PreOp Meds: Benzodiazepine concepts Flashcards

1
Q

Differentiate sedatives and hypnotics.

A
  • Sedatives: induce calm/sleep
  • Hypnotics: induce hypnosis/sleep
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2
Q

When is anesthesia awareness most common?
What are the rates of this occurring?

A
  • During sedation cases and during emergence.
  • 1:1000 (or 1:10,000 per some studies)
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3
Q

What is the mechanism for less EEG activity seen during anesthesia/sedation?

A
  • Less cerebral blood flow (CBF) and cerebral metabolic requirement of oxygen (CMRO₂) = less metabolism = less EEG activity.
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4
Q

What was the first compressed EEG?
Give the details of the study exploring its use.

A
  • Bispectral analysis
  • 1500 subjects w/ 5000 hours of EEG signaling
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5
Q

What drugs were utilized in the bispectral analysis study?

A
  • Isoflurane/ O₂
  • Propofol/nitrous
  • Propofol/alfentanil
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6
Q

Which drugs exhibit a strong correlation between BIS change and patient movement?
Which drugs do not exhibit this correlation?

A
  • Hypnotic drugs
  • Narcotics
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7
Q

In the BIS study, what reading indicated that a patient was for sure unconscious?

A
  • <58
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8
Q

In the BIS study, a reading of <65 indicated a ___% of return to consciousness within the minute.

A
  • 5%
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9
Q

What is a normal BIS range?

A
  • 40-60
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10
Q

What are the four parameters (other than the BIS itself) noted on a BIS monitor?

A
  • SQI
  • EMG
  • EEG
  • SR
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11
Q

What is the SR noted on a BIS monitor?
What would an SR of 60 indicate?

A
  • Suppression Ratio (how many seconds per minute that the EEG is flat)
  • SR of 60 means EEG is completely flat (could be brain death).
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12
Q

Name drugs that could suppress EEG activity.

A
  • Hypnotics, volatiles, NMBDs, Opioids
  • β-blockers
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13
Q

Name drugs that could enhance EEG activity.

A
  • Ketamine, epinephrine
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