Table Of ContentFrontmatter.qxd 18/7/05 3:18 PM Page ii
Commissioning Editor: Natasha Andjelkovic
Project Development Manager: Joanne Scott
Project Manager: Anne Dickie
Cover Designer: Jayne Jones
Text Designer: Stewart Larking
Illustration Manager: Mick Ruddy
Illustrator: Antbits Illustration
Marketing Manager(s) (UK/USA): Brant Emery/Emily M Christie
Frontmatter.qxd 18/7/05 3:18 PM Page iv
An imprint of Elsevier Limited
First edition 2000
©2006, Elsevier Limited. All rights reserved.
The right of Hugh C Hemmings Jr and Philip M Hopkins to be identified as authors of this
work has been asserted by them in accordance with the Copyright, Designs and Patents
Act 1988.
No part of this publication may be reproduced, stored in a retrieval system, or transmitted in
any form or by any means, electronic, mechanical, photocopying, recording or otherwise,
without the prior permission of the Publishers. Permissions may be sought directly from
Elsevier’s Health Sciences Rights Department in Philadelphia, USA: telephone: (+1) 215 239
3804; fax: (+1) 215 239 3805; or, e-mail: [email protected]. You may also
complete your request on-line via the Elsevier homepage (http://www.elsevier.com), by
selecting ‘Support and contact’ and then ‘Copyright and Permission’.
ISBN 0 3230 3707 0
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
Notice
Medical knowledge is constantly changing. Standard safety precautions must be followed, but
as new research and clinical experience broaden our knowledge, changes in treatment and drug
therapy may become necessary or appropriate. Readers are advised to check the most current
product information provided by the manufacturer of each drug to be administered to verify
the recommended dose, the method and duration of administration, and contraindications. It
is the responsibility of the practitioner, relying on experience and knowledge of the patient, to
determine dosages and the best treatment for each individual patient. Neither the Publisher
nor the authors assume any liability for any injury and/or damage to persons or property arising
from this publication.
The Publisher
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
Frontmatter.qxd 18/7/05 3:18 PM Page viii
Foreword
Drs Hemmings and Hopkins have assembled seventy three effect quantitative recovery to the volatility of ether rather than
chapters written by well-recognized authorities from both sides to the possibility of its metabolism by the body. The importance
of the Atlantic. Though the sea of knowledge is never full, they of water solubility on the speed of anesthetic action was soon
have completed an extraordinary and successful labor in produc- elucidated by Seymour Kety. So opened a new era in the
ing a significant tidal surge that will be regarded as the high water scientific understanding of what had previously been largely a
mark to be noted by generations of anesthesiologists yet unborn. clinical art.
Essential to the understanding of this text is the editors’ When Dr Hemmings honored me by asking me to write this
conviction that the successful practice of the art of anesthesia piece, I asked myself not only what to say, but also who might
requires a sound understanding of the underlying scientific prin- have said it very well in the past. The answer rose immediately
ciples’. This quotation from the invitational letter to each contrib- to mind: more than 30 years ago, John Severinghaus wrote the
utor summarizes the philosophy which underlines the entire foreword for the first edition of John Nunn’s classic book on
work. The seventy three chapters are grouped under eight major respiratory physiology- a book which, like this one, combined
headings (General Principles, Neurosciences, Cardiovascular and correlated basic science with clinical practice. He chose the
system, Respiratory system, Pathological sciences, Renal system, title ‘ A Flame for Hypos’, and illustrated it with a photograph
Gastrointestinal system and metabolism, and Adaptive phys- of a lighted candle before the statue of the god of sleep. No one
iology). Within each section of the book, there are chapters that has ever said it so well. Never have I read a more beautiful
cover the essential basic science information necessary for the foreword and append a part of it here with the permission of Dr
understanding of the section’s utility in clinical practice. Severinghaus (who himself has contributed a chapter to this
The amount of basic science information has grown tremen- book). So from the work of many minds and hands this book
dously during my half century in medicine. When I started my goes forth, that we too, by understanding the process, may
training, I was initially taught clinical anesthesia by very skillful better the art.
nurse anesthetists who were far more concerned with the art of Alan Van Poznak, M.D.
