Anesthesia Flashcards Preview

Surgery/ER Fall 2013 > Anesthesia > Flashcards

Flashcards in Anesthesia Deck (47):
1

local anesthetics act by

blocking sodium channels of axon causing reversible blockade of neural conduction

2

what can decrease effectiveness of drug

weakly basic-acidic environment

3

local anesthetics can be either...

amides (liver) or esters (hydrolysis)

4

amides in local anesthetics

lidocaine, bupivicaine, ropivicaine

5

esters in local anesthetics

benzocaine, cocaine, chloroprocaine, procaine, tetracaine

6

pain pumps used for

long acting local anesthetic to minimize post-op pain and the need for narcotics

7

regional anesthesia includes

spinal, epidural anesthesia, and peripheral nerve block

8

difference between spinal vs. epidural anesthesia

spinal- CSF obtained. epidural- No CSF obtained.

9

Local anesthetic (lidocaine or bupivacaine) plus EPI plus Opiate. CSF obtained=

spinal anesthesia

10

"sympathectomy" can occur from cephalic spread in spinal anesthesia resulting in

hypotension and bradycardia

11

complications from spinal anesthesia

spinal headache, hypotension and bradycardia, urinary retention

12

where is needle placed in epidural?

between ligamentum flavum and dura

13

epidural complications

slower onset, hemi-block, urinary retention, CV effects, misplacement in subarachnoid space

14

useful for surgery on extremity

peripheral nerve block. UE- brachial plexus block. LE- Lumbar plexus block

15

moderate vs. deep conscious sedation

moderate- patient opens eyes to voice or pain. deep- patient does not respond to voice or open but maintains their own airway

16

anesthetic agents

IV anesthetics, inhalation anesthetics, amnestics, narcotic

17

what is good for inducing children?

inhalation anesthetics

18

use inhalation anesthetics if preggo?

NO- TERATOGENIC

19

inhalation anesthetics examples

"fluranes"- isoflurane, sevoflurane, nitrous oxide, halothane

20

IV anesthetic agents

ketamine, propofol, etomidate, barbiturates

21

phecycyclidine derivative, diisopropylphenol, and carboxylated imidazole

ketamine, propofol, etomidate

22

IV anesthetic used a lot in kids and burn patients. causes dissociative amnesia, hallucinations, emergence delerium

ketamine

23

IV anesthetic that has rapid onset and rapid awakening. Lipid soluble, looks like mild. Side effects are resp and CV depression, seizures

propofol

24

IV anesthetic that has short half life (acts for about 30 seconds). MINIMAL CV effects. causes involuntary muscle movement, seizures (SE)

etomidate

25

barbiturates MOA

suppresses reticular activating system

26

amnestics

diazepam (valium), midazolam (versed), lorazepam (ativan)

27

reversal agent for benzos

flumazenil 0.2-0.4 mg

28

sedation accomplished by

benzo plus narcotic, nitrous oxide, or propofol

29

reversal agent of narcotics

narcan 2 mg every 3 minutes (max of 10 mg)

30

depolarizing muscle relaxant/paralytic

succinylcholine

31

non depolarizing muscle relaxants/paralytics

"curonium" or "curium" (mivacurium, pancuronium)

32

CI to paralytics

history of malignant hyperthermia, NM problems, allergy, lack of sedation

33

succinylcholine can cause...

malignant hyperthermia

34

twitches check in paralytics

if 4 twitches seen, 0-75% of receptors blocked, 3 twitches seen-75% of receptores blocked, 2 twitches seen, 80% of receptors blocked, 1 twitch- 90% of receptors blocked. no twitches- all receptors blocked

35

if patient is going for urgent/emergent surgery, and last po was less than 4 hours ago...

need NG tube to empty stomach

36

airway managed by

oral airway, nasal trumpet, LMA, endotracheal tube

37

post op pain control

oral analgesics (codeine), pain patches, IV narcotics, PCA pumps, epidural catheter

38

vicodin vs narco in oral analgesic for pain

norco- tylenol stays constant. Vicodin- tylenol dose escalates with each dose (toxic to kidneys)

39

tylenol in pain preparation

no more than 4 g for first few days, then no more than 2 g/day

40

pain patches are NOT indicated for post-op pain. for Long-term management of pain. apply every..

72 hours

41

IV narcotics

morphine, dilaudid, fentanyl, demerol

42

morphine dose per hour

0.5-1 mg/hour

43

lockout morphine

6-10 minutes

44

morphine one hour max dose

5 mg

45

morphine basal dose/continuous

0-1 mg

46

morphine breakthrough dose

1-3 mg q 2 hours prn

47

If using IV morphine BASAL dose

always place pulse ox if ordering basal dose