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Essentials of Neuroanesthesia - 1st Edition - ISBN: 9780128052990, 9780128054307

Essentials of Neuroanesthesia

1st Edition

Editor: Hemanshu Prabhakar
Hardcover ISBN: 9780128052990
eBook ISBN: 9780128054307
Imprint: Academic Press
Published Date: 24th March 2017
Page Count: 1036
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Essentials of Neuroanesthesia offers useful insights on the anesthetic management of neurosurgical and neurologic patients. This book covers all topics related to neuroanesthesia, providing essential knowledge on the brain and spinal cord. Sections include chapters on anatomy, physiology, and pharmacology, along with specific chapters related to various neurosurgical and neurological problems and their anesthetic management.

This book provides an understanding of related issues, such as palliative care, evidence based practice of neuroanesthesia, sterilization techniques, biostatistics, and ethical issues, and is useful for trainees, clinicians, and researchers in the fields of neurosurgery, neurocritical care, neuroanesthesia, and neurology.

Key Features

  • Offers useful insights on the anesthetic management of neurosurgical and neurologic patients
  • Discusses related issues, such as palliative care, evidence based practice of neuroanesthesia, sterilization techniques, biostatistics, and ethical issues
  • Useful for trainees, clinicians, and researchers in the fields of neurosurgery, neurocritical care, neuroanesthesia, and neurology


Trainees, clinicians, and researchers in the fields of neurosurgery, neurocritical care, neuroanesthesia and neurology

Table of Contents

Section I. Neuroanatomy

Chapter 1. Neuroanatomy

  • Introduction
  • Embryological Differentiation of Different Parts of Brain
  • Anatomy of Brain
  • Vascular Supply of the Brain
  • The Meninges and Cerebrospinal Fluid

Chapter 2. Neuroembryology

  • Formation of Zygote
  • Formation of Blastocyst
  • Formation of Embryonic or Germ Disc
  • Formation of Definitive Notochord
  • Development of Nervous System

Chapter 3. Blood–Brain Barrier

  • Introduction
  • Permeability at the Blood–Brain Barrier
  • Cellular and Molecular Effects of Anesthetics on the Blood–Brain Barrier
  • Clinical and Experimental Implications of Anesthetics on the Blood–Brain Barrier
  • Conclusion

Section II. Neurophysiology

Chapter 4. Neurophysiology

  • Intracranial Pressure
  • Normal Intracranial Pressure
  • Cerebral Compliance
  • Importance of Intracranial Pressure
  • Summary
  • Cerebral Blood Flow
  • Vascular Anatomy
  • Summary
  • Brain Metabolism
  • Normal Cerebral Metabolism
  • Summary
  • Cerebrospinal Fluid
  • Ventricular System
  • Summary
  • The Spinal Cord
  • Anatomy
  • Organization of the Spinal Cord
  • Summary

Chapter 5. Brain Protection in Neurosurgery

  • Introduction
  • Nonpharmacological Strategies
  • Mild Hypothermia
  • Blood Pressure Control
  • Induced Arterial Hypertension
  • Normoglycemia
  • Target Hemoglobin Concentration
  • Pharmacological Strategies
  • Nonanesthetic Agents
  • Anesthetic Agents
  • Conclusion

Section III. Neuropharmacology

Chapter 6. Neuropharmacology

  • Anesthetic Drugs and Sedatives
  • Intravenous Anesthetic Agents
  • Inhalational Anesthetic Agents
  • Neuromuscular Blocking Agents
  • Local Anesthetic Agents
  • Miscellaneous Drugs
  • Future Directions in Neuropharmacology
  • Conclusion

Chapter 7. Anesthetic Agents: Neurotoxics or Neuroprotectives?

  • Introduction
  • Pharmacological Considerations
  • Anesthesia Practice: Clinical Outcomes
  • Anesthesia and Fragile Brain
  • Conclusion
  • Abbreviations

Section IV. Neuromonitoring

Chapter 8. Neuromonitoring

  • Introduction
  • Cerebral Blood Flow
  • Transcranial Sonography
  • Thermal Diffusion Flowmetry
  • Laser Doppler Flowmetry
  • Intra-Arterial 133Xenon
  • CT Perfusion
  • Xenon Enhanced CT
  • Positron Emission Tomography
  • Single Photon Emission Computed Tomography
  • Magnetic Resonance Imaging
  • Intracranial Pressure
  • Electroencephalogram
  • Evoked Potential Monitoring
  • Motor Evoked Potentials
  • Depth of Anesthesia
  • Cerebral Oxygenation Monitoring
  • Jugular Venous Oximetry
  • Regional Cerebral Oximetry
  • Brain Tissue Oxygen Monitoring
  • Cerebral Microdialysis
  • Conclusion

