SECTION I

INTRODUCTION

1

Evidence-Based Practice Parameters—The American Society of Anesthesiologists Approach   David G. Nickinovich, PhD; Richard T. Connis, PhD; Robert A. Caplan, MD; and James F. Arens, MD

3

SECTION II

PREOPERATIVE PREPARATION

2

Does Routine Testing Affect Outcome?   L. Reuven Pasternak, MD, MPH, MBA

11

3

Is a Preoperative Screening Clinic Cost-Effective?   Sheila R. Barnett, MD

15

4

Who should have a Preoperative 12-Lead Electrocardiogram?   Barbara S. Gold, MD

20

5

Should Preoperative Hemoglobin Always be Obtained?   Bradly J. Narr, MD, and Daniel R. Brown, MD, PhD

24

6

Is Routine Preoperative Pregnancy Testing Necessary?   Clinton S. Steffey, MD, and Rebecca S. Twersky, MD, MPH

28

7

What are the Risk Factors for Perioperative Stroke?   Alexander Papangelou, MD, and Marek Mirski, MD, PhD

33

8

Should We Delay Surgery in the Patient with Recent Cocaine Use?   Nabil Elkassabany, MD

44

9

Should All Antihypertensive Agents be Continued Before Surgery?   John G.T. Augoustides, MD, FASE

49

10

Is there an Optimal Timing for Smoking Cessation?   James Y. Findlay, MBChB, FRCA

55

11

Should Patients with Asthma be Given Preoperative Medications Including Steroids?   George Pyrgos, MD, and Robert H. Brown, MD, MPH

60

12

Which Patient should have a Preoperative Cardiac Evaluation (Stress Test)?   Amy L. Miller, MD, PhD, and Joshua A. Beckman, MD,MS

65

13

Should Patients with Stable Coronary Artery Disease Undergo Prophylactic Revascularization Before Noncardiac Surgery?   Santiago Garcia, MD, and Edward O. McFalls, MD, PhD

73

14

How Long should You Wait After Percutaneous Coronary Intervention for Noncardiac Surgery?   John G.T. Augoustides, MD, FASE; Hynek Riha, MD, DEAA; and Lee A. Fleisher, MD, FACC, FAHA

79

15

How should We Prepare the Patient with a Pacemaker/Implantable Cardioverter-Defibrillator?   Marc A. Rozner, PhD, MD

87

16

When should Pulmonary Function Tests be Performed Preoperatively?   Anthony N. Passannante, MD, and Peter Rock, MD, MBA

95

SECTION III

PERIOPERATIVE MANAGEMENT

17

Does the Airway Examination Predict Difficult Intubation?   Satyajeet Ghatge, MD, and Carin A. Hagberg, MD

101

18

Should Regional or General Anesthesia be Used for Cases in Which the Patient has an Anticipated Difficult Airway?   Seth Akst, MD, MBA, and Lynette Mark, MD

116

19

Is there a Best Approach to Induction of Anesthesia in Emergent Situations?   Richard P. Dutton, MD, MBA

121

20

Do Inhalational Agents have Beneficial or Harmful Effects?   Stefan G. De Hert, MD, PhD

126

21

Is One General Anesthetic Technique Associated with Faster Recovery?   Ralph Gertler, MD, and Cirish P. Joshi, MBBS, MD, FFARCSI

131

22

Does the Choice of Muscle Relaxant Affect Outcome?   Ashish C. Sinha, MD, PhD

139

23

Does Anesthetic Choice Affect Surgical and Recovery Times?   Anil Gupta, MD, FRCA, PhD

143

24

What are the Benefits of Different Ventilatory Techniques?   Maurizio Cereda, MD

148

25

Is there an Optimal Perioperative Hemoglobin?   Jeffrey L. Carson, MD, and Barbara Armas, MD