anesthesia. Scientific information was scarce. John Snow’s clas- New York City
sic monograph on the inhalation of the vapor of ether was one 1999
of the first publications to provide a scientific basic for the
practice of our art. In 1924, Howard Haggard published five The world will little note nor long remember what I say here, but
classic papers in the Journal of Biological Chemistry on the it can never forget what we did here.
uptake and elimination of diethyl ether, attributing his failure to Abraham Lincoln, Gettysburg November 19, 1863
The lighted candle respires and we call it flame. The body
respires and we call it life. Neither flame nor life is substance,
but process. The flame is as different from the wick and wax as
life from the body, as gravitation from the falling apple, or love
from a hormone. Newton taught science to have faith in processes
as well as substances–to compute, predict and depend upon an
irrational attraction. Caught up in enlightenment, man began to
regard himself as a part of nature, a subject for investigation. The
web of self-knowledge, woven so slowly between process and
substance, still weaves physiology, the process, and anatomy, the
substances, into the whole cloth of clinical medicine. Within this
multihued fabric, the warp fibres of process shine most clearly
in the newest patterns, among which must be numbered
anesthesiology.
And what of the god of sleep, patron of anesthesia? The
centuries themselves number more than 21 since Hypnos
wrapped his cloak of sleep over Hellas. Now before Hypos, the
Excerpted from the foreword to the first edition (1969) of
artisan, is set the respiring flame–that he may, by knowing the
Applied Respiratory Physiologyby John F. Nunn, reprinted with
process, better the art.
the permission of Butterworth-Heinemann
John W Severinghaus
San Francisco
viii
Frontmatter.qxd 18/7/05 3:18 PM Page ix
Preface
The successful practice of the art of anesthesia, critical care and review of specialized research areas for the scientist. Rather, the
pain medicine demands a sound understanding of underlying fundamental information necessary to understand ‘why’ and
scientific concepts and familiarity with the evolving vocabulary ‘how’ is stressed, and basic concepts are related to relevant
of medical science. This is recognized in the postgraduate exami- anesthesia situations. The style stresses a conceptual approach to
nations in anesthesia in North America, Europe and Australasia, learning, using factual information to illustrate the concepts.
for which a thorough understanding of the relevant basic Chapters are self-contained with minimal repetition, and include
sciences is required. Furthermore, many trainees in anesthesia a short list of Key References and suggestions for Further
come to view learning the basic sciences to the required depth Reading to stimulate further exploration of interesting topics.
as a necessary chore. This is disappointing to those of us who This style and approach is modeled after the ground-breaking
find the scientific basis for our clinical practice to be a constant text Scientific Foundations of Anaesthesia,edited by Cyril Scurr
source of interest, fascination and, indeed, sometimes excite- and Stanley Feldman, updated to cover the revolutionary devel-
ment. Part of the problem is that basic science texts directed opments in modern molecular biology and physiology. Recog-
towards anesthetists tend to be fact, rather than concept- nizing that graphics are the most expressive way of conveying
oriented, and therefore difficult to read and to learn from. concepts, full-color illustrations facilitate use of the book as a
Foundations of Anesthesia: Basic Sciences for Clinical Practice learning aid and make it enjoyable to read.
second edition, provides comprehensive coverage in a single text The second edition of Foundations of Anesthesia: Basic
of the principles and clinical applications of the four major areas Sciences for Clinical Practice includes a number of notable
of basic science that are relevant to anesthesia practice: molec- developments. Text boxes are included to highlight important
ular and cell biology, physiology, pharmacology, and physics and points with particular relevance to clinical implications for the
measurement. The approach is integrated and systems oriented, practice of anesthesia. Important key words from the American
avoiding the artificial boundaries between the basic sciences. in-training examination are highlighted in the index. A number
Recognizing that no single author possesses the breadth and of new chapters have been incorporated: Adverse Drug
depth of understanding of all relevant subjects, each chapter is Reactions, Sensory Systems, Physiology of Pain, General
authored by an expert in that area. These authorities represent Anesthetics: Mechanisms of Action, Consciousness and
many of the finest institutions of North America, the United Cognition, Sleep and Anesthesia, Ischemic Brain Injury, Blood
Kingdom and Europe to take advantage of the globalization of Constituents and Transfusion and Hemostasis and Coagulation.
