AAGBI Core Topics in Anaesthesia 2012 by Ian Johnston, William Harrop-Griffiths, Leslie Gemmell

By Ian Johnston, William Harrop-Griffiths, Leslie Gemmell

Based at the organization of Anesthetists of significant Britain and Ireland's (AAGBI) carrying on with schooling lecture sequence, this clinical-oriented ebook covers the most recent advancements in learn and the scientific program to anesthesia and ache control.

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Surgery, Operative. 3. Operations, Surgical. I. Johnston, Ian G. II. Harrop-Griffiths, William. III. Gemmell, Leslie. IV. Association of Anaesthetists of Great Britain and Ireland. V. Title: Association of Anaesthetists of Great Britain and Ireland core topics. VI. Title: Core topics. [DNLM: 1. Anesthesia–methods. 2. Anesthesia–contraindications. 3. Surgical Procedures, Operative. 9′6–dc23 2011024801 A catalogue record for this book is available from the British Library. List of Contributors Graham Arthurs Wrexham Maelor Hospital Wrexham, UK Nick Boyd Derriford Hospital Plymouth, UK Ian Calder The National Hospital for Neurology and Neurosurgery London, UK Leslie Gemmell Wrexham Maelor Hospital Wrexham, UK Alex Grice Royal Devon and Exeter NHS Foundation Trust Exeter, UK Richard Griffiths Peterborough City Hospital Peterborough, UK Ed Hammond Royal Devon and Exeter NHS Foundation Trust Exeter, UK William Harrop-Griffiths Imperial College Healthcare NHS Trust London, UK Ian Johnston Raigmore Hospital Inverness, UK Michelle Leemans The National Hospital for Neurology and Neurosurgery London, UK Stephen Leslie Raigmore Hospital Inverness, UK David Levy Nottingham University Hospitals NHS Trust Queen’s Medical Centre Campus Nottingham, UK Andrew McIndoe University Hospitals Bristol NHS Foundation Trust Bristol, UK Simon Marshall Musgrove Park Hospital Taunton, UK Colin Moore Royal Infirmary of Edinburgh Edinburgh, UK Christopher Newell University Hospitals Bristol NHS Foundation Trust Bristol, UK Carol Peden Royal United Hospital Bath, UK Mansukh Popat Oxford Radcliffe Hospital NHS Trust Oxford, UK Stuart White Brighton and Sussex University Healthcare NHS Trust Brighton, UK Glyn Williams Great Ormond Street Hospital for Children NHS Trust London, UK Foreword Iain Wilson, President of AAGBI The Association of Anaesthetists of Great Britain and Ireland has worked tirelessly since 1932 to promote and advance patient safety by offering anaesthetists the educational materials they need to support safe and effective practice.

If patients are stable, then PCI should be performed within 72 h as an inpatient. Unstable patients with heart failure or arrhythmias should be considered for urgent PCI. In patients with chronic stable angina, PCI offers relief of the symptoms of angina in the medium term and decreases the need for anti-anginal drugs. However, elective PCI for chronic stable angina does not confer any mortality benefit. In patients with multivessel coronary artery disease for whom there is a choice between CABG and PCI, CABG is more cost-effective and may offer better outcomes, especially in diabetic patients.

The position of the stent may also influence the duration of treatment, with some cardiologists preferring lifelong, dual antiplatelet therapy in patients who have a left mainstem stent or proximal left anterior descending artery stents due to the potential catastrophic result of acute stent thrombosis in these patients compared with more distal stent placement. Early discontinuation of dual antiplatelet therapy is associated with a greatly increased risk of acute stent thrombosis. There is high mortality (up to 40%) if surgery is performed with four weeks of coronary stenting.

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