Anaesthetic physiology Flashcards
Where to measure core temp?
Distal oesophagus
Bladder
Rectum
ECG findings in hypothermia
J wave
Pre op hypothermia
< 36
Severe hypothermia
<28 degrees
Minimum patient temp for surgery
36
Minimum theatre temp for surgery
21
Malignant hypothermia genetics
Mutation of ryanodine receptors
Autosomal dominant
Which anaesthetics trigger malignant hyperthermia?
Suxamethonium
Pathophysiology of malignant hyperthermia
Unregulated sarcoplasmic calcium release
Blood findings in rhabdomyolysis
High - CK, K, phosphate, urea
Low - calcium
Management of rhabdomyolysis
Fluids
Haemofiltration
Drugs causing rhabdomyolysis
Statins
Temazepam
EMLA cream
Lidocaine
Prilocaine
Max dose of lidocaine
3mg/kg
Max dose of lidocaine with adrenaline
7mg/kg
Drug for LA toxicity
Intralipid
Max dose of bupivicaine
2mg/kg
Amount of lidocaine in 1%
10mg in 1ml
Methaemoglobin
FE3+ –> bluish brown blood
Management of methaemoglobinaemia
Methylene blue
LA used in Bier’s block
Priolocaine
How long needed between last dose of LMWH and epidural?
12 hours
Spinal anaesthetic
Subarachnoid space
Epidural anaesthetic
Epidural space
Suxamethonium
Depolarising anaesthetic
Used for RSI
Which fluid used in gastric outlet obstruction?
NaCl 0.9%
Paeds fluids
100ml/kg for first 10kg
50ml/kg for second 10kg
20ml/kg for every kg after
Paracetamol dose in paeds
15mg/kg/6hours
What HbA1c should elective surgical patients have?
Less than 69
Target peri op BM
6-10
Acceptable peri op BM
4-11
Why should SGLT-1 inhibitors be stopped peri-operatively?
Due to increase risk of lactic acidosis