medicine facilitated by electronic communication. This allows An accompanying CD includes the figures and tables to facilitate
an international presentation of current anesthesia science pre- teaching from the text and a searchable index. These improve-
sented by relevant experts at the cutting edge of anesthesia ments significantly enhance the use of Foundations of Anesthesia:
research and education. Basic Sciences for Clinical Practice as a tool for learning,
Each chapter stresses the scientific principles necessary to teaching and review of the fundamental concepts essential to
understand and manage various situations encountered in anes- anesthesiology, pain and critical care medicine.
thesia. Detailed explanations of techniques are avoided since
this information is available in many clinical subspecialty anes-
thesia texts. Nor is this book intended to provide a detailed Hugh C Hemmings Jr and Philip M Hopkins 2005
ix
Frontmatter.qxd 18/7/05 3:18 PM Page x
List of Contributors
John P Adams MB ChB MRCP FRCA Mark C Bellamy MA MB BS FRCA Iain T Campbell MB BS MD FRCA
Consultant in Anaesthesia and Intensive Care Professor of Critical Care Anaesthesia Consultant Anaesthetist
Department of Anaesthesia Intensive Care Unit Department of Anaesthesia
Leeds General Infirmary St James’s University Hospital University Hospital of South Manchester
Leeds Leeds Manchester
UK UK UK
Maria G Annetta MD Keith H Berge MD Franco Carli MD MPhil FRCA FRCPC
Assistant Professor Assistant Professor of Anesthesiology Professor of Anesthesia
Universita Cattolica Mayo Clinic College of Medicine Department of Anesthesia
Rome Rochester, Minnesota McGilll University Health Centre
Italy USA Montreal, Quebec
Canada
James Arden MD PhD Thomas JJ Blanck MD PhD
Consultant Anaesthetist Professor and Chairman of Anesthesiology Surinder PS Cheema MBBCh DA FRCA
Department of Anaesthesia Professor of Physiology and Neuroscience Consultant Anaesthesiologist
King’s College Hospital Department of Anesthesiology Dept of Anaesthetics
London NYU Medical Center Bradford Royal Infirmary
UK New York, New York Bradford
USA UK
Solomon Aronson MD FRCA
Professor of Anesthesiology Andrew R Bodenham FRCA Andrew T Cohen MBChB DRCOG FRCA
Department of Anesthesiology Consultant in Anaesthesia and Intensive Care Consultant in Anaesthesia and Intensive Care
Duke University Medical Center Medicine Department of Anaesthesia
Durham, North Carolina Department of Anaesthesia St James’s University Hospital
USA Leeds General Infirmary Leeds
Leeds UK
Helen A Baghdoyan PhD UK
Professor of Anesthesiology and Pharmacology Joan P Desborough MBChB FRCA MD
Department of Anesthesiology Francis Bonnet MD FRCA Consultant Anaesthetist
The University of Michigan Professor of Anesthesiology Anaesthetic Department
Ann Arbor, Michigan Department of Anesthesia Reanimation Epsom and St Helier NHS Trust
USA Hospital Tenon Surrey
Paris UK
Jeffrey R Balser MD PhD France
Associate Vice Chancellor for Research, Marc L Dickstein MD
Professor of Anesthesiology and Pharmacology Timothy J Brennan PhD MD Associate Professor of Anesthesiology
Vanderbilt University Medicine Center Associate Professor of Anesthesia and Columbia University
Nashville, Tennessee Pharmacology New York, New York
USA Department of Anesthesia USA
University of Iowa Hospitals and Clinics
Christofer D Barth MD Iowa City, Iowa Xueqin Ding MD PhD
Fellow, Cardiothoracic Anesthesia USA Research Fellow
Cleveland Clinic Foundation Center for Anesthesiology Research
Cleveland, Ohio Marek Brzezinski MD The Cleveland Clinic Foundation
USA Anesthesiology Fellow Cleveland, Ohio
Department of Anesthesiology USA
