Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery. This review contains 7 figures, 2 videos, 2 tables, and 110 references. Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery
{"title":"Surgical Treatment of Obesity and the Metabolic Syndrome","authors":"Iman Ghaderi, Nisha Dhanabalsamy, C. Galvani","doi":"10.2310/surg.2066","DOIUrl":"https://doi.org/10.2310/surg.2066","url":null,"abstract":"Obesity and obesity-related comorbid conditions have been steadily increasing in the United States over the past few decades. Despite the availability of several anti-obesity measures such as diet, exercise, pharmacotherapy and behavioral modifications, bariatric surgery is the only effective modality that can provide a sustainable long-term weight loss and improve obesity-associated comorbidities. In this chapter, we discuss perioperative assessment and work-up of morbidly obese patients, minimally invasive approaches to various bariatric surgery procedures including laparoscopic adjustable gastric band, sleeve gastrectomy, gastric bypass and biliopancreatic diversion with duodenal switch, and their short and long term outcomes. We also address revisional bariatric surgery and use of robotic platform and other new procedures and their role in metabolic and bariatric surgery.\u0000This review contains 7 figures, 2 videos, 2 tables, and 110 references.\u0000Keywords: Obesity, comorbidities, metabolic surgery, bariatric surgery, gastric bypass, adjustable gastric band, sleeve gastrectomy, Biliopancreatic Diversion with Duodenal Switch, revisional surgery","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80758479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Approximately 700,000 inguinal hernia repairs are performed in the United States annually, making it one of the most commonly performed operations in surgical practice. The anatomy of the inguinal region is quite complex, and a thorough understanding of this region is required to successfully and safely repair these defects. The science of inguinal hernia repair continues to evolve and over the past several years has expanded to include laparoscopic and robotic approaches, as well as time-honored open repairs that still play an essential role in treating this disease process. The following review describes the relevant anatomy, types of groin hernias, the role of different hernia prostheses and meshes, common and evolving repair techniques, and the common complications encountered in hernia surgery, including chronic groin pain after inguinal hernia repair. The review contains 19 figures, 15 tables, and 50 references. Keywords: Inguinal hernia, femoral hernia, transabdominal preperitoneal repair, total extraperitoneal repair, laparoscopy, Bassini repair, Lichtenstein repair
{"title":"Inguinal Hernia","authors":"B. Richmond, Mike Q. Tran","doi":"10.2310/surg.2084","DOIUrl":"https://doi.org/10.2310/surg.2084","url":null,"abstract":"Approximately 700,000 inguinal hernia repairs are performed in the United States annually, making it one of the most commonly performed operations in surgical practice. The anatomy of the inguinal region is quite complex, and a thorough understanding of this region is required to successfully and safely repair these defects. The science of inguinal hernia repair continues to evolve and over the past several years has expanded to include laparoscopic and robotic approaches, as well as time-honored open repairs that still play an essential role in treating this disease process. The following review describes the relevant anatomy, types of groin hernias, the role of different hernia prostheses and meshes, common and evolving repair techniques, and the common complications encountered in hernia surgery, including chronic groin pain after inguinal hernia repair. \u0000The review contains 19 figures, 15 tables, and 50 references.\u0000Keywords: Inguinal hernia, femoral hernia, transabdominal preperitoneal repair, total extraperitoneal repair, laparoscopy, Bassini repair, Lichtenstein repair","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76582157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The preferred methods for facial rejuvenation have been changing over the past decade, with operative procedures on the decline and minimally invasive, office-based procedures on the rise. As a result, it is critical for plastic surgery practitioners to understand the intricacies of the use of neuromodulators and soft tissue fillers in this milieu. While these procedures are usually performed in an office, without general anesthesia, the risk of significant complications still exists. The knowledge of facial anatomy, techniques, and pitfalls is essential for achieving high quality, predictable, and reproducible results. Likewise, when a complication arises, prompt recognition and appropriate treatment is paramount. In this chapter, the history, purpose, technical guidelines, and complications of adjunctive techniques for facial rejuvenation are reviewed in detail. This review contains 2 tables, and 52 references. Keywords: facial rejuvenation, neuromodulator, soft tissue filler, botulinum toxin, dermal filler, aging face, facial rhytids, filler complications, glabellar lines, nasolabial fold
