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Surgery > Anesthesia > Flashcards

Anesthesia Flashcards

1
Q

Types of Anesthesia

A

General
Sedation
Regional

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2
Q

Define General Anesthesia

A

Suppression of activity in the CNS

Unconsciousness & total lack of sensation

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3
Q

Define Sedations

A

Inhibition of transmission of nerve impulses between higher & lower centers of the brain
Inhibition of anxiety & memory

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4
Q

Define Regional Anesthesia

A

Use of local anesthetics to make a portion of the body insensate by blocking transmission of nerve impulses between a part of the body & the spinal cord

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5
Q

Peripheral Anesthesia

A

Inhibits sensory perception within a specific location

Nerve blocks

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6
Q

Central Anesthesia

A

Local anesthetic delivered around the spinal cord & removes sensation of the body below the level of the block

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7
Q

Risks of Anesthesia

A

Death
MI
PE
Post op N/V

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8
Q

ASA 1

A

Normal healthy patient

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9
Q

ASA II

A

Patient with mild systemic disease

Smoking, pregnancy, obesity, well controlled DM or HTN, lung disease

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10
Q

ASA III

A

Patient with sever systemic disease, not incapacitating
DM, poorly controlled HTN, hx of MI, CVA, TIA, cardiac stent; COPD, ESRD, hepatitis, pacemaker, EF less than 40%, congenital metabolic abnormalities

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11
Q

ASA IV

A

Patient with severe systemic disease that is a constant threat to life
Recent MI, CVA, TIA, cardiac stent; ongoing cardiac ischemia or severe valve dysfunction; ICD; EF below 25%

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12
Q

ASA V

A

Moribund patient who is not expected to survive

Ruptured AAA; intracranial bleed; ischemic bowel with significant cardiac path

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13
Q

ASA VI

A

Delivered brain-dead

Organ donor for transplantation

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14
Q

Regional/Local Anesthesia

A

Pain blocked from a part of the body using local anesthetics

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15
Q

Types of Regional Anesthesia

A 
Infiltrative
Peripheral nerve block
IV regional anesthesia
Central nerve blockage
Topical anesthesia
Tumescent anesthesia
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16
Q

Infiltrative Regional Anesthesia

A

Local anesthetic injected in a small area to stop sensation

17
Q

Peripheral Nerve Block

A

Local anesthetic injected near a nerve that provides sensation to a portion of the body

18
Q

IV Regional Anesthesia

A

Dilute local anesthetic infused to a limb through a vein with a tourniquet placed to prevent the drug from diffusing out of the limb

19
Q

Central Nerve Blockage

A

Infusion or injection of local anesthetic in or around a portion of the CNS
Spinal or epidural

20
Q

Topical Anesthesia

A

Special formulation that diffuses through the skin or mucous membranes

21
Q

Tumescent Anesthesia

A

Large amount of dilute local anesthesia infiltrated into the subcutaneous tissue used in liposuction

22
Q

Indications for Neuroaxial Anesthesia

A

Surgery or pain

Appropriate distribution

23
Q

Contraindications to Neuroaxial Anesthesia

A

Patient refusal
Infection
Coagulopathy

24
Q

Benefits of Spinal Anesthesia

A

Decreased surgical time
Less blood loss
Less intraoperative transfusion requirements
Decrease the incidence of DVT or PE

25
Q

Benefits of Epidural Anesthesia & Analgesia

A

Less blood loss
Reduced platelet aggregation
Reduced stress response to surgery
Decreased incidence of DVT
Improved graft potency after LE revascularization
Patients with general & epidural for aortic surgery had lower incidence of death & major complications

26
Q

Complications of Spinal/Epidural

A

Post procedural headahce

Spinal hematoma or abscess

27
Q

Drug Concentration (%) of Local Anesthetics

A

% x 10=mg/mL

28
Q

Epinephrine (g/mL)

A

1:200,000

5 ug/mL

29
Q

Why add epinephrine to local anesthetics?

A

Prolong surgical anesthesia time
Decrease peak serum levels
Intravascular marker
Decrease surgical site bleeding

30
Q

When to not add epinephrine to lidocaine?

A

Fingers/toes
Penis
Ear/nose
Skin flaps

31
Q

Scale of Local Anesthetic Toxicity

A 
Dizziness
Tinnitus
Nystagmus, dysphoria, shivering
Somnolence, muscle twitching
Seizures
Cardiac arrhythmias
Cardiovascular instability & collapse
32
Q

Treatment of Local Anesthetic Toxicity

A 
Stop injection
Call for help
Supportive care
20% intralipid 1.5 mL/kg IV bolus (may repeat 1-2 times)
Cardiopulmonary bypass

Surgery (20 decks)

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