Anesthesia Flashcards
Plavix and ASA management periop
Stop both 5 days preop, continue ASA if within 6months of stent
Sudden vfib upon induction after crush/burn/spinal cord injury, med
Succinylcholine
Initial tx seizures, why
Ativan, more rapid onset than diazepam with longer half life than versed
Cyanosis, hypoxia, without cardiopulmonary dysfunction, dx and tx
Methemoglobinemia, remove agent, O2, observe
Succinylcholine SE
Malignant hyperthermia, hyperkalemia
Ketamine SE
Tachycardia
Propofol SE
HypoT, infusion syndrome (brady to asystole with acidosis or rhabdo in children)
Etomidate SE
Adrenal insufficiency
Meperidine SE
Seizures
Perioral numbness/tingling, tinnitus, seizures, dx and tx
Local anesthetic toxicity, lipid emulsion therapy 1.5mL/kg 20% over 1min followed by 0.25mL/kg/min
Most effective smoking cessation tx
Varenicline 4wks prior to sx
Factors that decrease MAC
Older age, metabolic acidosis, hypothermia
Initial sign of local anesthetic toxicity
Dizziness
Sudden brady and mill wheel murmur, tx
Steep Tburg, aspirate CVC
Tachy, arrhythmia, febrile, acidosis after induction, dx and tx
Malignant Hyperthermia, Dantrolene (stop anesthetic/sx and administer O2)
Revised Cardiac Risk Index Components and score
Ischemic HD, CHF, CVA, DM, CKD, intraperitoneal/thoracic sx each 1pt; 3pts >11% risk cardiac death, MI, arrest
ET tube position
2fm above carina 20-23cm from incisors
Meperidine metabolism and toxic metabolite
Renal, Normeperidine
Best predictor opioid toxicity
Respiratory rate <12
IV anesthetic that decreases intracranial pressure, antiemetic effects, metabolized by liver
Propofol
Revised Cardiac Risk Index risk factors
Cerebrovascular Dz
CHF
Cr >2
DM
Ischemic HD
Intraabdominal/intrathoracic sx
Response to CO2 pneumoperitoneum; MOA
Bradycardia (vagal stretch)
Hypotension (decreased CO from IVC compression)
New-onset harsh, continuous murmur intraop; next step
Air embolism ->Left lateral decubitus and Trendelenburg, aspirate via central line