Chapter 9. Multimodal Monitoring

  • Introduction
  • Temperature
  • Oxygen Transport, Hemodynamics, and Brain Metabolism
  • Intracranial Pressure Monitoring
  • Electroencephalography and Depth of Anesthesia Monitoring
  • Miscellaneous
  • Integration of Information and Decision-Helping Systems
  • Clinical Pearls

Section V. Positions in Neurosurgery

Chapter 10. Positioning in Neurosurgery

  • Introduction
  • Historical Background
  • Principles of Positioning
  • The Conduct of Positioning
  • Surgical Approach for Craniotomies
  • Positioning for Craniotomy
  • Positions Used for Craniotomies
  • Surgical Approach for Procedures of the Spine
  • Conclusion
  • Abbreviations

Section VI. Preanesthetic Evaluation

Chapter 11. Preanesthetic Evaluation of Neurosurgical Patients

  • Introduction
  • Preoperative Evaluation of Patient-Related Risk Factors
  • Preoperative Evaluation of Specific Neurosurgical Conditions

Section VII. Neurosurgery

Chapter 12. Supratentorial Lesions

  • Introduction
  • Classification
  • Pathophysiology and Clinical Correlations
  • Clinical Features
  • Neuroimaging
  • Intraoperative Considerations: The Team Approach
  • Anesthetic Management
  • Intraoperative Management
  • Emergence From Anesthesia
  • Postoperative Management
  • Awake Craniotomy
  • Conclusions

Chapter 13. Emergence From Anesthesia

  • Introduction
  • Neurophysiological Response During Emergence in Neurosurgical Patients
  • Specific Perioperative Considerations
  • Delayed Emergence and Arousal
  • Complications
  • Conclusion

Chapter 14. Anesthesia for Posterior Fossa Surgery

  • Introduction
  • Anatomy
  • Clinical Presentation
  • Perioperative Management of Patients for Posterior Fossa Surgery
  • Venous Air Embolism
  • Postoperative Management
  • Complications
  • Abbreviations

Chapter 15. Transesophageal Echocardiography

  • Introduction
  • Basics of Transesophageal Echocardiography
  • Summary

Chapter 16. Anesthesia for Epilepsy Surgery

  • Introduction
  • Surgical Management of Epilepsy
  • Types of Surgical Treatment
  • Presurgical Evaluation
  • Anesthesia for Epilepsy Surgery
  • Effect of Anesthetic Agents in Patients With Epilepsy
  • Antiepileptic Drug Interactions
  • Preanesthetic Evaluation and Preparation
  • Anesthetic Management of Preoperative Procedures
  • Anesthesia for Intracranial Electrode Insertion
  • Anesthetic Management of Resection of Seizure Focus
  • Awake Craniotomy
  • Resection of Epileptogenic Focus Under General Anesthesia
  • Neurostimulation for Drug-Resistant Epilepsy
  • Anesthetic Management of the Patient With Epilepsy for Incidental Surgery
  • Abbreviations

Chapter 17. Refractory Status Epilepticus

  • Introduction
  • Epidemiology
  • Classification
  • Cause
  • Pathophysiology
  • Diagnosis
  • Management
  • Treatment
  • Conclusions

Chapter 18. Aneurysmal Subarachnoid Hemorrhage

  • History
  • Introduction
  • Clinical Presentation and Diagnosis
  • Grading of Subarachnoid Hemorrhage
  • Initial Management Concerns in Neurocritical Care Unit
  • Timing of Surgery
  • Clipping or Coiling
  • Evaluation of a Patient With Subarachnoid Hemorrhage for Anesthesia
  • Anesthetic Management
  • Temporary Clipping and Brain Protection Strategy
  • Intraoperative Aneurysm Rupture
  • Giant Aneurysms and Circulatory Arrest
  • Endovascular Management for Aneurysm Ablation
  • Postoperative Management of Patients
  • Conclusion

