Anesthesia Flashcards
Third stage (plane 1)
onset of automatic respiration to the cessation of eyeball movements
Third stage (plane 2)
cessation of eyeballs movements to beginning of paralysis of intercostal muscles)
Third stage (plane 3)
beginning to the end of intercostal muscle paralysis
Third stage (plane 4)
complete intercostal paralysis to complete diaphragmatic paralysis
Side effects of spinal anesthesia
hypotension, urinary retention, infection, palsies, headaches (but less with pencil point needles)
Best inhaled anesthetic for asthma patients
Sevoflurane
Most commonly used inhaled anesthetics
NO (gas), isoflurane, desflurane, sevoflurane
Associated with increased risk of malignant hyperthermia
isoflurane and sevoflurane (halogenated inhaled)
succinylcholine (depolarizing muscle relaxant)
Halogenated inhaled gases liver toxicity in order
Most –> least
Halothane, Sevoflurane, Isoflurane, desflurane
Halogenated inhaled gas not used in USA
enflurane
Most cardioprotective halogenated inhaled gas
Isoflurane
DOC for local anesthetic induced arythmias
amiodarone
Next: procainamide and lidocaine
Preop testing lab results should be how old?
4-6 months
Why should ASA be held 5-7 days prior to surgery
due to its irreversible inhibitor of platelet anticyclooxygenase
Why should metformin be discontinued prior to sx?
acidosis
Why should clopidrogel be discontinued prior to sx?
due to its irreversible antiplatelet effect
Why should lipid lowering meds be discontinued prior to sx?
risk of rhabdomyolosis
Epinephrine contraindications
thyrotoxicosis, CAD, severe PVD, vasospastic conditions, tricyclic antidepressants (monoamine oxidase inhibitors)
Allergy commonly associated with spina bifida, atopic dermatitis and chronic urologic problems
latex allergy
Recommendations for VTE prophylaxis with neuroaxial anesthesia
precautions to reduce risk of bleeding:
wait 10-12 hrs after prophylactic dose of LMWH before inserting epidural catheter
wait 10-12 hrs after last dose before removing catheter
wait at least 2 hrs after last dose before restarting LMWH
Sevoflurane
sweet smelling
induction and maintenance
Desflurane
foul odor
bronchoconstriction for people w/ lung problems
Isoflurane
pungent odor
bronchodilator
breath holding, coughing, laryngospasm
Enflurane
nephrotoxic, causes seizures
MAC 1.7%
