Anesthesia Flashcards
What rule describes anesthetic dosing for children?
Clark’s rule
Childs weight in pounds divided by 150 and then multiplied by the adults weight.
What is the rule that describes anesthetic dosing for infants?
This is the Frieds rule.
Infants age in months divided by 15 and then multiplied by the adult dose.
What is the maximum dose for lidocaine 1%?
30 mL/ or 300 mG
What is the max dose for lidocaine with epi?
50 mL or 500 mg
What is the maximum dose for bupivicaine 1%?
175 mg or 17.5 mL
What is the maximum dose for bupivicane 1% with epi?
225 mg or 22.5 mL
What route does general anesthesia follow?
Cerebral cortex (Amnesia/analgesia) Basal ganglia (Delerium) Cerebellum (Surgical anesthesia/paralysis) Medula (Respiratory depression/death) Brain stem/spinal cord
What are the four stages of anesthesia?
Stage 1: Amnesia/Analgesia (3 planes)
Stage 2: Delerium
Stage 3: Surgical Anesthesia (Four planes)
Stage 4: Medullary Paralysis (2 planes)
What are the planes of stage 3 anasthesia?
Termed “Surgical Anesthesia”
Plane 1: Sleeping, residual lid reflex, normal pupils and breathing.
Plane 2: Pupils dialate, full analgesia, HR and BP are normal.
Stage 3: Partial intercostal paralysis, tachycardic, hypotensive, hypotonic
Stage 4:Complete intercostal paralysis and respiratory arrest requiring ventilation
Eflurane, isoflurane, and halothane are all?
These are all inhalation agents used to achieve general anesthesia.
What do enflurane and isoflurane have in common?
Both of these agents are inhalation agents that can be hepatotoxic.
Both support heart rate and can be used with epinephrine.
This inhalation agent can be negative ionotropic leading to arythmias and cause shivering post surgery.
Halothane.
Also commonly associated with malignant hyperthermia.
What are the two scary associations seen with prolonged nitrous oxide use?
Can cause
Fatal agranulocytosis
Or
Spontaneous abortion
What should be given to patients after receiving nitrous oxide?
Post surgical O2 deliverance to prevent postanesthetic delayed diffusion hypoxia.
Why is fetanyl a useful sedative/hypnotic agent?
Fetanyl is a short acting narcotic sedative reversed by naloxone.
What is fetanyl?
A sedative/hypnotic narcotic drug.
What is propofol (diprivan)?
IV sedative hypnotic agent used for induction and maitenance.
What is midazolam (Versed)?
A short acting benzo typically used with an analgesic for short term conscious sedation.
Waht are phenergan and compazine?
These are both phenothiazine tranquilizers.
Which two meds can be used as premedications to minimize post surgical respiratory secretions while blocking parasympathetic overtone (block the vagus) to allow for positive chronotropic heart effects
Atropine and Scopalamine
How does Zofran (Ondansetron) work?
It is a 5-HT3 receptor antagonist with strong antiemetic properties.
Originally used in patients undergoing chemo and now used following general anesthesia.
What does succinycholine do?
Paralytic agent used for intubation with a fast onset skeletal muscle blockade.
What should one watch out for when using succinycholine?
Intragastric and intraocular pressure rise with a rise in serum potassium as well (arrythmic)
Why would you want to avoid using succinycholine in patients undergoing a trauma, burn, uremia or lower motor neuron disease?
These patients are predisposed to be hyperkalemic.
Succinycholine raises potassium levels even more potentially causing arythmias.
What are the three major contraindications to spinal anasthesia?
Anticoaguation therapy
Bleeding diathesis (peridermal hematoma or spinal swelling)
Hypovolemia
Systemic infection, neuromuscular disease, COPD, obesity or lumbosacral disk disease are all included as well.
What spinal level is safe for epidurals?
Below L2
Can be maintained 24-48 hours for ongoing anesthesia.
What is the most common acute complication of spinal anesthesia?
Hypotension secondary to sympathectomy.
Dont forget spinal migrane.
