Anaesthesia Flashcards
What are post operative mx for any kinds of procedure
1) immediate post op anaesthesia issues - decision to extubate depends on anticipated oropharyngeal edema, bleeding, risk of aspiration
2) maintaining patent airway, ventilation n oxygenation -ensuring adequate ventilatory drive with the anaesth drugs (which may interfere in the medulla respi center) despite being awake n strong breaths.
3) pain management - opioids or nsaids peroral or iv.
4) tempt - post op hyperthermia (early post op - before 48hrs - anaesthesia related. Late post op >48hrs usually related to wound infection/ urti, pneumonia/ uti/ catheters)
5) urine output - anaesth drugs causes reduction in gfr -> oliguria. Other causes of oliguira: stress hormones, fluid loss, blood loss. Usually temporary and resume to normal within 24hrs. Prolonged oliguria caused by hypovolemia. May cause arf. Ensure urine output 30-50mls/hr (adults) or 0.5-1mls/hr/kg. Treat postop pain (whic releases stress hormones), treat cause of oliguria (hypovolemia/ mechanical obstruction)e
6) N&V - due to anaesth tube, ingest blood during intraoral/nasal procedures. Use throat pack to prevent ingestion. Antiemetics.
7) hemodynamic considerations. Post op hypertension: preexisting hpt, pain, gastric/bladder distension, fluid overload.
Postop fluid maintenance - isotonic fluid NS or 2D1S. Postop fluid restoration: colloids/blood.
8) wound care. Incision and suture sites. Monitor discharge, pressure dressing, open undressed wound, prevent infection with antibiotics/antiseptics. Collection of blood or serum may cause infction. Avoid disturbing intraoral wound esp D3-D5. NG tube if eating disturbs delicate wound. Prevent scarring by early suture removal D3-5 extraoral, D5-7 intraoral.
9) free flap care : first 48hours crucial for flap viability. Check for venous thrombosis- purple flap starting at edges. Arterial leak/block - pale, swelling, hematoma. Necrose flap. Color, consistency, swelling,