{"title":"Adjuncts to Facial Rejuvenation","authors":"Heather R. Faulkner","doi":"10.2310/PS.10038","DOIUrl":"https://doi.org/10.2310/PS.10038","url":null,"abstract":"The preferred methods for facial rejuvenation have been changing over the past decade, with operative procedures on the decline and minimally invasive, office-based procedures on the rise. As a result, it is critical for plastic surgery practitioners to understand the intricacies of the use of neuromodulators and soft tissue fillers in this milieu. While these procedures are usually performed in an office, without general anesthesia, the risk of significant complications still exists. The knowledge of facial anatomy, techniques, and pitfalls is essential for achieving high quality, predictable, and reproducible results. Likewise, when a complication arises, prompt recognition and appropriate treatment is paramount. In this chapter, the history, purpose, technical guidelines, and complications of adjunctive techniques for facial rejuvenation are reviewed in detail.\u0000This review contains 2 tables, and 52 references.\u0000Keywords: facial rejuvenation, neuromodulator, soft tissue filler, botulinum toxin, dermal filler, aging face, facial rhytids, filler complications, glabellar lines, nasolabial fold ","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78428889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ischemic time, defined as the period from donor procurement to surgical implantation and restoration of intrinsic allograft function, is an independent risk factor for post-transplant mortality. In general, the ischemic time should be less than 4 hours. Most programs will accept donor hearts from within their own UNOS region or within a radius of 500 to 1000 miles to minimize ischemic time. Given the prevalent use of ventricular assist devices (VAD) as bridge to transplant and the increased time required to explant both the native heart and VAD hardware, patients must live within 2-3 hours (by car or air) of the transplant center. Coordinating the donor harvest and recipient preparation requires close collaboration between multiple surgeons, surgical teams and coordinators. This review contains 11 figures, 7 tables, and 52 references. Key words: heart transplant, immunosuppression, allograft rejection, infection, hypertension, hyperlipidemia, diabetes, malignancy, cardiac allograft vasculopathy, survival
{"title":"Heart Transplantation - Part II: Aspects of Procedure and Medical Management","authors":"M. Givertz","doi":"10.2310/surg.1611","DOIUrl":"https://doi.org/10.2310/surg.1611","url":null,"abstract":"Ischemic time, defined as the period from donor procurement to surgical implantation and restoration of intrinsic allograft function, is an independent risk factor for post-transplant mortality. In general, the ischemic time should be less than 4 hours. Most programs will accept donor hearts from within their own UNOS region or within a radius of 500 to 1000 miles to minimize ischemic time. Given the prevalent use of ventricular assist devices (VAD) as bridge to transplant and the increased time required to explant both the native heart and VAD hardware, patients must live within 2-3 hours (by car or air) of the transplant center. Coordinating the donor harvest and recipient preparation requires close collaboration between multiple surgeons, surgical teams and coordinators.\u0000This review contains 11 figures, 7 tables, and 52 references.