Marcus R Beadle MB BS FRCA Duke University Medical Center
Specialist Registrar Anaesthetics Durham, North Carolina James D Dodman MBBS FRCA
Department of Anaesthesia USA Specialist Registrar in Anaesthesia
St James’s University Hospital Department of Anaesthesia
Leeds Donal J Buggy MB ChB (Hons) MD MSc DME Leeds General Infirmary
UK FRCPI FCA (Ire) FRCA Leeds
Honorary Senior Lecturer in Anaesthesia UK
Paul CW Beatty PhD MSc BSc C Eng FIPEM Department of Anaesthesia
Senior Lecturer in Biomedical Engineering National University of Ireland
Imaging Science and Biomedical Engineering Mater Misericordiae University Hospital
University of Manchester Dublin
Manchester Republic of Ireland
UK
x
Frontmatter.qxd 18/7/05 3:18 PM Page xi
List of Contributors
Mary Doherty MB ChB FCA(Ire) Helen F Galley PhD FIMLS Norman L Herman MD PhD
Specialist Registrar in Anaesthesia Senior Lecturer Assistant Professor Anesthesiology (Retired);
Department of Anaesthesia Institute of Medical Sciences Associate Attending Anesthesiology (Retired)
Mater Misericordiae University Hospital University of Aberdeen Weill Medical College of Cornell University
Dublin Aberdeen New York, New York
Republic of Ireland UK USA
Marcel E Durieux MD PhD Susan Garwood MBChB FRCA Sue A Hill MA (Cantab) PhD (Cantab) FRCA Dip
Professor of Anesthesiology & Neurological Associate Professor of Anesthesiology Comp Dip Stats
Surgery Department of Anesthesiology Consultant Neuroanaesthetist
Department of Anesthesiology Yale University School of Medicine Shackleton Department of Anaesthesia
University of Virginia Health System New Haven, Connecticut Southampton University Hospitals Trust
Charlottesville, Virginia USA Southampton
USA UK
Kevin J Gingrich MD
Thomas J Ebert MD PhD Associate Professor of Anesthesiology Andrew T Hindle MB ChB BSc(Hons) DA FRCA
Professor of Anesthesiology and Staff NYU School of Medicine Consultant Anaesthetist
Anesthesiologist Department of Anesthesiology Department of Anaesthesia
Department of Anesthesiology New York, New York Warrington Hospital
The Medical Center of Wisconsin USA Warrington
Milwaukee, Wisconsin UK
USA Jean-Antoine Girault MD PhD
Director of Research Kirk Hogan MD JD
Simon M Enright MBChB FRCA Laboratory of Signal Transduction and Plasticity Professor of Anesthesiology
Clinical Director, ICU in the Nervous System Department of Anesthesiology
Pinderfields Hospital Institut du Fer à Moulin University of Wisconsin Hospitals and Clinics
Wakefield Paris Madison, Wisconsin
UK France USA
John R Feiner MD Andrew P Gratrix MBChB FCARCSI Philip M Hopkins MB BS MD FRCA
Associate Professor Specialist Registrar in Anaesthesia and Intensive Professor of Anaesthesia
Department of Anesthesia and Perioperative Care Medicine Academic Unit of Anaesthesia
Care Pinderfields Hospital St James’s University Hospital
University of California Wakefield Leeds
San Francisco, California UK UK
USA
Roger Hainsworth MB ChB PhD DSc Simon J Howell MBBS MA (Cantab) MRCP FRCA
Gary Fiskum PhD Emeritus Professor of Applied Physiology MSc MD
Professor and Vice-Chair for Research of Institute for Cardiovascular Research Senior Lecturer in Anesthesia
Anesthesiology University of Leeds Academic Unit of Anaesthesia
Department of Anesthesiology Leeds Leeds General Infirmary
University of Maryland School of Medicine UK Leeds
Baltimore, Maryland UK
USA Neil L Harrison BA PhD
Professor of Anesthesiology and Pharmacology Michael J Hudspith MB BS BSc PhD FRCA
Patricia Fogarty-Mack MD Department of Anesthesiology Consultant in Pain Management and Anesthesia
Associate Professor of Clinical Anesthesiology, Weill Medical College of Cornell University Norfolk & Norwich University Hospital