Chapter 19. Circulatory Arrest

  • Introduction
  • Deep Hypothermic Circulatory Arrest
  • Anesthesia Management
  • Complications
  • Adenosine-Induced Circulatory Arrest
  • Anesthesia Considerations
  • Complications
  • Summary

Chapter 20. Cerebrovascular Disease

  • Intracerebral Hemorrhage
  • Incidence and Risk Factors
  • Imaging
  • Clinical Presentation
  • Management of Intracerebral Hemorrhage
  • Arteriovenous Malformations
  • Cause and Incidence
  • Natural History
  • Pathophysiologic Effects and Clinical Presentation
  • Grading of Arteriovenous Malformations
  • Imaging
  • Cerebral Hemodynamics in Arteriovenous Malformation
  • Management
  • Surgical Resection of Arteriovenous Malformation
  • Anesthetic Considerations for Resection of Arteriovenous Malformation
  • Postoperative Management
  • Anesthetic Considerations for Arteriovenous Malformation Embolization
  • Complications During Arteriovenous Malformation Embolization
  • Pediatric Arteriovenous Malformations
  • Pregnancy and Arteriovenous Malformations
  • Vein of Galen Aneurysmal Malformations
  • Dural Arteriovenous Fistula
  • Clinical Presentation
  • Management
  • Carotid Endarterectomy
  • Preoperative Evaluation
  • Management of Carotid Artery Disease
  • Monitoring
  • Intraoperative Management
  • Postoperative Complications and Outcomes
  • Coronary Angioplasty and Stenting
  • Moyamoya Disease
  • Management of Moyamoya Disease

Chapter 21. Flow Arrest in Cerebrovascular Surgery

  • Deep Hypothermic Circulatory Arrest
  • Adenosine-Assisted Cerebral Blood Flow Arrest
  • Rapid Ventricular Pacing–Assisted Cerebral Blood Flow Arrest

Chapter 22. Neuroendocrine Lesions

  • Hypothalamic-Pituitary–Adrenal Axis Evaluation
  • Neuroendocrine Response Related to Anesthesia and Surgery
  • Pituitary Gland Adenomas
  • Physiology of Pituitary Gland
  • Endocrine Diseases
  • Nonfunctioning Tumors
  • Intraoperative Considerations
  • Advantages of Endoscopic Endonasal Approach
  • Relative Contraindications to Transsphenoidal Approach
  • Intraoperative Issues
  • Disorder of Water and Electrolytes

Chapter 23. Pituitary Apoplexy

  • Clinical Features
  • Management

Chapter 24. Spinal Surgery

  • Introduction
  • Spine
  • Types of Spine Surgeries
  • Surgical Approaches to the Spine
  • Common Spine Disorders
  • Imaging in Spine Lesions
  • Positioning for Spine Surgeries
  • Neurophysiological Intraoperative Monitoring During Spine Surgeries
  • Preanesthetic Assessment and Optimization
  • Anesthesia Management
  • Postoperative Management
  • Special Considerations
  • Conclusion

Chapter 25. Postoperative Visual Loss

  • Introduction
  • Central Retinal Artery Occlusion
  • Ischemic Optic Neuropathy
  • Cortical Blindness
  • Recent Advances
  • Conclusion

Chapter 26. Neuroendoscopy

  • Introduction
  • Anesthetic Goals and Management
  • Anesthetic Management of Specific Neuroendoscopic Procedures
  • Advances in Neuroendoscopy
  • Conclusion
  • Clinical Pearls

Chapter 27. Pressure Inside the Neuroendoscope

  • Introduction
  • Indications and Procedures
  • How Do Neurosurgeons Perform an Intraventricular Endoscopic Procedure?
  • Anesthetic Procedure: What to Take Into Account?
  • Perioperative Complications
  • Conclusion

Chapter 28. Anesthesia for Functional Neurosurgery

  • Introduction
  • Procedure
  • Anesthetic Consideration
  • Anesthetic Techniques
  • Complications
  • Anesthesia in Patients With Deep Brain Stimulator In Situ
  • Conclusion

Chapter 29. Awake Craniotomy

  • Introduction
  • Patient Selection
  • Awake Craniotomy for Tumor Surgery
  • Awake Craniotomy for Epilepsy
  • Conclusion

