Anesthesia

Question 1

What is Anesthesia?

Answer 1

Drug induced state in which the central nervous system is altered to produce varying degrees of pain relief, loss of sensation, depression of consciousness, skeletal muscle relaxation, and diminished or absent reflexes

Question 2

What are the two types of anesthesia?

Answer 2

General global state of aesthesia affecting the whole body, can produce a loss of consciousness

Local/Regional specific portion of body insensitive to sensations without affection consciousness

Question 3

4 Stages of Anesthesia

Answer 3

Stage 1: Induction to loss of consciousness. (fentynal lollipop)

Stage 2: Loss of consciousness until point of automatic, reflex breathing. (Have to help them breathe)

Stage 3: begins with onset of reflex breathing and extends until apnea (absence of breathing) and diaphragmatic paralysis. (Must have artificial airway/breathing, Also known as the surgical stage)

Stage 4: Overdose

Question 4

IV Anesthesia Meds

Answer 4

Rapid onset but short duration

-benzos, opiates, barbituates, hypnotics

Propofol (Diprivan)

Question 5

Propofol

Answer 5

lets you hit the pause bottom to assess neuro reactions- milk of amnesia (white drug that attracts bacteria)

STRICT ASEPTIC TECHNIQUE

Short half-life makes it easy to “bring patient up” then put under again

Question 6

Neuromuscular Blocking Agents

Answer 6

Depolarizing: succinylcholine
ADR- malignant Hyperthermia
Antidote: Dantolene

Non-depolarizing- “onium Family”
Antidote: neostigmine- puts more acetylcholine at receptor site.

Question 7

General Anesthetics Inhalation

Answer 7

“Ane” Family
-Halothane
-enflurane
-isoflurane

Also Nitrous oxide (laughing gas)

ADR: Malignant hyperthermia in genetically predisposed individuals

Question 8

Conscious Sedation

Answer 8

“Twilight sleep”

-patient can answer questions and protect own airway

-RAMSAY scale 2-4 and rapid recovery rate of 30-90 min.

-Example for use is cholonoscopy

Question 9

Dissociative Anesthesia

Answer 9

Primary Drug: ketamine

Caution: May produce psychological reactions such as hallucinations and delirium

Example: Major burn dressing changes

Question 10

Local Anesthesia

Answer 10

“caine” Family

-Lidocaine (Xylocaine) is the most common
Used for injections or topical include throat spray
-Cocaine used only for ear/nose/throat (ENT) as a topical because unlike the others it also causes intense vasoconstriction
-Procaine (Novacaine) used primarily by dentist
-Benzocaine mostly topical
-Others, bupivacaine, tetracaine, etc