EMERGENCE NOTES Flashcards
Delayed anesthesia emergence may be prevented by avoiding
Lower mean Body Temperature and mean ETCO2 in pediatric patients.
2 that are not factors associated with tracheal extubation time.
method of anesthetic management
total amounts of fentanyl
What are very important in avoiding delayed emergence for pediatric patients.
Perioperative vital signs
shortens the emergence time from inhalation anesthetics.
Hypercapnia-induced hyperpnea (Hyperpnea is breathing more deeply and sometimes faster than usual_
Hypercapnia effect on cerebral arterial smooth muscle and effect on increased blood flow?
Hypercapnia dilates the cerebral arterial smooth muscle and increases blood flow.
The increase in blood flow facilitates rapid elimination of inhaled anesthetics from the brain, and hyperventilation decreases the arterial concentration of the inhaled anesthetic
Intraoperative hypercapnia may facilitate
Faster tracheal extubation after ambulatory surgery in pediatric patients
Hypercapnia and CO2 diffusion?
causes carbon dioxide diffusion into the cerebrospinal fluid from the cerebral vessels and liberates H+ ions that stimulate the central chemoreceptors lying below the ventral surface of the medulla.
Hypercapnia might accelerate
spontaneous breathing and emergence after surgery.
Conversely, it has been suggested that perioperative hypocapnia is associated with the risk of
delayed anesthesia emergence and poor cognitive function in adult patients .
Lower mETCO2 may increase
emergence time in pediatric ambulatory surgery, are consistent with the results from these studies.
Central chemoreceptors are sensitive to
increases in arterial carbon dioxide and decreases in arterial pH (High CO2 and low pH)
How does Hypercarbia stimulate minute ventilation?
elicits a rapid and vigorous increase in minute ventilation
As arterial PCO2 rises, so does the CO2 content of CSF why?
cerebrospinal fluid; This occurs because the BBB is permeable to CO2 but not to hydrogen ions.
CO2 diffuses across the BBB into the cerebrospinal fluid (CSF) where it is
hydrated to carbonic acid, which quickly ionizes to increase CSF hydrogen ion concentration and hence reduce pH
Central chemoreceptors do not respond to systemic pH?
These chemoreceptors do not respond to systemic pH because the blood brain barrier prevents hydrogen and bicarbonate ion diffusion, effectively insulating the brain from changes in arterial pH