\u0000Key words: heart transplant, immunosuppression, allograft rejection, infection, hypertension, hyperlipidemia, diabetes, malignancy, cardiac allograft vasculopathy, survival ","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89573735","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Heart failure (HF) is a major public health problem with significant associated morbidity and mortality. In 2001, the American College of Cardiology/American Heart Association (ACC/AHA) guideline committee proposed a new approach to the classification of HF that emphasized both the development and progression of disease. Stage A and B patients are at high risk for developing HF, and include those without structural heart disease (Stage A) and those with structural heart disease, but without signs or symptoms of HF (Stage B). Stage C and D patients have structural heart disease with prior or current symptoms of HF (Stage C) or refractory HF requiring specialized interventions (Stage D). Rregistries suggest that between 5% and 10% of patients with HF have advanced disease, which is associated with 1-year mortality in excess of 50% and a poor quality of life. The Heart Failure Society of America (HFSA) defines Stage D heart failure as “the presence of progressive and/or persistent severe signs and symptoms of heart failure despite optimized medical, surgical, and device therapy…generally accompanied by frequent hospitalization, severely limited exertional tolerance, and poor quality of life.” In this two-part chapter, we focus on heart transplantation, which remains the standard-of-care for highly selected patients with end-stage HF and absence of contraindications to transplant.1-5 This review contains 7 figures, 8 tables, and 46 references. Key words: heart failure, cardiomyopathy, heart transplant, mechanical circulatory support, prognosis, pulmonary hypertension, diabetes, HLA sensitization, donor
{"title":"Heart Transplantation - Part I: General Considerations","authors":"M. Givertz","doi":"10.2310/surg.1331","DOIUrl":"https://doi.org/10.2310/surg.1331","url":null,"abstract":"Heart failure (HF) is a major public health problem with significant associated morbidity and mortality. In 2001, the American College of Cardiology/American Heart Association (ACC/AHA) guideline committee proposed a new approach to the classification of HF that emphasized both the development and progression of disease. Stage A and B patients are at high risk for developing HF, and include those without structural heart disease (Stage A) and those with structural heart disease, but without signs or symptoms of HF (Stage B). Stage C and D patients have structural heart disease with prior or current symptoms of HF (Stage C) or refractory HF requiring specialized interventions (Stage D). Rregistries suggest that between 5% and 10% of patients with HF have advanced disease, which is associated with 1-year mortality in excess of 50% and a poor quality of life. The Heart Failure Society of America (HFSA) defines Stage D heart failure as “the presence of progressive and/or persistent severe signs and symptoms of heart failure despite optimized medical, surgical, and device therapy…generally accompanied by frequent hospitalization, severely limited exertional tolerance, and poor quality of life.” In this two-part chapter, we focus on heart transplantation, which remains the standard-of-care for highly selected patients with end-stage HF and absence of contraindications to transplant.1-5\u0000This review contains 7 figures, 8 tables, and 46 references.\u0000Key words: heart failure, cardiomyopathy, heart transplant, mechanical circulatory support, prognosis, pulmonary hypertension, diabetes, HLA sensitization, donor","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81596261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cleft lip is one of the most common congenital anomalies that present to plastic surgeons. Care involves a multidisciplinary approach to address both aesthetic and functional needs. This review covers embryology, epidemiology, classification, and anatomy. It also provides a more in-depth description of treatment for unilateral, bilateral, and minor form clefts. Given the spectrum of presentation and the multiple tissue types involved, the general principles of reconstructive surgery are used as the framework for this review. This review contains 16 figures, 3 tables, and 119 references. Keywords: cheiloplasty, cleft lip, Fisher repair, microform cleft lip, Millard repair, orbicularis muscle, primary rhinoplasty, septoplasty, Tennison-Randall repair
