drugs for local anesthesia Flashcards
what is general anesthesia
loss of sensation throughout the entire body, accompanied by LOC
what kind of anesthesia ; loss of sensation throughout the entire body, accompanied by LOC
general
what is local anesthesia
person is awake, loss of sensation limited to a body region, with no LOC
regional anesthesia
this is the loss of sensation to a larger body area with no LOC
ROA for regional anesthesia
epidural, spinal
roa for local anesthesia
topical, nerve block, infiltration
how can we improve the duration of action of local anesthetics
by adminstering the anesthetic with epinephrine, this causes vasodialation limiting blood flow to the area so the drug stays where it belongs
procaines and lidocaine
esters and amines
esters - procaines and lidocaine
rapidly metabolized in the blood stream, short half life
pka of 8.6-8.9
amides - procaines and lidocaine
metabolized in the liver, longer half life, pka ranges from 7.5-8
regional anesthesia in labour - how is it usually administered
nerve blocks, epidural or intrathecal injection, edidural adminsitratio of opiods
how do opiods work - what aspects of pain to they attnuate to
they attenuate to both the emotional and sensory aspects of pain
eipdural injection of anesthsia, where do we administer
it is the injection of a drug into a highly vascularized area, this is the fat filled space
what is injected into a highly vascularized area aka; faT FILLED SPACE
this is the epidural injection
what anesthetic causes the client to become bed bound
local anesthetic
intrathecal regional anesthesia
injection is directly into the CSF
what anesthesia is injected into the CSF space
intrathecal
what anesthesia is typically adminstered during labour?
intrathecal
what is the easiest administered anesthesia?
intrathecal
what is administered in the space just above the coccyx
intrathecal
what can be administered in the CSF or epidural space?
opiods or regional anesthesia
how do opioids and regional anesthesia work?
they bind to the presynaptic receptors, inhibiting the release of pain signalling NT in the spinal cord
then the bind to the post synaptic receptors in the brain-decreasing neuronal excitability
this will inhibit the pain receptors that are descending from the central nervous system
inhibiting the release of pain signalling NT in the spinal cord
then the bind to the post synaptic receptors in the brain-decreasing neuronal excitability
this will inhibit the pain receptors that are descending from the central nervous system
this is how opiod and regional anesthesia work
what anesthesia allows for no blockade on the motor neurons
opioid and regional anesthesia
adverse effects of opiod regional analgesia
pruitis, itchy, nausea, vomiting, respiratory depression
adverse effects of epidural and spinal anesthesia
backache infection, inadequate anesthesia, arachinoidititis, spinal headache, CSF leak
how is a spinal headache treated
treated with a blood patch, you draw the pt blood, apply to the area to resolve the CSF
what is spinal headache
this is a CSF leak, that causes traction on the brain from the meninges
what are the stages of general anesthesia - (4)
- analgesia
- disinhibition
- surgical anesthesia
- medullary depressed - can lead to death
what stage of general anesthesia do we want
we want stage 3 - surgical anesthesia
what stage of general anesthesia can lead to death
stage 4 - medullary depression
what is stage one of general anesthesia
analgesia
stage 2 of general anesthesia
disinhibition
stage 3 of general anesthesia
surgical
stage four of general anesthesia
medullary depression
what is the purpose of general anesthesia - what factors do we want to induce (6)
the purpose is to induce;
- analgesia
- sedation
- relaxation
- hypnosis
- amesnia
- loss of reflex
- analgesia
- sedation
- relaxation
- hypnosis
- amesnia
- loss of reflex
these are all goals of what
general anesthesia
since no single drug can safely accomplish all of the goals of general anesthesia what must be used
balanced anesthesia
what is balanced anesthesia - what do we use, what do we want to accomplish
this is the use of several drugs to accomplish general anesthesia
what can be used to achieve balanced anesthesia - pharmacological
neuromuscular blockers, short acting benzodiazepines, opioids, general anesthetics
neuromuscular blockers, short acting benzodiazepines, opioids, general anesthetics - can all be used to achieve what
balanced anesthesia
intravenous anesthetics are typically co-administered with what
typically co-administered with inhaled general anesthetics once the client loses consiousness
typically co-administered with inhaled general anesthetics once the client loses consiousness - what
intravenous anesthetics
how do we top of IV anesthetics
with inhaled anesthetics
what anesthetics allows for the patient to move slowly through stages 1 and 2 of general anesthesia
intravenous
inhaled general anesthetics
used to maintain anesthesia, highly lipid soluble
how do inhaled general anesthetics work
they prevent the flow of sodium ions into the neurons in the CNS reducing neural activity
what prevent the flow of sodium ions into the neurons in the CNS reducing neural activity
inhaled general anesthetics
what should patients be monitored for post operatively after inhaled general anesthetics
nausea and vomiting, CNS depression, respiratory depression, changes in vital signs
drugs as adjuncts to general anesthesia; pre op - think about ways you can relieve anxiousness in the patient pre operatively
benzos, anticolinergics, histamine
how to benzos work pre operatively
as anti-anxiety
how to anticholinergics work pre operatively
they dry the repsiratory an oral secretions
how does histamine work preoperatively
decrease the gastric fluid volume
during surgery, what drugs could be added to increase efficacy of the general anesthetic
neuromuscular blockers
how to neuromusclar blockers work during surgery
they induce relaxation of the skeletal muscle for surgery and intbation
what drugs can be given as adjuncts to the general anesthesia
opiates and nsaids
antiemetics
cholinergics
why is it good to give cholinergic drugs postoperatively
stimulate smooth muscle contraction in the GI tract and bladder to induce peristalisis and urination
