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Anesthesia Flashcards

1
Q

Which anesthetic is not affected by renal disease?

A

Rocuronium

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2
Q

What kinds of effects does roc/vec have on the CV system?

A

Nothing significant

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3
Q

If anything, what can prolong the action of roc/vec?

A

Liver disease

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4
Q

Which non-depolarizing neuromuscular blocking drug can cause bronchospasm?

A

Atracurium

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5
Q

Explain why Neostigmine and Glycopyrrolate should be given together

A

If glyco is not given, Neo can cause bradycardia, bronchospasm, secretions, intestinal spasms and pupil constriction

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6
Q

About how long does it take for Neostigmine and glycopyrrolate to reverse the NM blockade?

A

~4-10 min

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7
Q

What part(s) of the body do the supraclavicular and infraclavicular blocks block?

A

Arm/Elbow/Hand

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8
Q

What do you have to think about when a patient gets a block in the upper half of the body?

A

Pneumothorax

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9
Q

Which artery do you have to be cautious of with the Supracalvicular and infraclavicular nerve blocks?

A

Subclavian A.

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10
Q

Which nerve may be spared when blocking the supraclaviular and/or infraclaviular nerves?

A

Ulnar N.

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11
Q

Which nerve can possibly cause ipsilateral phrenic nerve paralysis?

A

Supraclavicular N. Block ~50%
Interscalene N. block

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12
Q

Which area does the PECs blockade block?

A

Intercostal nerves

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13
Q

Which artery is in proximity to the PECs nerve block?

A

Thoracoacromial a.

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14
Q

What type of surgery uses an interscalene block?

A

ONLY shoulder

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15
Q

What are some side effects of an interscalene nerve block?

A

recurrent laryngeal paralysis (aka hoarseness)

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16
Q

What are signs of Horner syndrome?

A

drooping eyelid, blurred vision, decreased pupil size

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17
Q

What are reasons to not give a nerve block?

A

local infection, serious coagulopathy, allergy or refusal

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18
Q

What does giving nitrous oxide put you at high risk for?

A

PONV

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19
Q

What are some reason to not give nitrous oxide?

A

air embolism, pneumo, bowel obstruction, intra-ocular bubbles, tympanic grafting (anything where added air would make the situation worse)

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20
Q

Which inhaled anesthetic is not likely to cause a bronchospasm?

A

Sevoflurane

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21
Q

Why shouldnt desflurane be given as an induction anesthetic?

A

Due to strong odor it could cause bronchospasm and coughing

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22
Q

What are some reasons to not give sevoflurane or desflurane?

A

severe hypovolemia, susceptibility to MH, intracranial HTN

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23
Q

How is versed metabolized?

A

Metabolized in liver, excreted in urine

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24
Q

What are possible side effects of Versed?

A

Can worsen psychosis, agitation and dementia in elderly

25
What is a down fall from using Versed?
No analgesic properties
26
What is a benefit of using Nitrous oxide?
Has analgesic properties
27
When is the best time to use Ketamine?
In hypvolemia, shock and trauma asthmatics - bronchodilator
28
What are some side effects of Ketamine and possible solutions?
Hallucinations, give with benzos to help Salivation, give glyco
29
Which patients should be monitored carefully when given Ketamine?
CAD, uncontrolled HTN, CHF
30
What is a benefit of propofol?
Can be used in ESRD and heptatic failure
31
What are some "issues" of propofol?
Burning sensation upon insertion, no analgesic effect
32
What can prolong the action of succinylcholine? What actions might need to be taken?
hypothermia and pseudocholinesterase. If pt has the deficiency, might need to be put on mechanical ventilation and sedated until the medicine wears off.
33
What is a MAJOR side effect of succinylcholine?
HYPERKALEMIA, MH, laryngospasm, myalgias, masseter rigidity
34
What meds should not be given with succynincholine?
neostigmine, MAOIs, esmolol, reglan
35
Which population shouldn't be given succinylcholine
Pediatrics UNLESS for emergent intubation d/t possiblity of undiagnosed cardiac issues and high probability of laryngospasm
36
What type of surgeries use an adductor canal block?
Knee and leg
37
Which part of the leg does the adductor block not cover?
posterior or sometimes lateral knee
38
Which artery is close to the adductor canal block?
Femoral Artery
39
Which nerve(s) is/are blocked by the adductor canal block?
saphenous n.
40
What type of surgery uses a popliteal sciatic nerve block?
Foot and ankle
41
What is a benefit of using a popliteal sciatic nerve block?
Spares the hamstrings making it easier to walk
42
Which vessels do you have to be cautious of around a popliteal sciatic nerve block?
popliteal vessels
43
Which med/mixture and dosage is used for malignant hyperthermia?
Dantrolene in Sterile water, 2.5mg/kg IV
44
What are other treatments to help with malignant hyperthermia?
charcoal filters, 100% O2, cooling measures (cold towels) until core is 100.4 Call hot-line
45
Which medications trigger malignant hyperthermia?
inhaled agents (sevoflurane, desflurane, isoflurane), succinylcholine, halothane
46
What are some early signs of maligant hyperthermia?
Unanticipated doubling/tripling end tidal CO2, unexpected tachycardia, tachynpea, and JAW RIGIDITY
47
What are some major things to monitor for with a patient that has malignant hyperthermia?
DIC, metabolic acidosis
48
What are signs for DIC?
extreme bleeding, Hypothermia, acidosis, coagulopathy
49
What causes L.A.S.T.
large doses of local anesthetic from local cases or nerve blocks
50
What are early signs of LAST
dizzy, lightheaded, metallic taste, slurred speech,
51
What are late signs of LAST?
hypotension, bradycardia, Vtach
52
How is LAST treated?
Lipids, O2, benzos, barbiturates
53
What causes a postdural puncture HA?
Lumbar puncture, more commonly after an epidural
54
What is the reversal of inhaled anesthetics?
The action of inhaled anesthetics is so quick, it just needs to be turned off
55
What affect does Versed have on anesthesia?
Prolongs sedation
56
Which patients should not receive succinylcholine?
pts w/ extensive burns, severe trauma, severe abd infections, NM disease, paraplegia/quad
57
With what type of patient should you be careful when giving neostigmine?
Cardiac, can cause dysrhythmias
58

CPAN (3 decks)

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