223. Agents, Techniques, and Mapleson Circuits Flashcards
What are the characteristics of children’s blood vessels?
Children have very elastic blood vessels, higher body water content, shorter stature, and lower blood pressure than adults.
What types of anesthetics are examined for their hemodynamic effects?
Inhaled, intravenous, and awake spinal anesthetics.
How does the hemodynamic impact of anesthetics in healthy children vary?
It varies by technique, and most are well tolerated.
What is the effect of nitrous oxide on pulmonary vascular resistance (PVR) in infants?
Nitrous oxide has no impact on PVR in infants.
What is the effect of potent inhalation agents on systemic vascular resistance (SVR) in infants?
They decrease SVR and also decrease PVR.
What are the benefits of pediatric total intravenous anesthesia (TIVA)?
Reduction of respiratory complications and reduction of emergence delirium.
What impact do opioids have on SVR and PVR?
Opioids decrease SVR; they have no impact, decrease, and increase PVR, respectively.
Can ketamine be used safely in children with pulmonary hypertension?
Yes, as long as normocarbia is maintained.
What is the impact of dexmedetomidine on PVR and SVR?
Dexmedetomidine decreases PVR and increases SVR.
What are the hemodynamic benefits of awake spinal anesthetics?
Less hypotension observed compared to inhaled anesthetics.
What are the components of Mapleson breathing circuits?
Fresh gas inlet, adjustable pressure limiting (APL) valve, and reservoir bag.
What is the most efficient Mapleson circuit for spontaneous ventilation?
Mapleson A circuit.
What is the primary advantage of the Mapleson D circuit?
Warmth and humidity due to FGF flowing around exhaled gas.
What modification does the Bain system introduce to the Mapleson D circuit?
Delivers FGF through a small tube fixed inside a larger expiratory tube.
What is a unique feature of the Mapleson E circuit?
It has no reservoir and is the simplest circuit.
