Anesthesia

Question 1

What is anesthesia?

Answer 1

-Without sensation

Question 2

When doing anesthesia what do you want to provide?

Answer 2

• Hypnosis
• Analgesia
• Amnesia
• Autonomic stability
• Immobility

Question 3

What early doctors used nitrous oxide for extractions?

Answer 3

-Morton and Wells

Question 4

What doctor used either for removal of a neck tumor?

Answer 4

-Morton

Question 5

What are characteristics that ether provides?

Answer 5

• Hypnosis
• Amnesia
• Immobility

Question 6

What is stage 1 anesthesia?

Answer 6

-Progressive abolition of pain “dreamlike state” and perhaps some dissociative sensation “light anesthesia”

Question 7

What is stage 2 anesthesia?

Answer 7

-Excitation

Question 8

What are properties of an ideal anesthetic?

Answer 8

• Rapid induction
• Rapidly reversed
• Safe (Wide therapeutic index)
• No active metabolites
• No residual after-effects
• Smooth loss of consciousness

Question 9

What characteristics do you see in light sedation?

Answer 9

• Anti-anxiety

- Reflexes OK and awake

Question 10

What characteristics do you see in moderate sedation?

Answer 10

• Conscious sedation
• Relaxed
• Drowsy
• Responds to commands
• Quick recovery

Question 11

What can you give pre-operatively to achieve deep sedation?

Answer 11

-Benzodiazapenes

Question 12

What can you give for induction for deep sedation?

Answer 12

• Propofol

- Thiopentathol

Question 13

What are the features of CNS depressants?

Answer 13

• Enhance GABA

- Decrease Glutamate

Question 14

What does lipid solubility affect?

Answer 14

-Onset and distribution of drug

Question 15

What is elimination of drugs dependent on?

Answer 15

-Water solubility of metabolites (soluble in urine and renal eliminated)

Question 16

What are Benzodiazepines used today?

Answer 16

• Diazepam
• Lorazepam
• Midazolam

Question 17

How are benzodiazepines metabolized?

Answer 17

-Hepatic

Question 18

What do benzodiazepines do at lower doses?

Answer 18

-Calm and reduce stress with some amnestic (anxiolytics)

Question 19

What is the benzodiazepine antagonist used to reverse effects Benzodiazepines?

Answer 19

-Flumazenil

Question 20

What does Benzodiazepines inhibit at high doses?

Answer 20

-Polysynaptic reflexes and skeletal neuromuscular junction

Question 21

T/F Benzodiazepines can be used as muscle relaxants

Answer 21

True

Question 22

What do general anesthetics probably affect?

Answer 22

-Cl channels in GABA or K+ channels or diminishes activity of excitatory channels such as nicotinic or glutamate

Question 23

What are properties of volatile inhaled general anesthetics?

Answer 23

-Low vapor pressure and high boiling point

Question 24

What are types of volatile inhaled general anesthetics?

Answer 24

• Halothane
• Enflurane
• Isoflurane
• Nitrous oxide
• Ether

Question 25

What is induction of a volatile inhaled general anesthetic determined by?

Answer 25

-Blood:gas partition coefficient

Question 26

What type of blood:gas coefficient does nitrous have?

Answer 26

-Low coefficient

Question 27

What type of solubility does nitrous have?

Answer 27

-Not very soluble in blood so need higher concentrations for effects

Question 28

What type of blood:gas coefficient does Halothane have?

Answer 28

-High coefficient

Question 29

What type of solubility does Halothane have?

Answer 29

-Very soluble in blood so it requires a lower concentration

Question 30

What is the induction phase based on?

Answer 30

-Blood concentration that most likely affects the target tissues

Question 31

What type of induction and recovery does nitrous have?

Answer 31

-Rapid induction and recovery

Question 32

What type of induction and recovery does enflurane and halothane have?

Answer 32

-Moderate induction and recovery because they have high coefficient