Anesthesiologist's Manual of Surgical Procedures, 4th ed.


The goals of the fourth edition remain unchanged from those of the first—that is, to provide an easily accessible source of clinically relevant information about a wide variety of both common and not so common surgical procedures. As with the first edition, this edition does not pretend to be either a textbook of anesthesia or a textbook of surgery. Indeed, in the formulation of an anesthetic plan, there is no substitute for experience and sound clinical judgment.

Those familiar with the preceding editions will notice that the format and organization of this edition remain largely unchanged. Color has been added to improve readability of the tables and clarity of the figures. Along with new chapters and new procedures, every existing procedure was reviewed and revised as necessary to reflect current practices.

Once again we have made extensive use of abbreviations, medical symbols, and telegraphic sentence structure to present a large quantity of information in a condensed format. While we realize that it may be aesthetically more pleasing to read: “hypoxia or hypercapnia can lead to the development of tachycardia and hypertension”, it takes up a lot less space to write: ↓PaO2 or ↑PaCO2 → ↑HR + ↑BP.

This will be the last edition to benefit from the unique talents of my long-time colleague Stanley Samuels. His retirement, however, does give me the opportunity to review his important contributions to this textbook. First a bit of history; I was a resident in Anesthesiology when I developed the concept for this book, and it did not take long to realize that I had no idea how to go about getting a textbook published. The most successful medical textbook author I knew was my former chairman, William F. Ganong. So, shortly after I joined the faculty at Stanford, I approached him for advice. He liked the concept and agreed to put me in contact with one of his publishers. About this same time I had another realization—that it might be difficult to convince a large number of my new surgical and anesthesia colleagues to contribute their valuable time and talent to what they might view as a not particularly rewarding endeavor. Fortunately as a resident I had many occasions to work with Stanley, and had quickly come to realize that he possessed a certain Irish charm and almost magical ability to elicit the cooperation of others. Recognizing how important these special talents would be for the successful completion of the book, I approached him regarding collaboration. He agreed, and some 2 1/2 years later the first edition was published, an accomplishment that was in no small part a result of his persuasive powers.

This edition also marks another transition at the editorial level with the addition of two associate editors. Cliff Schmiesing and Brenda Golianu, both faculty members in the Department of Anesthesia at Stanford, bring special expertise in areas of adult and pediatric anesthesia respectively. I am thankful that they kindly agreed to assist with the time-consuming and complex editorial process involved in the production of this new edition.

Unlike previous editions, this edition was edited almost entirely online. While advantageous in theory, the translation to practice was much more difficult than anyone anticipated. Computer software no matter how well-intentioned is no substitute for a dedicated, thoughtful, and talented editorial assistant. Dee Mosteller, our editorial assistant for the previous editions, was sorely missed.

As always, the editorial team welcomes the comments and suggestions of our readers (email:, and we hope that this 4th edition will become a useful resource in their clinical practice.

Richard A. Jaffe

Stanford University, School of Medicine, August 2008