5.20 Anesthesia Flashcards

1
Q

What 4 things do you need to have anesthesia

A

amnesia
hypnosis
analgesia
muscle relaxant

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2
Q

Stages of Anesthesia

A

1: hypnosis and amnesia (painful stimuli will wake you up; give propofol)
2: respond inappropriately to a painful stimuli (laryngospasm, posturing, etc)
3: Surgical plane of anesthesia (you will not respond to painful stimuli)
4: Brain stem depression, lose autonomic function (hypotension, bradycardia, apnea, death)

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3
Q

What drug do we give for amnesia

A

Versed

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4
Q

What drug do we give for hypnosis

A

Propofol

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5
Q

What drug do we use for analgesia

A

fentanyl

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6
Q

What drug do we use for muscle relalxant

A

rocuronium

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7
Q

Malignant hyperthermia

A

exposure to succinylcholine or anesthetic gases potentially deadly

  • problem with ryanidine receptor so you get lots of Ca from sarcoplasmic reticulum
  • Treat with Dantrolene
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8
Q

Pseudocholinesterase deficiency

A

If you use some drugs, it will last a very long time

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9
Q

Post op nausea/vomiting

A

tends to correlate with motion sickness

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10
Q

Preop exam

A

Fam Hx
Airway - tongue, teeth, ROM neck
Veins

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11
Q

Mallampati scale

A

scale based on how easy it should be to intubate based on how much of back of throat you can see

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12
Q

Monitors for anesthesia

A

Pulse ox
EKG
Blood Pressure
Temp

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13
Q

What is the PACU

A

Post anesthesia care unit

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14
Q

Goal of PACU

A
  • smooth transition back to normal
  • end hyponosis, amnesia, muscle relaxation, taper/stop analgesia
  • Pain management: narcotics and/or regionalanesthesia
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15
Q

Narcotics examples

A

IV: fentanyl, morphine, hydromorphone (dilaudid), meperidine (Demerol)

Oral: oxycodone, hydrocodone, codeine w/ or w/o APAP and Ibuprofen

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16
Q

How do narcotics work

A

takes away perception of pain; pain isn’t actually gone

Mu receptors, Kappa receptors

17
Q

Side effects of Narcotics

A

sleepy, itchy, lower tidal volume, constipation, dysphoria, urinary retention, Nausea/vomiting, tolerance, apnea

18
Q

Regional anesthesia and analgesia

A

Spinal, epidural, and nerve blocks

  • can be single dose or continuous
  • drugs used are local anesthetics
19
Q

2 main classes of anesthetics

A

Esters and Amides

20
Q

Amide examples

A

Lidocaine, bupivacaine , Ropivacaine

21
Q

Esters

A

Procaine (novocaine), Chloroprocaine, Tetracaine

  • people get allergic to esters
22
Q

How do local anesthetics work

A

act on fast and slow Na channels

- These actually prevent you from sensing pain (don’t get catecholamines/cytokines up in that area)

23
Q

Downside to local anesthetics

A

Toxicity
Accidental IV injection
Seizures
Heart Block

24
Q

Warning signs of toxicity

A
1. Strange feeling
act/look weird
2. Numb/tingly around lips
3) ears ringing
4. tachycardia if contains EPI
25
Q

Rescue drug

A

Interlipid - give as bolus

Can stop everything but exparel!