  cardiovascular  response  to  altered  cardiac  anatomy  and  physiology.  The  task  in  cardiac  surgery  is  unique  because  of  the  nature  of  the  operations  and  the  narrow  tolerance  for  hemodynamic  alterations  in  patients  with  critical  cardiac  disease.  Anesthetic  management  of  the  cardiac  surgical  patient  is  intimately  related  to  the  planned  operative  procedure  and  the  anticipated  timing  of  intraoperative  events.