Director Neuroanesthesiology New York, New York Norwich
Department of Anesthesiology USA UK
Weill Medical College of Cornell University
New York, New York Paul M Heerdt MD PhD Uday Jain PhD MD
USA Associate Professor of Anesthesiology and Department of Anesthesia
Pharmacology St Mary’s Medical Center
Manuel L Fontes MD Weill Medical College of Cornell University San Francisco, California
Associate Professor of Anesthesiology and New York, New York USA
Critical Care USA
Department of Anesthesiology Peter M Kimpson MB ChB BSc FRCA
Weill Medical College of Cornell University Hugh C Hemmings Jr MD PhD Lecturer in Anaesthesia
New York, New York Professor of Anesthesiology and Pharmacology Academic Unit of Anaesthesia
USA Department of Anesthesiology St James’s University Hospital
Vice Chair of Research Leeds
Kirsty Forrest MBChB BSc (Hons) FRCA Weill Medical College of Cornell University UK
Lecturer in Anaesthesia New York, New York
Academic Unit of Anaesthesia USA
Leeds General Infirmary
Leeds
UK
xi
Frontmatter.qxd 18/7/05 3:18 PM Page xii
List of Contributors
H Thomas Lee MD PhD Thomas S McDowell MD PhD Klaus T Olkkola MD PhD
Assistant Professor of Anesthesiology Assistant Professor of Anesthesiology Professor and Chairman
Department of Anesthesiology Department of Anesthesiology Department of Anaesthesiology and Intensive
Colombia University Medical Center University of Wisconsin Care Medicine
New York, New York Madison, Wisconsin Turku University Hospital
USA USA Turku
Finland
Jerrold Lerman MD FRCPC FANZCA Gregory A Michelotti PhD
Clinical Professor of Anesthesia Assistant Research Professor Beverley A Orser MD PhD FRCPC
Department of Anesthesiology Duke University Medical Center Professor of Physiology and Anesthesia; Canada
Woman and Children’s Hospital of Buffalo Durham, North Carolina Research Chair in Anesthesia
Buffalo, New York USA Department of Physiology
USA University of Toronto
Salim Mujais MD Toronto, Ontario
Cynthia A Lien MD Vice President Medical Affairs Canada
Professor of Clinical Anesthesiology Renal Divison
Department of Anesthesiology Baxter Healthcare Corporation Gavril W Pasternak MD PhD
Weill Medical College of Cornell University McGaw Park, Illinois Anne Burnett Tandy Chair of Neurology; Member
New York, New York USA and Attending Neurologist; Head, Laboratory of
USA Molecular Neuropharmacology
Rajesh Munglani MB BS FRCA Memorial Sloan-Kettering Cancer Center
Martin J London MD Consultant in Pain Management New York, New York
Professor of Clinical Anesthesia West Suffolk Hospital USA
Department of Anesthesia and Perioperative Bury St Edmonds and BUPA Lea Hospital
Care Cambridge Misha A Perouansky MD
University of California UK Associate Professor of Anesthesiology
San Francisco, California Department of Anesthesiology
USA Paul G Murphy MA MB ChB FRCA University of Wisconsin Medical School
Consultant in Anaesthesia and Intensive Care Madison, Wisconsin
Andrew B Lumb MB BS FRCA Department of Anaesthesia USA
Consultant Anaesthetist Leeds General Infirmary
Department of Anaesthesia Leeds Raymond M Planinsic MD
St James’s University Hospital UK Director of Hepatic, Intestinal and Multivisceral
Leeds Transplantation Anesthesiology and Associate
UK Paul A Murray PhD Professor of Anesthesiology
Carl E Wasmuth Endowed Chair and Director of UPMC Presbyterian/Montefiore
Ralph Lydic PhD Anesthesiology Research, Professor of Pittsburgh, Pennsylvania
Bert La Du Professor of Anesthesiology and Anesthesiology USA
Associate Chair for Research Center for Anesthesiology Research
Department of Anesthesiology The Cleveland Clinic Foundation Alison J Pittard MBChB MD FRCA
