Patients and Pre-Anesthetic Considerations Flashcards
(35 cards)
Definition of General Anesthesia
-Reversible state of unconsciousness, immobility, muscle relaxation, and loss of sensation throughout the entire body produced by administration of one or more anesthetic agents
-A patient cannot be aroused even with painful stimulation
-Commonly used to prepare patients for surgery or other acutely painful procedures
Definition of Surgical Anesthesia
A specific stage of general anesthesia in which there is a significant degree of analgesia and muscle relaxation to allow surgery to be performed without patient pain or movement
Definition of Analgesia
A loss of sensitivity to pain
Definition of Sedation
-Drug-induced CNS depression or drowsiness that vary in intensity from light to deep
-Patient generally minimally aware or unaware of its surroundings but can be aroused by noxious stimulation
-Often used to prepare patients for diagnostic imaging, grooming, wound treatment, or other mild procedures
Definition of Tranquilization
-Drug-induced state of calm in which the patient is reluctant to move and is aware of but unconcerned about its surroundings
-Term often used interchangeably with sedation even though they are not exactly the same in meaning
Definition of Hypnosis
-Drug induced sleeplike state that impairs the ability of the patient to respond appropriately to stimuli
-Term somewhat imprecise as it is used to describe various degrees of CNS depression*
*In textbook, used to mean a sleeplike state from which the patient can be aroused with sufficient stimulation
Definition of Narcosis
Drug-induced sleep from which the patient is not easily aroused and that is most often associated with the administration of narcotics
Definition of Local Anesthesia
-Loss of sensation in a small area of the body produced by administration of a local anesthetic agent in proximity to the area of interest
-Example: Infiltration of local anesthetic into the tissues surrounding a small tumor to facilitate removal
Definition of Topical Anesthesia
-Loss of sensation of a localized area produced by administration of a local anesthetic directly to a body surface or to a surgical or traumatic wound
-Example: Use of ophthalmic local anesthetic drops in the eye before an ophthalmic examination and application of local anesthetic to an open declaw incision for the purpose of pain control
Definition of Regional Anesthesia
-Larger areas can be targeted by use of regional anesthesia, which refers to a loss of sensation in a limited area of the body produced by administration of a local anesthetic or other agent in proximity to sensory nerves
-Can be produced with a variety of techniques including nerve blocks and epidural anesthesia
Benefits of Balanced/Multimodal Anesthesia
-Maximizes the benefits of each drug
-Minimizes adverse side effects
-Gives the anesthetist the ability to produce anesthesia with the degree of CNS depression, muscle relaxation, analgesia, and immobilization appropriate for the patient and procedure
Anesthetic drugs have a ___ therapeutic index.
Narrow
Most anesthetic drugs cause temporary changes in ___ and ___ function.
-Pulmonary and Cardiovascular function
List some of the effects of anesthetic drugs on pulmonary and cardiovascular function.
-Decrease in cardiac output, respiratory rate, tidal volume, and blood pressure
List the criteria and a representative condition for a Class PS2 patient.
-Patient with mild systemic disease
-Neonatal, geriatric, or obese patients, mild dehydration
List the criteria and a representative condition for a Class PS3 patient.
-Patient with severe systemic disease
-Anemia, moderate dehydration, compensated major organ disease
List the criteria and a representative condition for a Class PS4 patient.
-Patient with severe systemic disease that is a constant threat to life
-Ruptured bladder, internal hemorrhage, pneumothorax, pyometra
List the criteria and a representative condition for a Class PS5 patient.
-Moribund patient that is not expected to survive without the operation
-Severe head trauma, pulmonary embolism, GDV, End-stage major organ failure
Explain how anesthetics should be dosed on obese patients and why.
-Anesthetics should be dosed accordingly to lean body weight (excluding body fat) instead of total body weight
-Fat increases total body weight, but not the volume or weight of the nervous tissue on which anesthetics exert their effect
-Administration of a dose calculated using total body weight results in an anesthetic overdose
List the physical exam findings on a patient that is 5% dehydrated.
-Minimal loss of skin turgor
-Semidry mucous membranes
-Normal eyes
List the physical exam findings on a patient that is 5% dehydrated.
-Moderate loss of skin turgor
-Dry mucous membranes
-Weak rapid pulses
-Enophthalmos (depressed globes within orbits)
List the physical exam findings on a patient that is >10% dehydrated.
-Considerable loss of skin turgor
-Extremely dry mucous membranes
-Tachycardia and weak/thready pulses
-Hypotension
-Severe enophthalmos
-Altered level of consciousness
Describe the signs associated with a lethargic patient.
-Mildly depressed
-Aware of surroundings
-Can be aroused with minimal difficulty (verbal or tactile stimulus)
Describe the signs associated with an obtunded patient.
-Very depressed
-Uninterested in surroundings
-Responds to but cannot be fully aroused by a verbal or tactile stimulus