Section VIII. Neuroradiology

Chapter 30. Anesthesia for Neuroradiology

  • Introduction
  • Issues Relating to Anesthesia Care in Neuroradiology
  • Anesthesia for Computed Tomographic Study
  • Anesthesia for Magnetic Resonance Imaging Study
  • Anesthesia for Diagnostic Angiography
  • Anesthetic Management of Endovascular Coiling
  • Anesthetic Management of Endovascular Embolization of Arteriovenous Malformation, Arteriovenous Fistula, and Vein of Galen Malformation
  • Anesthesia for Stroke Interventions
  • Issues Related to Radiation During Neurointervention
  • Anesthesia for Stereotactic Radiosurgery
  • Pregnancy and Neuroradiology
  • Clinical Pearls

Chapter 31. Magnetic Resonance Imaging: Anesthetic Implications

  • Introduction: The Road From X-Ray to Magnetic Resonance Imaging
  • Principles of Nuclear Magnetic Resonance and Magnetic Resonance Imaging
  • Various Types of Signals Recorded
  • Hazards Related to Magnetic Resonance Imaging
  • Magnetic Resonance Imaging Safety: General Considerations
  • Magnetic Resonance Imaging Safety: Management of Cardiac Implantable Electronic Devices and Other Implantable Devices
  • Anesthesia for Magnetic Resonance Imaging
  • Research Applications/Emerging Clinical Applications of Magnetic Resonance Imaging

Section IX. Neurotrauma

Chapter 32. Neurotrauma

  • Traumatic Brain Injury
  • Definition
  • Epidemiology
  • Classification of Traumatic Brain Injury
  • Physiologic Response to Brain Injury
  • Neuroimaging
  • Severity of Traumatic Brain Injury
  • Management of Traumatic Brain Injury
  • Outcome
  • Emerging Treatment Modalities
  • Conclusion
  • Spine and Spinal Cord Trauma
  • Epidemiology
  • Classification of Spinal Injury
  • Pathophysiology of Spinal Cord Trauma
  • Systemic Complications of Spinal Cord Injuries
  • Management of Spine and Spinal Cord Injury
  • Emerging Treatment Modalities

Chapter 33. Biomarkers in Traumatic Brain Injury

  • Introduction
  • Conclusion

Section X. Neurointensive Care

Chapter 34. Neurological Critical Care

  • Introduction
  • History of Neurocritical Care
  • Design of a Neurocritical Care Unit
  • Clinical Conditions Requiring Admission to Neurocritical Care Unit
  • Justification for Neurological Critical Care Units
  • Pathophysiological Issues in Neurological Critical Care
  • Management of Patients in a Neurological Intensive Care Unit
  • Management of General Systemic Physiology
  • Specific Therapeutic Issues in Individual Clinical Conditions
  • Advanced Neuromonitoring
  • Outcomes of Neurological Intensive Care Unit
  • End-of-Life Issues in Neurological Critical Care
  • Clinical Pearls

Chapter 35. Antibiotics: Prophylactic and Therapeutics

  • Introduction
  • Principles of Antimicrobial Therapy in Neurosurgery
  • Treatment of Central Nervous System Infections in the Neurosurgical Patient
  • Antimicrobial Prophylaxis in Neurosurgery

Section XI. Special Considerations

Chapter 36. Pediatric Neuroanesthesia

  • Overview
  • Pediatric Neurophysiology
  • General Principles of Pediatric Neuroanesthesia
  • Intraoperative Management
  • Postoperative Considerations
  • Management of Specific Conditions
  • Conclusion

Chapter 37. Fluid and Blood Transfusion in Pediatric Neurosurgery

  • Introduction
  • Fluid and Electrolyte Choices
  • Type of Fluids for Perioperative Administration in Pediatric Patients
  • Fluid Management in Pediatric Neurosurgery
  • Osmotherapy
  • Fluid and Electrolyte Disturbances in Pediatric Neurosurgery
  • Blood Transfusion
  • Blood Components
  • Special Situations
  • Epilepsy Surgery
  • Scoliosis
  • Conclusion

Chapter 38. Geriatric Neuroanesthesia

  • Introduction
  • Implications of Surgical Stress and Anesthesia on the Elderly
  • Neurosurgical Concerns Unique to the Elderly
  • Conclusion

Chapter 39. Postoperative Cognitive Dysfunction

  • Introduction
  • Definitions, Epidemiology, and Pathophysiology
  • Risk Factors
  • Prevention
  • Screening Tools
  • Treatment
  • Outcome

