Anesthetic Lecture

Question 1

difference between local/general anesthetic?

Answer 1

local = specific portion of body, less systemic side effects, decrease pain but increase risk of falls

general = nervous system depression (reversible), various meds used (IV or inhaled), sedation, 4 stages

Question 2

ideal characteristics of general anesthesia?

Answer 2

rapid onset, skeletal muscle relaxation, minimum toxic side effects, rapid recovery, amnesia, analgesia

Question 3

what is stage 1 of general anesthesia?

Answer 3

analgesia

decrease pain, induce drowsiness

Question 4

what is stage 2 of general anesthesia?

Answer 4

delirium

excitement
loss of consciousness
irregular/rapid breathing
increased BP

Question 5

what is stage 3 of general anesthesia?

Answer 5

surgical anesthesia

regular, even, deep breathing
skeletal muscle relaxation

Question 6

what is stage 4 of general anesthesia?

Answer 6

medullary paralysis

respiratory paralysis
death

Question 7

are inhaled anesthetics lipid or water soluble?

Answer 7

lipid soluble, there’s a hangover effect where it sticks to fat tissue.

anesthetics that are highly soluble in blood have a slower onset

Question 8

ADRs for inhaled anesthetics?

Answer 8

tachycardia
arrhythmia
muscle rigidity
increased BP/HR
hepatotoxicity
nephrotoxicity
increased ICP
decreased RR

Question 9

what is propofol infusion syndrome?

Answer 9

A rare, fatal condition from prolonged/high-dose propofol use.

Features: Metabolic acidosis, rhabdomyolysis, cardiac/renal failure.
Risk: High dose >48 hrs, critical illness.
Management: Stop propofol, supportive care.

Question 10

In what order are the anesthetic medications given?

Answer 10

premeds first
paralytics ONLY AFTER sedation
opioids, benzos before IV or inhaled anesthetics are at discretion of anesthetic team

Question 11

what are the therapeutic concerns of treating someone post-sedation?

Answer 11

hangover effect (weakness, lethargy)
excess mucous and secretion
abdominal distention

Question 12

regional vs local anesthesia?

Answer 12

local = small part of the body such as tooth or area of skin

regional = larger part of body (distal to injection), arm/leg

Question 13

what is LAST and how do you treat it?

Answer 13

local anesthetic systemic toxicity

treat with lipid rescue

Question 14

do topical anesthetic agents have risk of systemic toxicity?

Answer 14

yes

Question 15

what to keep in mind regarding topical anesthetic agents?

Answer 15

do not apply heat over a patch

still risk for systemic toxicity as it’s well absorbed from mucous membranes

Question 16

what causes headaches associated with intrathecal administration?

Answer 16

altered CSF pressure

Question 17

What are the purposes and risks of central neuraxial blocks?

Answer 17

Purpose: Epidural/intrathecal anesthesia for surgeries involving the lower body.

Risks: Headaches (intrathecal), paralysis, and altered CSF pressure

Question 18

What are the purposes and risks of peripheral nerve blocks?

Answer 18

Purpose: Block sensation near a surgical site (e.g., foot, hand).

Risks: Nerve damage, localized toxicity.

Question 19

What are the indications and adverse effects of thiopental?

Answer 19

Indications: Induction of anesthesia; reduces intracranial and intraocular pressure.

Adverse Effects: Respiratory depression, hangover effect, reflex tachycardia

Question 20

What drugs are used for the induction and maintenance of anesthesia?

Answer 20

Induction: Propofol, thiopental, ketamine, etomidate.

Maintenance: Inhaled anesthetics (enflurane), IV agents like propofol

Question 21

Which anesthetic drug can cause increased intracranial pressure (ICP), and which patients should avoid it?

Answer 21

Drug: Ketamine

Avoid in: Patients with traumatic brain injuries or pre-existing elevated ICP