5.20 Anesthesia Flashcards Preview

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Flashcards in 5.20 Anesthesia Deck (25):
1

What 4 things do you need to have anesthesia

amnesia
hypnosis
analgesia
muscle relaxant

2

Stages of Anesthesia

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)

3

What drug do we give for amnesia

Versed

4

What drug do we give for hypnosis

Propofol

5

What drug do we use for analgesia

fentanyl

6

What drug do we use for muscle relalxant

rocuronium

7

Malignant hyperthermia

exposure to succinylcholine or anesthetic gases potentially deadly
- problem with ryanidine receptor so you get lots of Ca from sarcoplasmic reticulum
- Treat with Dantrolene

8

Pseudocholinesterase deficiency

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

9

Post op nausea/vomiting

tends to correlate with motion sickness

10

Preop exam

Fam Hx
Airway - tongue, teeth, ROM neck
Veins

11

Mallampati scale

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

12

Monitors for anesthesia

Pulse ox
EKG
Blood Pressure
Temp

13

What is the PACU

Post anesthesia care unit

14

Goal of PACU

- smooth transition back to normal
- end hyponosis, amnesia, muscle relaxation, taper/stop analgesia

- Pain management: narcotics and/or regionalanesthesia

15

Narcotics examples

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

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

16

How do narcotics work

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

Mu receptors, Kappa receptors

17

Side effects of Narcotics

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

18

Regional anesthesia and analgesia

Spinal, epidural, and nerve blocks
- can be single dose or continuous
- drugs used are local anesthetics

19

2 main classes of anesthetics

Esters and Amides

20

Amide examples

Lidocaine, bupivacaine , Ropivacaine

21

Esters

Procaine (novocaine), Chloroprocaine, Tetracaine

- people get allergic to esters

22

How do local anesthetics work

act on fast and slow Na channels
- These actually prevent you from sensing pain (don't get catecholamines/cytokines up in that area)

23

Downside to local anesthetics

Toxicity
Accidental IV injection
Seizures
Heart Block

24

Warning signs of toxicity

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

25

Rescue drug

Interlipid - give as bolus

Can stop everything but exparel!