Chapter 40. Pregnancy

  • Requirement of Neurosurgery During Pregnancy
  • Physiological Alterations During Pregnancy
  • Effect of Anesthetic Agents on Fetal Outcome
  • Uteroplacental Drug Transfer and Neonatal Depression
  • Timing and Method of Delivery
  • Anesthetic Considerations During Pregnancy
  • Induction: Rapid Sequence Versus Slow Neuroinduction
  • Combined Cesarean Delivery and Neurosurgery
  • Intracranial Pressure and Regional Anesthesia
  • Postoperative Management
  • Anesthesia for Interventional Neurosurgical Procedures

Chapter 41. Cerebral Venous Thrombosis

  • Definition
  • Venous Anatomy
  • Incidence of Cerebral Venous Thrombosis
  • Risk Factors
  • Pathophysiology
  • Clinical Manifestations
  • Diagnostic Evaluation
  • Treatment
  • Anesthetic Management
  • Prognosis
  • Conclusion

Chapter 42. Neurosurgical Anesthesia in Patients With Coexisting Cardiac Disease

  • Introduction
  • Preoperative Evaluation
  • Risk Stratification
  • Perioperative Monitoring
  • Ischemic Heart Disease
  • Valvular Heart Disease
  • Tumors of the Heart
  • Congenital Heart Disease
  • Hypertension
  • Conclusion

Chapter 43. Intraoperative Cardiopulmonary Resuscitation

  • Introduction
  • Incidence, Morbidity, and Mortality
  • Survival From Intraoperative Cardiac Arrest
  • Predictors
  • Cause of Intraoperative Cardiac Arrest
  • Cardiopulmonary Resuscitation Quality
  • Cardiac Arrest and Cardiopulmonary Resuscitation in Neurosurgical Patients
  • Prognosis
  • Conclusion

Chapter 44. Coexisting Diabetes Mellitus in Neurosurgical Patients

  • Introduction
  • Incidence of Diabetes Mellitus
  • Glycemic Indices
  • Modes of Glucose Measurement
  • Pathophysiology of Diabetes Mellitus
  • Cerebral Glucose Metabolism
  • Hyperglycemia and the Brain
  • Hyperglycemic Neuropathy
  • Diabetic Dysautonomia
  • Hypoglycemia and the Brain
  • Evidence of Glycemic Control in Important Neurosurgical Subsets
  • Traumatic Brain Injury
  • Subarachnoid Hemorrhage
  • Cerebrovascular Accidents
  • Tumor Surgery
  • Spine Surgery
  • Blood Sugar Management in Perioperative Period and Neurocritical Care
  • Intraoperative Management
  • Anesthetic Management
  • Postoperative Glycemic Management
  • Blood Sugar Control in Emergency Neurosurgical Patient
  • Blood Sugar Control in Intensive Care Setup
  • Nutrition
  • Conclusions
  • Coexisting Hypertension in Neurosurgical Patients
  • Physiology of Cerebral Circulation
  • Pathophysiology of Arterial Hypertension
  • Hypertension in Patients With Traumatic Brain Injury
  • Perioperative Management
  • Preoperative Evaluation
  • Antihypertensive Drugs
  • Intraoperative Management
  • Monitoring
  • Induction of Anesthesia
  • Maintenance of Anesthesia
  • Recovery From Anesthesia
  • Postoperative Care
  • Neurocritical Care
  • Conclusion

Chapter 45. Neuromuscular Disorders

  • Introduction
  • Myasthenia Gravis
  • Myasthenic Crisis
  • Lambert–Eaton Myasthenic Syndrome
  • Guillain–Barré Syndrome
  • Periodic Paralysis
  • Myotonias
  • Muscular Dystrophies
  • Motor Neuron Diseases
  • Multiple Sclerosis
  • Parkinson’s Disease
  • Alzheimer’s Disease
  • Huntington’s Disease

Chapter 46. Neuromuscular Electrical Stimulation in Critically Ill Patients

  • Introduction
  • Neuromuscular Electrical Stimulation: Basic Concepts and Practical Considerations
  • Neuromuscular Electrical Stimulation in the Intensive Care Unit
  • Contraindications and Adverse Effects
  • Recommendations for the Use of Neuromuscular Electrical Stimulation in the Intensive Care Unit

Chapter 47. Neurological Patients for Nonneurosurgeries

  • Neurodegenerative Diseases
  • Demyelinating Disease
  • Neuromuscular Disease: Myasthenia Gravis
  • Epilepsy
  • Intracranial Tumors
  • Traumatic Brain Injury