156

26

When are Platelet/Plasma Transfusions Indicated?   Gregory A. Nuttall, MD

163

27

What Drugs Decrease Postoperative Bleeding?   Veena Guru, MD, and Stephen E. Fremes, MD

169

28

Does Perioperative Hyperglycemia Increase Risk? Should We have Aggressive Glucose Control Perioperatively?   Stanley Rosenbaum, MA, MD, and Sherif Afifi, MD, FCCM, FCCP

177

29

When should Perioperative Glucocorticoid Replacement Be Administered?   Diane E. Head, MD; Aaron Joffe, DO; and Douglas B. Coursin, MD

184

30

Does the Choice of Fluid Matter in Major Surgery?   Anthony M. Roche, MBChB, FRCA, MMed; Catherine M.N. O’Malley, MBBS, FCARCSI; and Elliott Bennett-Guerrero, MD

192

31

What Works in a Patient with Acute Respiratory Distress Syndrome?   Michael G. Fitzsimons, MD, FCCP, and William E. Hurford, MD

201

32

What Actions can be Used to Prevent Peripheral Nerve Injury?   Sanjay M. Bhananker, MBBS, MD, DA, FRCA, and Karen B. Domino, MD, MPH

210

33

When is Forced-Air Warming Cost- Effective?   Andrea Kurz, MD

219

34

What is the Best Means of Preventing Perioperative Renal Injury?   Vivek Moitra, MD; Alan Gaffney, MBBCh; Hugh Playford, MBBS, FANZCA, FFICANZCA; and Robert N. Sladen, MBChB, MRCP(UK), FRCP(C), FCCM

226

35

Are Alpha-2 Agonists Effective in Reducing Perioperative Cardiac Complications in Noncardiac Surgery?   Douglas C. Shook, MD, and John E. Ellis, MD

240

36

Which are the Best Techniques for Reducing the Incidence of Postoperative Deep Vein Thrombosis?   Charles Marc Samama, MD, PhD, FCCP

245

37

What is the Optimal Perioperative Management for Latex Allergy?   Robert S. Holzman, MD, FAAP

250

38

Are there Special Techniques in Obese Patients?   David M. Eckmann, PhD, MD

258

39

Is there an Ideal Approach to the Malignant Hyperthermia–Susceptible Patient?   Charles B. Watson, MD, FCCM

263

40

What is the Best Strategy to Prevent Postoperative Nausea and Vomiting?   Ashraf S. Habib, MBBCh, MSc, FRCA, and Tong J. Gan, MBBS, FRCA, FFARCSI

269

41

How can We Prevent Postoperative Cognitive Dysfunction?   Terri G. Monk, MD, MS, and Catherine C. Price, PhD

276

42

Do Intensive Care Specialists Improve Patient Outcomes?   Patrick Neligan, MA, MB, FCARCSI, and Clifford S. Deutschman, MD, MS, FCCM

282

43

Can We Prevent Recall During Anesthesia?   T. Andrew Bowdle, MD, PhD

291

44

What is the Best Technique in the Patient with an Open Globe and Full Stomach?   Kathryn E. McGoldrick, MD

296

45

Are Patients with Sleep Apnea Appropriate for Ambulatory Surgery?   Tracey L. Stierer, MD, and Nancy Collop, MD

300

46

What Criteria should be Used for Discharge After Outpatient Surgery?   Vinod Chinnappa, MBBS, MD, FCARCSI, and Frances Chung, FRCPC

305

47

What Must I Consider to Safely Anesthetize Someone in the Office Setting?   Laurence M. Hausman, MD, and Meg A. Rosenblatt, MD

314

48

Should Propofol be Given by Nonanesthesia Providers?   McCallum R. Hoyt, MD, MBA, and Beverly K. Philip, MD

318

49

Aspiration: Is there an Optimal Management Strategy?   Neal H. Cohen, MD, MPH, MS

