Flashcards in Neuromuscular - Co- Existing Deck (15):
SLE Anesthesia Managment:
*PreInduction: consider meds? infection/preg/position
* A/w management (3?)
* Consider drugs to AVOID in ?
* no one ideal agent, myocardial sparing drugs (propfol, etomidate, ketamine, versed = good)
* cricoaryternoid arthritis, mucosal ulceration, RLN palsy
* renal failure
RA Anesthetic Considerations:
* Concerns with A/W?
* Preop Imaging - Xray/CT
* Document - Preop?
* If difficult a/w then?
* TMJ, cricoarytenoid joint (use smaller tube) and cervical spine
* difficult intubation and DVL (use cervical collar)
* neuro fxn
* awake fiberoptic
RA and Anesthetic Considerations?
* CV involvement? - Tx influences managment?
* Resp involvement? - Positioning?
* arrhythmias, aortic insuff- consult
* RLD - post op vent, ABGs
* Steroids, ASA, NSAIDs, immune supressants, hepatic and renal dysfxn
* minimize compression risk and injury
Osteoarthritis - Anesthesia Management:
* Tx =?
* affects what important joints?
* consider drug tx and concerns?
* ASA and NSAIDs (no steroids)
* knee, hip, cervical/lumbar spine - hard to place epidural
MG: Anesthetic Considerations:
* consider drug therapy? * A/W considerations?
* case scheduled for? * Hold drug on AM of surgery?
* premed: consider? * Use short acting induction meds?
1. steroid therapy
2. first case of the day
3. muscle weakness
4. aspiration risk / RSI
5. hold pyridiostigmine
6. propofol or TPL
MG: Anesthetic Concerns
* MRs- succs vs NMDRs?
* Best Reversal?
* limited use
* IA good for induction and maintenance
* resistant to succs/sensitive to NMDRs
* RA with GA?
* needs to be responsive/full reversal
*monitor in PACU/resume pyridostigmine
* good choice for thymectomy
* sensitive to succs and NDMRs
Muscular Dystrophy: Anesthetic Considerations?
1. intubation? 4. AVOID? 7. RA? y or n?
2. IAs: cardiac effects? 5. consideration for NDMRs?
3. susceptible to? 6. Post op pulm dysfunction
1. delayed gastric emptying = RSI
2. prone to myocardial depressant effects
5. prolonged response
7. RA okay
Anesthetic Concerns: Marfan's
1. lung dz severity?
2. meds to reduce CV workload? 5. med prophylaxis?
3. A/w management?
4. Preop focus?
1. RLD (kyphoscoliosis, pneumo)
3. high palate (vent/oxygenate)
4. CV involvement
5. antibiotics (endocarditis)
Anesthetic Concerns: Marfan's
1. Intubation: AVOID?
1. extreme mvmt of mandible
2. smooth/avoid SNS stim
Ankylosing Spondylitis - Considerations?
1. hallmark sign? 5. treatment?
3. cardiac involvement?
4. pulm involvement?
1. sacroiliac joint pain (improves with mvmt)
2. lumbar spine -> ascends to upper back and neck
3. conduction issues
5. NSAIDs, methotrexate, spinal fusion
Ankylosing Spondylitis - Anesthetic Considerations?
1. consider regional?
3. Induction goals?
1. hard to place epidural into fused space
2. awake fiberoptic
3. controlled vent & maintain SVR
Achondroplasia: Anesthesia Management
1. difficult a/w? 3. temp dysfxn?
*OSA, central sleep apnea *hydrocephalus
* facial feature *no change to response to IA/MRs
2. Pulm picture?
1. upper a/w obstruction, unable to expose glottis, small a/w
3. prone to hyperthermia