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Periop 101 > Anesthesia > Flashcards

Anesthesia Flashcards

(48 cards)

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1
Q

Devices used to secure and manage patient’s airways:

A

Laryngeal mask airways (LMAs)

Laryngoscopes

Video laryngoscopy devices

Fiberoptic bronchoscopes

Endotracheal tubes (ET tubes)

Oral and nasopharyngeal airways

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2
Q

Types of anesthesia (5)

A

General

Regional

Monitored Anesthesia care (MAC)

Moderate sedation

Local anesthesia

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3
Q

General anesthesia:

A

Drug-induced reversible state of unconsciousness

Amnesia, analgesia, loss of responsiveness, decreased stress response, loss of skeletal muscle reflexes (varying degree)

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4
Q

Regional anesthesia:

A

Injection of local anesthetics near nerve fibers to cause reversible loss of sensation over an area of the body.

Spinal, epidural, peripheral nerve blocks

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5
Q

Monitored anesthesia care (MAC):

A

Anesthesiologist monitors the patient, administers sedatives and other agents needed

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6
Q

Moderate sedation:

A

Administration of sedative, analgesic, and/or anxiolytic (benzos) agents by a MD or under MD supervision.

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7
Q

Local anesthesia:

A

Infiltration of topical administration of agents to anesthetize a part of the body. Typically used for minor procedures, does not involve a MD or sedation.

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8
Q

3 Phases of anesthesia

A

Induction (Phase 1)

Maintenance (Phase 2)

Emergence (Phase 3)

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9
Q

Anesthetics used in IV induction

A

Propofol

Etomidate

Methohexital and ketamine

  • Narcotics (fentanyl) and/or sedatives (midazolam) are often given during induction or as premedication
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10
Q

Inhalational induction

A

Patient breathes in anesthetic by face mask

Sevoflurane with or without nitrous oxide is a common choice

Patients receiving an inhalation induction may become agitated and thrash as they lose consciousness

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11
Q

Muscle relaxants:

A

Often given during induction and maintenance of anesthesia. Used to facilitate intubation and/or optimize surgical conditions

Succinylcholine: SHORT ACTING muscle relaxant agent that causes muscle twitches (fasiculations)

Intermediate- acting: Cistracurium, atracurium, rocuronium, vecuronium

Long-acting: Pancuronium

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12
Q

Options for maintaining the airway

A

Mask ventilation

Supraglottic airway device (LMA)

ET tube

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13
Q

Inhalational maintenance:

A

Sevoflurane, isoflurane, desflurane- used for inhalational maintenance

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14
Q

TIVA:

A

Total intravenous anesthesia is a technique for maintaining anesthesia using infusions or short acting IV agents without inhalational anesthetics

Propofol and remifentanil commonly used

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15
Q

Succinycholine reversal agent

A

NONE!

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16
Q

Muscle relaxants can be reversed with

A

neostigmine or edrophonium

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17
Q

Reversal agent for Rocuronium, vecuronium and pancuronium

A

Sugammadex

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18
Q

Benzodiazepine (Midazolam) reversal agent

A

Flumazenil

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19
Q

Narcotics (fentanyl) can be reversed with

A

Naloxone

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20
Q

NPO Guidelines for clear liquids

21
Q

NPO guidelines for breast milk

22
Q

NPO guidelines for infant formula

23
Q

NPO guidelines for nonhuman milk

24
Q

NPO guidelines for light meal (toast and a clear liquid)

25
NPO guidelines for fried foots, fatty foods, meat
8 hours
26
Local anesthetics commonly used for regional anesthesia include:
Lidocaine Bupivacaine Ropivacaine Additional drugs such as epinephrine (increase density and duration of regional block) and bicarbonate (added to reduce the acidity of local anesthetic and speed the onset of block) can be added to local anesthetic
27
Signs of LAST (Local Anesthetic Systemic Toxicity)
Ringing in ears Tingling around the lips Metallic taste in mouth Dizziness LAST can progress to SEIZURES 222377and respiratory or cardiac arrest
28
Complications that can occur during anesthesia
Difficult airway Laryngospasm Cardiac problems Hemorrhage Anaphylaxis Hypo/Hyperthermia
29
Initial signs of malignant hyperthermia
Tachycardia and hypertension- common initial signs Increased end-tidal carbon dioxide is the most specific sign of MH Muscle rigidity Mottling of skin Ventricular dysrhythmia Hyperthermia, myoglobinuria
30
Drug used to treat MH
Dantrolene! Dilute with sterile water for injection
31
Adverse effects of hypothermia in surgery
vasoconstriction Coagulation/platelet function impairment Prolonged time for medications to take effect Surgical site infection Myocardial ischemia Increased length of stay
32
ASA Class 1:
Normal healthy patient
33
ASA 2:
Patient with mild systemic disease
34
ASA 3:
Patient with severe systemic disease
35
ASA 4:
Patient with severe systemic disease that is a constant threat to life
36
ASA 5:
Moribund patient who is not expected to survive without the operation
37
ASA 6:
Declared brain-dead patient whose organs are being removed for donor purposes
38
Phase 1:
Induction anesthetic agents are administered to "put the patient to sleep" IV agents (most adults) or inhalational agents (many small children) can be used
39
Phase 2:
Maintenance Provider continues to administer inhalational and/or IV agents to keep the patient anesthetized
40
Phase 3:
Emergence Anesthetic agents are discontinued and/or reversed and the patient is allowed to "wake up"
41
Spinal anesthesia
subarachnoid space is entered and local anesthetic is injected directly into the spinal canal
42
Potential complications of spinal anesthesia
hypotension may be caused by vasodilation high spinal can compromise respiration spinal headache may occur postop. Younger patients more susceptible, size of needle and design of the needle's point affect incidence
43
Epidural anesthesia
Space between the ligamentum flavum and dura Space is ID'd by a loss of resistance as the needle is advanced. single dose of anesthetic can be injected or a catheter can be placed Complications: dura puncture subarachnoid injection intravascular injection
44
Bier blocks can be used for
procedures on the hand, wrist or forearm anesthetic effect lasts until the tourniquet is deflated.
45
Most specific sign of MH is
Increased end-tidal carbon dioxide
46
Most common signs of MH that are not specific
Tachycardia and hypertension are most common initial signs but not specific to MH
47
Drug used to treat MH
Dantrolene
48
Protocol for treatment of MH
Stopping the surgery is possible and DC inhalational agents and succinylcholine Getting the MH cart and dantrolene Calling for help Hyperventilating with 100% oxygen at a flow of 10L/min Give 2.5mg/kg dantrolene rapidly by IV. repeat as needed until patient responds. Consider alternate diagnosis if more than 10mg/kg given without response obtain ABG's Cooling the patient if core temp is greater than 39 Celsius. Stop cooling if temp decreased to less than 38 Celsius Provide appropriate treatment for dysrhythmias and abnormal electrolytes

Periop 101 (15 decks)

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