Bone, joint and connective tissue disorders

This chapter describes the anaesthetic management of the patient with those musculoskeletal disorders which are relevant to anaesthetic practice. Topics covered include rheumatoid arthritis, ankylosing spondylitis, systemic lupus erythematosus (SLE); systemic sclerosis; scoliosis and achondroplasia. For each topic, pre-operative investigation and optimisation, treatment, and anaesthetic management are described.

Neurological and muscular disorders

This chapter describes the anaesthetic management of the patient with those neurological or muscular disorders which are relevant to anaesthetic practice, including malignant hyperthermia (MH). Other topics covered include epilepsy, cerebrovascular disease; Parkinson’s disease; spinal cord lesions; myasthenia gravis; multiple sclerosis; Guillain-Barré syndrome; motor neuron disease; dystrophia myotonica and the muscular dystrophies. For each topic, pre-operative investigation and optimisation, treatment, and anaesthetic management are described.

Psychiatric disorders

This chapter describes the anaesthetic management of the patient with those psychiatric disorders which are relevant to anaesthetic practice, including dementia, alcoholism and anorexia nervosa. Psychiatric medications which can affect anaesthetic practice are described, including monoamine oxidase inhibitors (MAOI), antipsychotic drugs and lithium. Anaesthesia for drug-misusing patients and electroconvulsive therapy (ECT) is described. Sedation of agitated patients on the ward is discussed.

Separate Consent for Anesthetic Practice: Need of the Moment

Decades of refinement and modifications have led the modern anaesthetic practice to be conducted so smoothly and safely, that sometimes we take for granted the enormous amount of risks involved with it. Furthermore, with the evolution of monitoring techniques, and discovery of safer drugs, anesthesia has facilitated the conduction of complex surgeries on sicker patients, and older patients. The expansion to critical care and pain management services has added another dimension to this field, with anesthesiologists not just working as facilitators for another procedure, but acting as primary physicians. Anesthesiologists are among the few clinicians, who are involved in patient morbidity and mortality in their daily routine. With the ever-changing ethical and legal background, the significance of obtaining a separate consent for anesthesia needs to be timely evaluated. In this review, we have discussed the significance of a separate consent for anesthesia and highlight its various aspects.