Overview Of Anesthesia

Question 1

Who was the pioneer of chemistry?

Answer 1

Joseph priestly (1773)

Question 2

Who coined the term “laughing gas” and what was it

Answer 2

Humphrey Davy & nitrous oxide

Question 3

Who associated ether with the potential for anesthesia?

Answer 3

Crawford Long (1842)

Question 4

In 1844 Horace Wells used what for a tooth extraction?

Answer 4

N2O

Question 5

Who received credit for the first ether anesthetic

Answer 5

Morton in 1846 at mass general

Question 6

First anesthetist

Answer 6

John snow

Question 7

Who had first OB anesthetic performed on them

Answer 7

Queen Victoria in 1850

Question 8

When was Na Lyme developed

Answer 8

1927

Question 9

First nurse known to have specialized in anesthesia:

Answer 9

Sister Mary Bernard at St Vincent’s hospital in Erie PA in 1887

Question 10

“Mother of anesthesia” for mastery of open drop ether

Answer 10

Alice Magow

Question 11

First court ruling that threatened nurses providing anesthesia

Answer 11

Frank vs South of 1917
Nurses won

Question 12

When was NANA founded and by who

Answer 12

Agatha Hodgins in 1934

Question 13

AANA

Answer 13

founded by Agatha hodgins
Located in Illinois
4 month program

Question 14

First certification exam developed

Answer 14

1945

Question 15

CRNA credential adopted

Answer 15

1956

Question 16

When was the first certification exam done via computers

Answer 16

1996

Question 17

Three categories of anesthesia

Answer 17

MAC
Regional
General

Question 18

MAC

Answer 18

monitored anesthesia care
Local sedation
Anesthesia on standby

Question 19

Regional

Answer 19

Bier block
Epidural
Spinal
Axillary block
Scalene block

Question 20

General

Answer 20

MAsk
LMA
ETT

Question 21

Inhalation agents

Answer 21

Isoflurane
Sevoflurane
Desflurane

Question 22

Isoflurane

Answer 22

Forane

Question 23

Sevoflurane

Answer 23

Ultane

Question 24

Desflurane

Answer 24

Suprane

Question 25

What determines the selection of the type of anesthesia?

Answer 25

Patient condition Surgical procedure Patient preference Surgeon preference

Question 26

What is the ideal agent?

Answer 26

Stable in: temperature, humidity, light Nonflammable in air, O2, N2O Easily handled in liquid and gas forms Potent

Question 27

Ideal agents:

Answer 27

Poorly soluble in blood- rapid induction Nontoxic Not metabolized Minimal side effects No adverse interactions

Question 28

Occurs when anesthetizing partial pressure achieved in the brain

Answer 28

Induction

Question 29

3 characteristics of anesthesia

Answer 29

Amnesia Analgesia Akinesia

Question 30

What are grundel’s signs

Answer 30

Stage 1 amnesia Stage 2 delirium Stage 3 surgical plane Stage 4 overdose

Question 31

Explain MAC

Answer 31

Minimum alveolar concentration of inhalation agent at 1 atmosphere which prevents movement in 50% of the subjects in response to a noxious stimuli

Question 32

How much MAC do you need to prevent movement in 95% of patients

Answer 32

1.2-1.3

Question 33

Strengths of N2O

Answer 33

Analgesia, rapid uptake/elimination, little cardiac/respiratory depression

Question 34

Weaknesses of N2O

Answer 34

Expansion closed air space Effect on B12 metabolism limits fio2 N/v Toxic Carcinogenic to provider and pregnant patients

Question 35

Strengths of Isoflurane

Answer 35

Good muscle relaxation Stable cardiac rate/rhythm

Question 36

Weaknesses of Isoflurane

Answer 36

Pungent odor that cannot be used for mask induction or maintenance

Question 37

Strengths of Desflurane

Answer 37

Rapid induction/ emergence

Question 38

Weaknesses of Desflurane

Answer 38

Difficult to handle New vaporizer Costly

Question 39

Strengths of Sevoflurane

Answer 39

Similar to Isoflurane Can use for mask induction of adults or peds

Question 40

Weaknesses of Sevoflurane

Answer 40

Unstable in CO2 absorbers Metabolized to fluoride New vaporizer Costly Causes fires

Question 41

Thiopental

Answer 41

Barbiturate 3-5mg/kg/IV

Question 42

Methohexital (brevital)

Answer 42

Barbiturate 1-1.5mg/kg/IV kids rectally 25mg/kg Can be used in propofol shortage

Question 43

Midazolam (versed)

Answer 43

Benzodiazepine 1-3 mg IV

Question 44

Etomidate (amidate)

Answer 44

Nonbarbiturate 0.2-0.3mg/kg/IV induction No analgesic effects Good for unstable cardiac patient or hypovolemic patient

Question 45

Ketamine

Answer 45

Dissociative 1-2mg/kg/IV Interferes with communication between limbic and thalamus No resp depression Bronchodilator

Question 46

Propofol (diprivan)

Answer 46

Hypnotic 2-2.5mg/kg/IV induction 20-200mcg/kg/min infusion

Question 47

Describes drugs which bind to morphine receptor Useful for induction Used for maintenance with inhalation

Answer 47

Opioids

Question 48

Effect of mu2. Receptor

Answer 48

Depress ventilation Decrease HR physical dependence Euphoria Muscle rigidity

Question 49

Narcan (naloxone)

Answer 49

Pure competitive antagonist for mu Dose 20-40 mcq IV peak 1-2 min Duration 30-45 min

Question 50

Flumazenil (Mazicon)

Answer 50

Pure benzodiazepine antagonist Dose 0.2-1mg Q1 min

Question 51

Inhalation agent Faster and better and less side effects than other agents

Answer 51

Halothane (1956)

Question 52

Caused renal issues

Answer 52

Methoxyflurane (1959)

Question 53

Caused seizures in EEGs

Answer 53

Enflurane (1972)

Question 54

Faster for onset and emergency and had less side effects than the previous

Answer 54

Isoflurane (1980)

Question 55

______ and other nurses provided anesthesia during the Civil War

Answer 55

Catherine S Lawrence (1861-1865)

Question 56

____ organized lakeside general hospital school of anesthesia in Ohio

Answer 56

Agatha Hodgins

Question 57

Dexmedetomidine (precedex)

Answer 57

Loading- 0.5-1mcg/kg IV over 10 min Onset 10-20 min Infusion: 0.4-0.7 mcg/kg/hr

Question 58

Intraoperative anesthetic dose of fentanyl

Answer 58

2-50mcg/kg IV

Question 59

Intraoperative anesthetic dose of sufentanil

Answer 59

0.25 mcg/kg IV

Question 60

Intraoperative anesthetic dose of morphine

Answer 60

0.03-0.15 mg/kg IV