The University of Michigan Cleveland,Ohio Consultant in Anaesthesia and Intensive Care
Ann Arbor, Michigan USA Department of Anaesthesia
USA Leeds General Infirmary
Timothy J Ness MD PhD Leeds
Ken Mackie MD Simon Gelman Endowed Professor of UK
Professor of Anesthesiology, Adjunct Professor of Anesthesiology
Physiology and Biophysics Department of Anesthesiology Brian J Pollard BPharm MB ChB MD FRCA
Department of Anesthesiology University of Alabama at Birmingham Professor of Anaesthesia
University of Washington Birmingham, Alabama Department of Anaesthesia
Seattle, Washington USA Manchester Royal Infirmary
USA Manchester
Ramona Nicolau-Raducu MD UK
Abhiram Mallick MD FRCA FFARCSI Instructor of Anesthesiology and Fellow of
Consultant in Anaesthesia and ICM Hepatic Transplantation Anesthesiology Ian Power MD FRCA FFPMANZCA FANZCA FRCS
Department of Anaesthesia UPMC Presbyterian/Montefiore Ed FRCP Edin
Leeds General Infirmary Pittsburgh, Pennsylvania Professor of Anaesthesia, Critical Care and Pain
Leeds USA Medicine
UK Department of Clinical and Surgical Sciences
Daniel Nyhan MD MRCPI The University of Edinburgh
Emmanuel Marret MD Professor of Anesthesiology and Critical Care Edinburgh
Associate Professor of Anesthesiology Medicine, Chief, Division of Cardiac Anesthesia, UK
Department of Anesthesia Reanimation Vice Chairman
Hospital Tenon Department of Anesthesiology and Critical Care Christopher B Prior BSc PhD
Paris Medicine Senior Lecturer in Pharmacology
France The Johns Hopkins Hospitals Department of Physiology and Pharmacology
Baltimore, Maryland University of Strathclyde
Ian G Marshall BSc PhD USA Glasgow
Department of Biomedical Sciences UK
University of Central Lancashire
Preston
UK
xii
Frontmatter.qxd 18/7/05 3:18 PM Page xiii
List of Contributors
Kane O Pryor MD Steven L Shafer MD David F Stowe BA MA MD PhD
Instructor in Anesthesiology Professor of Anesthesia, Adjunct Professor of Professor of Anesthesiology and Physiology
Department of Anesthesiology Biopharmaceutical Science Medical College of Wisconsin
Weill Medical College of Cornell University Anesthesiology Service Milwaukee, Wisconsin
New York, New York PAVAHCS USA
USA Palo Alto, California
USA Robert E Study MD PhD
Andrew Quinn MB ChB FRCA Staff Anesthesiologist
Specialist Registrar in Anaesthesia Stanton K Shernan MD First Colonies Anesthesia Associates
Department of Anaesthesia Director of Cardiac Anesthesia Suburban Hospital
St James’s University Hospital Department of Anesthesiology, Perioperative Bethesda, Maryland
Leeds and Pain Medicine USA
UK Brigham and Women’s Hospital
Havard Medical School Richard Teplick MD
Robert E Rosenthal MD Boston, Massachusetts Chief of Staff; Associate Dean for Clinical Affairs
Professor of Surgery, Program in Trauma; Section USA University of South Alabama Hospitals
Chief Hyperbaric Medicine Mobile, Alabama
R Adams Cowley Shock Trauma Center Philip J Siddall MBBS PhD FFPMANZCA USA
University of Maryland School of Medicine Clinical Senior Lecturer
Baltimore, Maryland Pain Management Research Institute Dafydd Thomas MB ChB FRCA
USA University of Sydney Consultant in Intensive Care
Royal North Shore Hospital Intensive Therapy Unit
David J Rowbotham MBChB MD FRCA MRCP Sydney, New South Wales Morriston Hospital
Professor of Anaesthesia and Pain Management Australia Swansea
University of Leicester and University Hospitals of UK
Leicester Jeffrey H Silverstein MD
Leicester Vice Chair for Research Stephen J Thomas MD
UK Department of Anesthesiology Topkins-Van Poznak Distinguished Professor of
Mount Sinai School of Medicine Anesthesiology
John J Savarese MD New York, New York Department of Anesthesiology