{"title":"Cleft Lip","authors":"R. Tse","doi":"10.2310/ps.10025","DOIUrl":"https://doi.org/10.2310/ps.10025","url":null,"abstract":"Cleft lip is one of the most common congenital anomalies that present to plastic surgeons. Care involves a multidisciplinary approach to address both aesthetic and functional needs. This review covers embryology, epidemiology, classification, and anatomy. It also provides a more in-depth description of treatment for unilateral, bilateral, and minor form clefts. Given the spectrum of presentation and the multiple tissue types involved, the general principles of reconstructive surgery are used as the framework for this review.\u0000This review contains 16 figures, 3 tables, and 119 references.\u0000Keywords: cheiloplasty, cleft lip, Fisher repair, microform cleft lip, Millard repair, orbicularis muscle, primary rhinoplasty, septoplasty, Tennison-Randall repair","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-05-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83516928","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Major salivary gland tumors constitute 3 to 6% of all tumors of the head and neck in adults, and about 85% of these salivary gland tumors are found in the parotid gland. Approximately 70% of parotid lesions are neoplastic, and roughly 16% of these neoplasms are malignant. The spectrum of histopathologic entities encompassed by the term parotid mass is exceedingly broad and continues to evolve as our understanding of the origin and clinical behavior of the various tumors arising from the parotid gland expands. This review discusses the anatomy, etiology, differential diagnosis, diagnostic workup and imaging, surgical management, and overall prognosis for parotid masses. This review contains 6 figures, 11 tables, and 84 references. Key words: facial nerve, fine-needle aspiration, imaging, malignant neoplasm, neck dissection, parotid mass, parotidectomy, pleomorphic adenoma
{"title":"Parotid Mass","authors":"N. Bhattacharyya, Y. Haidar, M. S. Trent","doi":"10.2310/surg.2026","DOIUrl":"https://doi.org/10.2310/surg.2026","url":null,"abstract":"Major salivary gland tumors constitute 3 to 6% of all tumors of the head and neck in adults, and about 85% of these salivary gland tumors are found in the parotid gland. Approximately 70% of parotid lesions are neoplastic, and roughly 16% of these neoplasms are malignant. The spectrum of histopathologic entities encompassed by the term parotid mass is exceedingly broad and continues to evolve as our understanding of the origin and clinical behavior of the various tumors arising from the parotid gland expands. This review discusses the anatomy, etiology, differential diagnosis, diagnostic workup and imaging, surgical management, and overall prognosis for parotid masses.\u0000This review contains 6 figures, 11 tables, and 84 references.\u0000Key words: facial nerve, fine-needle aspiration, imaging, malignant neoplasm, neck dissection, parotid mass, parotidectomy, pleomorphic adenoma ","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82830250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acute renal failure definitions have changed dramatically over the last 5 to 10 years as a result of criteria established through the following consensus statements/organizations: RIFLE (Risk, Injury, Failure, Loss of function, End stage renal disease), AKIN (Acute Kidney Injury Network), and KDIGO (Kidney Disease: Improving Global Outcomes). In 2002, the Acute Dialysis Quality Initiative was tasked with the goal of establishing a consensus statement for acute kidney injury (AKI). The first order of business was to provide a standard definition of AKI. Up to this point, literature comparison was challenging as studies lacked uniformity in renal injury definitions. Implementing results into evidence-based clinical practice was difficult. The panel coined the term “acute kidney injury,” encompassing previous terms, such as renal failure and acute tubular necrosis. This new terminology represented a broad range of renal insults, from dehydration to those requiring renal replacement therapy (RRT). This review provides an algorithmic approach to the epidemiology, pathophysiology, diagnosis, prevention, and management of AKI. Also discussed are special circumstances, including rhabdomyolysis, contrast-induced nephropathy, and hepatorenal syndrome. Tables outline the AKIN criteria, most current KDIGO consensus guidelines for definition of AKI, differential diagnosis of AKI, agents capable of causing AKI, treatment for specific complications associated with AKI, and options for continuous RRT. Figures show the RIFLE classification scheme and KDIGO staging with prevention strategies. This review contains 1 management algorithm, 2 figures, 6 tables, and 85 references. Keywords: Kidney, renal, KDIGO, azotemia, critical, urine, oliguria, creatinine, dialysis