Chapter 48. Anesthesia for Electroconvulsive Therapy

  • Background
  • Technique of Electroconvulsive Therapy
  • Contraindications
  • Preprocedure Management
  • Anesthesia for Electroconvulsive Therapy
  • Side Effects
  • Special Conditions
  • Conclusion

Section XII. Fluids and Electrolyte Management

Chapter 49. Fluids and Electrolyte Management

  • Introduction
  • Anatomy and Physiology
  • Pathophysiology
  • Definitions
  • Choice of Fluids
  • Hypertonic Fluids
  • Isotonic Fluids
  • Colloids
  • Hypotonic Fluids
  • Fluid Management
  • Commonly Encountered Fluid Abnormalities
  • Conclusion
  • Clinical Pearls

Chapter 50. Crystalloid and Colloid Fluids

  • Crystalloid Fluids
  • Colloid Fluids
  • Which Fluid to Choose?
  • Conclusions

Section XIII. Pain Management

Chapter 51. Pain Management

  • Postcraniotomy Pain
  • Incidence
  • Anatomical and Physiological Basis of Pain Following Craniotomy
  • Pain-Sensitive Structures of Cranium
  • Pathogenesis of Postcraniotomy Pain
  • Factors Affecting Postcraniotomy Pain
  • Classification and Assessment of Postcraniotomy Pain
  • Preemption of Pain
  • Treatment of Acute Pain
  • Postcraniotomy Pain Management in the Pediatric Population
  • Conclusion
  • Acute Pain Management After Spinal Surgery
  • Pathophysiology
  • Treatment Modalities for Acute Postoperative Spinal Pain
  • Conclusion

Section XIV. Brain Death and Ethical Issues

Chapter 52. Brain Death and Ethical Issues in Neuroanesthesia Practice

  • Part A: Brain Death
  • Criteria for Diagnosing Death
  • Need for Brain Death Diagnosis
  • Rules Regulating Diagnosis of Brain Death
  • Criteria for Certifying Brain Stem Death
  • Pitfalls/Controversies
  • Conclusion
  • Appendix I
  • Part B: Ethical Issues in Neuroanesthesia Practice
  • Ethical Issues in Clinical Care
  • Ethical Issues Related to Research
  • Ethical Issues Related to Team Work
  • Ethical Issues Related to Training
  • Ethical Issues Related to Innovative Neurosurgery
  • Conclusion

Chapter 53. Organ Donation

  • Introduction
  • Conclusion

Section XV. Evidence-Based Practice

Chapter 54. Evidence-Based Practice of Neuroanesthesia

  • Introduction
  • Evidence-Based Practice and Neuroanesthesia
  • Evidence and the Brain Trauma Foundation Guidelines
  • Unresolved Issues in the Practice of Neuroanesthesia
  • Conclusion
  • Clinical Pearls

Chapter 55. Translational Research

  • Introduction
  • Definition
  • In Neuroanesthesia
  • Why Not Lead to Clinical
  • To Be a Successful Translation
  • Conclusion

Section XVI. Recent Advances

Chapter 56. Recent Advances in Neuroanesthesiology

  • Introduction
  • Endovascular Treatment of Stroke and Perioperative Stroke
  • Indications for Deep Brain Stimulation
  • Anesthetic Neurotoxicity
  • Pre- and Postconditioning
  • Brain Monitoring
  • New Assays for Creutzfeldt–Jakob Disease

Chapter 57. Stem Cell Therapy

  • Hypothesis of Stem Cell Research
  • Stem Cell
  • Historical Background
  • Types of Stem Cells
  • Sources of Stem Cells
  • Mesenchymal Stem Cells
  • Stem Cells in Neurological Diseases
  • Mode of Action of Stem Cell Therapy
  • Ethical Issues
  • Recent Advances

Chapter 58. Pharmacogenomics

  • Introduction
  • Basic Genetic Principles
  • Basic Pharmacologic Principles
  • Anesthesia Contribution to the History of Pharmacogenomics
  • Pharmacogenomics: Current Application to Clinical Anesthesia
  • Conclusion