Professor and Chairman, USA Weill Cornell Medical College
Department of Anesthesiology New York, New York
Weill Medical College of Cornell University Karen H Simpson MBChB USA
New York, New York Consultant in Pain Medicine and Anaesthesia
USA Pain Management Service Annemarie Thompson MD
St James’s University Hospital Assistant Professor of Anesthesiology and
Thomas Schricker MD PhD Leeds Medicine
Assistant Professor UK Department of Anesthesiology
Department of Anesthesia Vanderbilt University Medical Center
McGilll University Health Centre Nikolaos Skubas MD Nashville, Tennessee
Montreal, Quebec Assistant Professor of Anesthesiology USA
Canada Department of Anesthesiology
Weill Cornell Medical College Howard M Thompson MD
Debra A Schwinn MD New York, New York Consultant in Anesthesia and Pain Management
James B Duke Professor of Anesthesiology, USA Pilgrim Hospital
Professor of Pharmacology/Cancer Biology & Boston
Surgery, Vice-Chairman of Research and Director Tod B Sloan MD MBA PhD UK
of Perioperative Genomics and Head of Professor of Anesthesiology
Molecular Pharmacology Laboratories Department of Anesthiology Simon Turner BSc(Hons) MBChB FRCA
Duke University Medical Center University of Colorado Health Sciences Center Clinical Lecturer in Anaesthesia
Department of Anesthesiology Denver, Colorado Academic Unit of Anaesthesia
Durham, North Carolina USA Leeds General Infirmary
USA Leeds
Richard M Smiley MD Ph D UK
Professor of Clinical Anesthesiology
Jane E Sellors MBChB FRCA Columbia University Robert A Veselis MD
Consultant Paediatric Anaesthetist New York, New York Associate Professor of Anesthesiology,
Department of Anaesthesia USA Director, Neuroanesthesiology Research
St James’s University Hospital Laboratory
Leeds Ian Smith BSc MD FRCA Department of Anesthesiology/Critical Care
UK Senior Lecturer in Anaesthesia Medicine
University Hospital of North Staffordshire Memorial Hospital in Memorial Sloan-Kettering
John W Severinghaus MD Stoke-on-Trent Cancer Center
Professor Emeritus UK New York, New York
Department of Anesthesia and Perioperative Care USA
University of California San Francisco School of Nina J Solenski MD
Medicine Associate Professor of Neurology
San Francisco, California Department of Neurology
USA University of Virginia School of Medicine
Charlottesville, Virginia
USA
xiii
Frontmatter.qxd 18/7/05 3:18 PM Page xiv
List of Contributors
Mladen Vidovich MD Ian G Wilson MBChB FRCA William L Young MD
Department of Medicine Consultant Paediatric Anesthetist Professor of Anesthesia
Northwestern University Department of Anaesthesia Department of Anesthesia and Perioperative Care
Chicago, Illinois St James’s University Hospital UCSF
USA Leeds San Francisco, California
UK USA
David O Warner MD
Professor of Anesthesiology Jay Yang MD PhD Michael Zaugg MD DEAA
Mayo Clinic College of Medicine Professor of Anesthesiology, Director of Head of Cardiovascular Anesthesia Laboratory
Rochester, Minnesota Neurobiology Research in Anesthesia Institute of Anesthesiology
USA Columbia University University Hospital
College of Physicians & Surgeons Zurich
Nigel R Webster MBChB PhD FRCA FRCP FRCS New York, New York Switzerland
Professor of Anaesthesia and Intensive Care USA
Academic Unit of Anaethesia and Intensive Care
Institute of Medical Sciences
University of Aberdeen
Aberdeen
UK
xiv
Frontmatter.qxd 18/7/05 3:18 PM Page xv
Acknowledgement
We would like to acknowledge our mentors and students, who have taught us and from whom we continue to learn.
Dedication
To our wives Katherine Albert and Carmel Hopkins, whose countless contributions and support were vital.
xv
