Anaesthetics Flashcards
What do you do with steroids pre-op?
Keep going as risk adrenocortical suppression
What to do with warfarin/DOAC pre-op?
Stop 4 days before surgery
check INR
What to do with beta blockers pre-op?
Always continued as risk precipitating tachycardia if stop (decreases diastolic time and O2 delivery to heart)
What to do with COCP pre-op?
Stop 4 weeks before and only restart 2 weeks after
What are food and drink stopping rules pre-op?
No food for 6h
No clear fluids for 2h
What measurements can be use to determine how difficult a patient may be to intubate?
Mallampati score
Thyromental and sternomental distance
3 criteria to gain proper consent
Doctor must be capable of performing procedure/ adequately trained
Written and explicit
CAPACITY
What antiemetics are used to tx post op N & V?
Intra-op = ondansetron Post-op = cyclizine
What does the percentage on local anaesthetics indicate?
grams per 100ml
e.g. 1% = 1g/100ml
Can you give more or less lidocaine when administered with adrenaline?
More
Give two examples of local anaesthetics
Lidocaine
Bupivocaine
What is the advantage of bupivacaine over lidocaine?
Slower onset but longer duration
Therefore preferred for nerve blocks and spinals.
When is the use of local adrenaline contraindicated?
Use in end organs
HTN, IHD, PVD
What is the antidote for local anaesthetic toxicity?
IV lipid emulsion (INTRALIPID)
