Depth of Anesthesia

Question 1

Mother of Anesthesia

Answer 1

Agatha Hodkins - develops Nitrous Oxide, opened first formal postgrad program, founded ANA

Question 2

Goals of depth of anesthesia monitors

Answer 2

Ability to detect level depth of anesthesia & decrease risk of awareness, determine if patient is unnecessarily too deep,

Question 3

How is does an EEG work

Answer 3

Cells within cerebral cortex provide synaptic activity & result in chances of voltage that can be detected by electrodes on forehead or scalp

Question 4

Beta wave

Answer 4

High frequency, low amplitude - awake state. In prefrontal regions, reflect thalamocortical pathways

Question 5

Alpha wave

Answer 5

medium frequency, higher amplitude. Awake but eyes closed.

Question 6

Theta wave

Answer 6

Low frequency, seen under general anesthesia- inhibition of thalamic pacemaker cells

Question 7

Delta wave

Answer 7

Very low frequency, depressed functions (coma, deep anesthesia, hypoxia, ischemia, infarction, poor metabolism)- thalamic depression

Question 8

Principle of BIS

Answer 8

2 dimensional spectral analysis (bispectral)- changes in clinical state represented by changes in phase coupling

Question 9

BIS Target range

Answer 9

40-60

Question 10

BIS algorithm designed for what drugs, and what drugs does it not work with?

Answer 10

Designed for: propofol, versed, iso

Not for: ketamine increases it, N2O BIS will not change