327

SECTION IV

REGIONAL ANESTHESIA

50

Nonsteroidal Antiinflammatory Drugs, Antiplatelet Medications, and Spinal Axis Anesthesia   Lynn M. Broadman, MD, and Edmund H. Jooste, MBChB

335

51

The Best Approaches to Prophylaxis Against DVT Formation When Using a Combination of Neuraxial Anesthesia and One of the Heparins   Lynn M. Broadman, MD

343

52

Is Regional Anesthesia Appropriate for Outpatient Surgery?   Michael F. Mulroy, MD, and Wyndam Strodtbeck, MD

359

53

Is Regional Anesthesia Superior to General Anesthesia for Hip Surgery?   Michael K. Urban, MD, PhD

364

54

Does Intraoperative Regional Anesthesia Decrease Perioperative Blood Loss?   Jeffrey M. Richman, MD; James F. Weller, MD; and Christopher L. Wu, MD

367

55

What is the Optimal Management of Post–Dural Puncture Headache?   David Wlody, MD

372

56

Should Ultrasound Guidance be Used for Peripheral Nerve Blockade?   Michael Aziz, MD

377

SECTION V

MONITORING

57

Does a Pulmonary Artery Catheter Influence Outcome in Noncardiac Surgery?   Glenn S. Murphy, MD, and Jeffery S. Vender, MD

385

58

What is the Best Method of Diagnosing Perioperative Myocardial Infarction?   Martin J. London, MD

391

59

Does Neurologic Electrophysiologic Monitoring Affect Outcome?   Michael L. McGarvey, MD, and Steven R. Messé, MD

397

SECTION VI

CARDIOVASCULAR ANESTHESIA

60

Is Regional Superior to General Anesthesia for Infrainguinal Revascularization?   R. Yan McRae, MD, and Grace L. Chien, MD

407

61

Evidence-Based Practice for Fast-Track Cardiac Anesthesia—Is It Safe?   Daniel Bainbridge, MD, FRCPC, and Davy Cheng, MD, MSc, FRCPC, FCAHS

411

62

Is there a Best Technique to Decrease Blood Loss and Transfusion After Coronary Artery Bypass Grafting?   John G.T. Augoustides, MD, FASE

415

63

Should Thoracic Epidural/Spinal Analgesia be Used for CABG?   Mark A. Chaney, MD

424

SECTION VII

NEUROSURGICAL ANESTHESIA

64

Is there a Best Technique in the Patient with Increased Intracranial Pressure?   Kristin Engelhard, MD, PhD; Nicole Forster, MD; and Adrian W. Gelb, MBChB

433

65

What Works for Brain Protection?   Izumi Harukuni, MD, and Stephen T. Robinson, MD

437

SECTION VIII

OBSTETRIC ANESTHESIA

66

Anesthesia for Cesarean Delivery—Regional or General?   Yaakov Beilin, MD

445

67

When should a Combined Spinal-Epidural (CSE) be Used?   Rolf A. Schlichter, MD, and Valerie A. Arkoosh, MD

451

68

Does Labor Analgesia Affect Labor Outcome?   B. Scott Segal MD

455

69

Does Anesthesia Increase the Risk to the Parturient Undergoing Nonobstetric Surgery?   Donald H. Penning, MD, MS, FRCP

462

SECTION IX

PEDIATRIC ANESTHESIA

70

How Young is the Youngest Infant for Outpatient Surgery?   Lucinda L. Everett, MD

469

71

Should a Child with a Respiratory Tract Infection Undergo Elective Surgery?   Christopher T. McKee, DO; Lynne G. Maxwell, MD; and R. Blaine Easley, MD

475

SECTION X

PAIN MANAGEMENT

72

Optimal Postoperative Analgesia   Michael A. Ashburn, MD, MPH, and Jane C. Ballantyne, MD, FRCA

485

73

Is Preemptive Analgesia Clinically Effective?   Allan Gottschalk, MD, PhD, and E. Andrew Ochroch, MD

493