Peri-operative care 8.9 Flashcards Preview

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Flashcards in Peri-operative care 8.9 Deck (43)
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1

P1

normal, healthy 0.1%

2

P2

mild systemic disease 0.2%

3

P3

severe systemic disease 1.8%

4

P4

severe systemic disease that is a constant threat to life 7.8%

5

P5

moribund patient, not expected to survive without operation 9.4%

6

P6

organ donor

7

ASA risk Index 1

unstable coronary syndromes

8

ASA risk index 2

decompensated HF, new HF, class IV HF

9

ASA risk index 3

significant new arrythmias

10

ASA risk index 4

severe valvular disease

11

Pre-anesthetic meds

Benzodiazepines, Barbituates, anithistamines, phenothiazine, butyrophenes

12

IV anesthetics

barbituates, etomidate, opioids, ketamine, propofol

13

Benzodiazepines actions

reduce anxiety, "calming" effects

14

BZD agents

Diazepam, Lorazepam, midazolam

15

Barbituates actions

sedation and reduce apprehension

16

Barbituate agents

phenobarbital, thiopental

17

Barbituate ADR

cardiac and respiratory depression

18

Etomidate actions

potent ultra-short acting hypnotic without analgesic properties. Conscious sedation or rapid sequence induction for cardioversion

19

Etomidate pearl

must follow with analgesic and muscle relaxant drugs

20

Etomidate dose

IV 0.3 mg/kg-->sleep for 5 mins

21

Etomidate ADR

hypotension, carbon dioxide retention, suppresses corticosteroid synthesis at adrenal cortex

22

Opioid action

inhibit nociceptive reflexes and induce analgesia through action at mu receptors. Inhibit release of neurotransmitters

23

Opioid ADR

respiratory depression, NV, constipation

24

Ketamine actions

dissociative anesthesia

25

Ketamine ADR

hallucinations, bad dreams, increased muscle tone

26

Propofol

Oil emulsion at room temperature, rapid onset and effective for induction and maintenance

27

Propofol ADR

apnea, hypotension, injection site pain

28

inhaled anesthetics

nitrous oxide, sevoflurane, Isoflurane, desflurane

29

inhaled anesthetics actions

used for induction and/or as adjuvant

30

inhaled anesthetic ADR

NV, malignant hyperthermia, caution with renal/hepatic dysfunction