Anesthesia Flashcards
What are the 3 types of anesthesia?
- General
- Regional
- Local
What is general anesthesia?
- Administration of anesthesia to the point of unconsciousness
- Used for extensive surgical procedures
What is regional anesthesia?
- Administration of anesthesia to the point where the patient remains conscious
- Used when a physician needs to anesthetize a specific region of the body
What is local anesthesia?
- Administration of anesthesia where the patient remains conscious
- Used when a physician is doing a surgery to a small, well-defined area
Is general anesthesia a reversible or nonreversible state of unconsciousness?
Reversible
Upon awakening from anesthesia does the patient have recollection of what occured?
No
The ideal anesthetic agent must be able to do what 7 things?
- Rapid onset of LOC (loss of consciousness) and sensation)
- Skeletal muscle relaxation
- Inhibition of sensory and autonomic reflexes
- Easy adjustment of anesthetic dosage during procedure
- Minimum of toxic side effects (I.e must be safe)
- Rapid, uneventful recovery after anesthesia is terminated
- Amnesia: no recollection of what occurred during surgery
What is stage 1 of general anesthesia induction?
Analgesia: begins to lose somatic sensation but still conscious and somewhat aware
What is stage 2 of general anesthesia induction?
Excitement (Delirium): Unconscious but may be agitated and restless. Need to move quickly through this
What is stage 3 of general anesthesia induction?
Surgical Anesthesia: Level desirable for surgical procedure. Onset of regular, deep respiration
What is stage 4 of general anesthesia induction?
Medullary Paralysis: Cessation of spontaneous respiration. Respiratory and circulatory support must be provided.
What is the anesthetic goal when it comes to the stages?
Bring patient to stage 3 as rapidly as possible and maintain there during the surgery
What are the pros and cons of IV anesthetics?
- Pro: rapid onset with quick move to stage 3
- Con: lack of control over dosage
What are the pros and cons of inhalation anesthetics?
- Pro: easier method of making dosage adjustments
- Con: longer time for onset of stage 3
Why would we use a combination of IV and inhalation anesthetics?
- IV is used to 1st rapidly induce anesthesia
- Inhalation is used to maintain the anesthesia
- Combination provides optimal anesthesia with minimal
What are examples of IV anesthetics?
- Ketamine
- Thiopental
- Propofol
- Fentanyl
- Remifentanil
- Midazolam
- Opioids
What are examples of inhalation anesthetics?
- Halothane
- Sevoflurane
- Desflurane
- Isoflurane
- Enflurane
What are the 5 different IV anesthetic drug categories?
- Barbiturates (ex: thiopental)
- Dissociative (ex: ketamine)
- Miscellaneous (ex: etomidate, propofol)
- Opioids (ex: fentanyl)
- Benzodiazepines (ex: midazolam)
What are the 2 different inhalation anesthetic drug categories?
- Gas (ex: nitrous oxide)
- Volatile Liquids (ex: halothane)
What is the mechanism of action of anesthesia?
- Target ligand gated ion channels
- GABA receptor gated chloride channels are the most important sites and they cause an inhibitory action
Anesthesia is highly lipid soluble and goes through the lipid bilayer cell membrane. Because of this what may cause someone to wake up slower from anesthesia than someone else?
Widely and uniformly distributed throughout the body and temporarily stored in the adipose tissue. It is slowly washed out during recovery and may take hours to days to depleted fully and can lead to confusion, disorientation, and lethargy as the drug is redistributed, especially if the pt is overweight or older.
What is the goal of regional anesthetics?
Produce loss of sensation and/or motor function in a specific extremity or area of the body
Regional anesthetics provide selective analgesia and muscle relaxation without affecting what?
The patients protective reflexes or altering cognitive abilities
Regional anesthetics and be used along with or in conjunction with what?
General anesthesia