Section XVII. Sterilization Techniques

Chapter 59. Sterilization and Disinfection

  • Background
  • Recommendation of Preferred Methods for Various Medical Devices
  • Recommendation for the Cleaning and Decontamination of Environmental Surfaces
  • Recommendation for Blood Spill on the Surface
  • Cleaning and Disinfection of Medical Instruments
  • Cleaning and Reprocessing of Patient Care Equipment
  • Reprocessing of Respiratory Apparatus and Endoscopes
  • Reprocessing of Endoscopes
  • Specific Issues
  • Special Precaution for Inactivation of Creutzfeldt–Jakob Disease
  • Health Care–Associated Infections
  • Infections in Operating Rooms and Intensive Care Units
  • Conclusion

Chapter 60. Universal Precautions in the Intensive Care Unit

  • Introduction
  • Prophylactics of Health Care–Associated Infections in the Intensive Care Unit
  • Early Diagnosis of Pathogens and Infection Complications in the Intensive Care Unit
  • Rational Antibiotic Therapy
  • Systemic Approach
  • Conclusion

Section XVIII. Palliative Care

Chapter 61. Palliative Care to Neurological and Neurosurgical Patients

  • Introduction

Chapter 62. Quality of Life and Health-Related Issues

  • Introduction
  • Quality of Life and Health-Related Quality of Life
  • Utility of Health-Related Quality of Life
  • Tools for Measuring Health-Related Quality of Life
  • Uses of Measuring Health-Related Quality of Life
  • Health-Related Quality of Life in Relation to Neurosurgical/Neurological Conditions
  • Conclusion

Section XIX. Biostatistics

Chapter 63. Biostatistics

  • Introduction to Biostatistics
  • Definition of Statistics
  • Biostatistics and Its Applications
  • Uses of Statistical Methods in Medical Sciences
  • Some Basic Statistical Concepts
  • Population and Sample
  • Scale of Measurements
  • Constant
  • Variables
  • Parameter and Statistic
  • Ratio, Proportion, and Rate
  • Statistical Inference
  • Estimation
  • Hypothesis Testing
  • Steps in Hypothesis Testing or Testing the Statistical Significance
  • Defining the Null and Alternative Hypotheses
  • Calculating the Test Statistic
  • Obtaining, Using, and Interpreting the p-Value
  • Errors in Hypothesis Testing
  • The Possible Mistakes We Can Make
  • Other Important Concepts That are Essential in Statistical Inference
  • Parametric and Nonparametric Statistical Methods
  • Basic Principles of Statistics
  • Probability Distributions
  • Study Design
  • Sample Size
  • Data Collection and Preparing Data for Analysis
  • Analysis and Presentation of Data
  • Summarizing Data
  • Comparing Groups: Continuous Data
  • Comparing Groups: Categorical Data
  • Comparing Groups: Time to Event Data
  • Relation Between Two Continuous Variables
  • Multivariable Analysis
  • Conclusion


No. of pages:
© Academic Press 2017
24th March 2017
Academic Press
Hardcover ISBN:
eBook ISBN:

About the Editor

Hemanshu Prabhakar

Hemanshu Prabhakar

Dr. Hemanshu Prabhakar is Professor in Department of Neuroanesthesiology and Critical Care at the All India Institute of Medical Sciences (AIIMS), New Delhi, India. He received his training in neuroanesthesia and PhD (Neuroanesthesia) in the same institute. He is recipient of the AIIMS Excellence award for notable contribution in academics. He has more than 250 publications in national and international journals to his credit. He is a reviewer for various national and international journals. . He is a guide and mentor of many DM and PhD students. He is also a review author for the Cochrane Collaboration and has special interest in evidence based practice of neuroanesthesia. He is a member of various national and international neuroanesthesia societies and past Secretary of the Indian Society of Neuroanesthesia and Critical Care. He is the present Secretary of Society of Neurocritical Care, India. He is an invited faculty for various national and international conferences. He is on the Editorial board of Indian Journal of Palliative care and is the past executive editor of the Journal of Neuroanaesthesiology and Critical Care.

Affiliations and Expertise

Professor, Department of Neuroanesthesiology and Critical Care, All India Institute of Medical Sciences (AIIMS), New Delhi, India


"This is a fantastic overview of high-yield, evidence-based practice in neuroanesthesia-related topics…recommended to both trainees and clinicians without hesitation. It does a superb job of introducing readers to the captivating physiology, clinical diversity, and everyday challenges involved in the perioperative care of neurological patients. Score: 96 - 4 Stars" --Doody's

Ratings and Reviews