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This new edition of Clinical Anesthesiology contains several important improvements and refinements of the three highly successful prior editions. For the first time, we have sought the expertise of non-anesthesiologist authorities in specific fields to review the content of selected chapters. The purpose of this plan was to put commonly accepted anesthetic tenets under the spotlight of the scientific literature of related, yet distinct, specialties. For example, those chapters dealing with the anesthetic management of surgical cases were typically reviewed by a surgeon specializing in that field, the pharmacology chapters by pharmacologists, and the equipment chapters by engineers. We hope the results of this endeavor provide the reader with as educational an exercise as was experienced by the authors.

For their review of specific chapters, the authors wish to express their gratitude to Nelson Koe, MD; Duraiyah Thangathurai, MD; Diana Wong, MD; Nabil Rashad, MD; Karen Morgan, MD; Rafael Llerena; Jodi Wabiszewski; Douglas Bacon, MD; C. George Merridew, MBBS; Barry Harrison, MBBS; Jerry Dorsch, MD; Stephen Grinton, MD; Octavio Pajaro, MD, PhD; John Odell, MD; Javier Aduen, MD; Patrick Kamath, MD; Wolf Stapelfeldt, MD; and Robert Hale, DDS.

Profiles in Anesthetic Practice are exciting, unique features introduced in the third edition, but expanded in the fourth edition. These brief essays, written by eighteen internationally recognized leaders in anesthesiology (five of whom practice anesthesiology outside the United States) present editorialized counterpoints to the usual textbook dogma. They involve the reader in the dynamics of thinking through anesthetic problems and controversies. Thus each essay is a profile in the sense that it represents more of a side perspective as opposed to a straight-on view. The Profiles in Anesthetic Practice are easily identified by the use of color, icons, and a line drawing of each author's profile.

Key Concepts are listed in the front of each chapter and a corresponding numbered icon identifies the section(s) within the chapter in which each concept is discussed. These should help the reader focus on truly important themes that constitute the core of understanding anesthesiology.

Case Discussions deal with clinical problems of current interest and provide a methodology and framework to approach oral examinations.

Key Terms and Topics are identified with color type. These highlighted words, the number of which has been significantly expanded in this edition, provide the reader with a quick guide to the subject matter, on which many written exam questions are based.

• All chapters have been thoroughly updated and revised. Chapters 4, 5, 6, and 17 underwent particularly extensive rewriting. The chapter on “Outpatient Anesthesia” was deleted in this edition, ironically because the outpatient setting has become so ubiquitous that it is an integral part of every chapter.

• The suggested reading has been expanded and updated to include pertinent Web addresses.

• Several new illustrations have been added.

Nonetheless, the goal of Clinical Anesthesiology remains unchanged from the first edition: “to provide a concise, consistent presentation of the basic principles essential to the modern practice of anesthesia.” To this end, the authors strove to minimize redundancies, eliminate contradictions, and write in a highly readable style. The case discussions that conclude each chapter continue to address the whys of clinical medicine, serve as a self-examination tool for the reader, and instill a logical approach to clinical situations. The suggested reading includes relevant texts, chapters, and review articles, emphasizing material published since 2000.

We wish to acknowledge Martin L. DeRuyter, MD, who helped with the extensive revision of Chapter 17 on Peripheral Nerve Blocks. We are also grateful to individuals who offered their expertise in addressing specific questions in selected chapters. They include Douglas Coursin, MD; Jeffrey Vender, MD; Roy Greengrass, MD; Udaya Prakash, MD; Roy Cucchiara, MD; Eric Bloomfield, MD; Jasper Daube, MD; John Noseworthy, MD; Gregory Cascino, MD; W. Andrew Oldenburg, MD; James Meschia, MD; Thomas Brott, MD; Thomas Bower, MD; Richard Prielipp, MD; Daniel Hurley, MD; John Miles, MD; Roger White, MD; Andrea Gabrielli, MD; Gale Van Norman, MD; Lance Oyen, PharmD; Jeffrey Ward, RRT; Steve Holets, RRT; and Frances Kennedy. Other individuals who offered insights include Alex Aidinoff, MD; Beverly Philip, MD; John Maydak, MD; and Sarah Tierney, CRNA. Also gratefully acknowledged is the assistance of Robin Williams. We would also like to thank Marc Strauss, Harriet Lebowitz, Marsha Loeb, and Arline Keithe for their invaluable assistance.

G. Edward Morgan, Jr., MD
Maged S. Mikhail, MD
Michael J. Murray, MD, PhD
May 2005

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