{"title":"Acute Kidney Injury","authors":"A. Ebadat, E. Bui, Carlos V. R. Brown","doi":"10.2310/surg.2154","DOIUrl":"https://doi.org/10.2310/surg.2154","url":null,"abstract":"Acute renal failure definitions have changed dramatically over the last 5 to 10 years as a result of criteria established through the following consensus statements/organizations: RIFLE (Risk, Injury, Failure, Loss of function, End stage renal disease), AKIN (Acute Kidney Injury Network), and KDIGO (Kidney Disease: Improving Global Outcomes). In 2002, the Acute Dialysis Quality Initiative was tasked with the goal of establishing a consensus statement for acute kidney injury (AKI). The first order of business was to provide a standard definition of AKI. Up to this point, literature comparison was challenging as studies lacked uniformity in renal injury definitions. Implementing results into evidence-based clinical practice was difficult. The panel coined the term “acute kidney injury,” encompassing previous terms, such as renal failure and acute tubular necrosis. This new terminology represented a broad range of renal insults, from dehydration to those requiring renal replacement therapy (RRT). This review provides an algorithmic approach to the epidemiology, pathophysiology, diagnosis, prevention, and management of AKI. Also discussed are special circumstances, including rhabdomyolysis, contrast-induced nephropathy, and hepatorenal syndrome. Tables outline the AKIN criteria, most current KDIGO consensus guidelines for definition of AKI, differential diagnosis of AKI, agents capable of causing AKI, treatment for specific complications associated with AKI, and options for continuous RRT. Figures show the RIFLE classification scheme and KDIGO staging with prevention strategies.\u0000\u0000This review contains 1 management algorithm, 2 figures, 6 tables, and 85 references.\u0000Keywords: Kidney, renal, KDIGO, azotemia, critical, urine, oliguria, creatinine, dialysis","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90086940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Advances in anesthesia have expanded the field of plastic surgery by allowing more procedures to be done, while also increasing the safety of the patient. Anesthesia is a spectrum ranging from local anesthetic injected by the surgeon, to regional and neuraxial blocks or general anesthesia with an anesthesia team. Anesthesiologists work with the surgeon to assess a patient’s preoperative risk and make joint decisions to determine if additional medical optimization is needed prior to surgery. New peripheral blocks allow alternatives to general anesthesia or serve as adjuncts to improve post-operative pain. Selection of drugs used to induce and maintain anesthesia are changing with the advent of Enhanced Recovery After Surgery Protocols and emphasis on decreasing opioids. Teamwork and excellent communication are imperative to navigate anesthetic and surgical emergencies. This review contains 3 figures, 4 tables, and 29 references. Keywords: sedation, general anesthesia, regional anesthesia, peripheral nerve blocks, local anesthetic toxicity syndrome, ASA physical status, preoperative fasting guidelines, opioids, multi-modal analgesia, ERAS, crisis checklists
{"title":"Anesthetic Principles","authors":"Britlyn D. Orgill, Douglas L. Helm","doi":"10.2310/ps.10035","DOIUrl":"https://doi.org/10.2310/ps.10035","url":null,"abstract":"Advances in anesthesia have expanded the field of plastic surgery by allowing more procedures to be done, while also increasing the safety of the patient. Anesthesia is a spectrum ranging from local anesthetic injected by the surgeon, to regional and neuraxial blocks or general anesthesia with an anesthesia team. Anesthesiologists work with the surgeon to assess a patient’s preoperative risk and make joint decisions to determine if additional medical optimization is needed prior to surgery. New peripheral blocks allow alternatives to general anesthesia or serve as adjuncts to improve post-operative pain. Selection of drugs used to induce and maintain anesthesia are changing with the advent of Enhanced Recovery After Surgery Protocols and emphasis on decreasing opioids. Teamwork and excellent communication are imperative to navigate anesthetic and surgical emergencies. \u0000This review contains 3 figures, 4 tables, and 29 references.\u0000Keywords: sedation, general anesthesia, regional anesthesia, peripheral nerve blocks, local anesthetic toxicity syndrome, ASA physical status, preoperative fasting guidelines, opioids, multi-modal analgesia, ERAS, crisis checklists","PeriodicalId":11151,"journal":{"name":"DeckerMed Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88953005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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