Anesthesia Flashcards
What is the guideline for aspirin use regarding surgical evaluation?
Hold 7-10 days prior to surgery
due to irreversible inhibitor activity of platelet COX
What is the guideline for NSAID use prior to surgery?
Hold 3 days prior to surgery
True or false: beta-blockers may be continued up to and day of surgery?
true (along wtih CCB, digoxin, clonidine)
what is the guideline for diuretics and ACEI prior to surgery?
hold the morning of surgery
what are the guidelines for diabetes medications prior to surgery?
Hold metformin 2 days prior (due to risk of lactic acidosis)
Hold short-acting insulin morning of surgery, give 1/2 normal dose of long-acting insulin
Hold sulfonylureas, TZDs, alpha-glucosidase inhibitors
What is ASA Class 1?
normal, healthy patient
What is ASA Class 2?
mild systemic dz (e.g. controlled HTN, controlled diabetes)
What is ASA Class 3?
severe systemic dz (e.g. poorly controleld HTN, morbid obesity, renal failure)
What is ASA Class 4?
severe systemic dz that is a constant threat to life (e.g. unstable angina, symptomatic COPD)
What is ASA Class 5?
critical condition with little chance of survival without surgical intervention (e.g. multiorgan failure, sepsis with hemodynamic instability)
What is ASA Class 6?
brain dead patient undergoing surgery for organ donation
which tract conveys sharp pain and temperature?
spinothalamic tract
what is the effect of local anesthetic?
vasodilation
what is the effect of epinephrine?
vasoconstriction
