ERAS Flashcards

1
Q

persistent post-surgical pain incidence is >30% after what 4 operations? (A, T, M, IH)

A

amputations, thoracotomy, mastectomy, inguinal herniorrhaphy

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2
Q

what is the Surgical Risk Calculator that estimates the chance of an unfavorable outcome? (NSQIP)

A

National Surgical Quality Improvement Program (NSQIP)

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3
Q

clears up to how many hours before induction in pts at low risk of aspiration?

A

2 hours

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4
Q

how many grams of preop CHO drink?

  1. at HS
  2. 2-3 hours pre-induction
A
  1. 100 grams

2. 50 grams

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5
Q

Preop CHO drink decreases what 4 things? (IR, H, F, PONV)

A

insulin resistance, hunger, fatigue, PONV

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6
Q

Abx prophylaxis:

  1. give how many hours before skin incision?
  2. d/c how many hours post op?
  3. d/c how many hours post op for cardiothoracic surgeries?
A
  1. 1 hour
  2. 24 hours
  3. 48 hours
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7
Q

timing of antithrombotics are critical for neuraxial blocks to avoid what? (EH)

A

epidural hematoma

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8
Q

are minidose SQ heparin doses a contraindication to neuraxial block or epidural catheter removal?

A

no

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9
Q

neuraxial blocks may be performed how many or more hours before heparin administration?

A

1 hour or more

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10
Q

if postop LMWH used, epidural catheter should be removed how many hours prior to first dose?

A

2 hours

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11
Q

if epidural catheter already present:

  1. it should be removed at least how many hours after dose of LMWH?
  2. subsequent LMWH dosing after catheter removal should not be for how many hours?
A
  1. 10 hours

2. 2 hours

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12
Q

neuraxial blocks blunt what 2 responses to surgery? (N, M)

A

neuroendocrine, metabolic

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13
Q

laparoscopic surgeries decrease what 2 things compared to open surgeries? (SSI, LOS)

A

surgical site infections, length of stay

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14
Q

epidural at what part of the spine is recommended for major abd and thoracic surgeries?

A

thoracic

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15
Q

are lumbar epidurals recommended for abd surgeries?

A

no

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16
Q

reasons to not use lumbar epidural for abd surgery:

  1. may not provide adequate what for the abd incision? (A)
  2. frequently causes what 2 things? (UR, LLS/MB)
A
  1. analgesia

2. urinary retention, lower limb sensory/motor block

17
Q

for arthroplasty surgery of hips and knees, what 2 nerves are blocked with continuous peripheral nerve block? (F, S)

A

femoral, sciatic

18
Q

what 2 surgeries have an open incision? (HR, A)

A
  1. hernia repair

2. arthroplasty

19
Q

thoracic epidural analgesia (TEA) is the sole regional technique for what 3 surgeries? (N, E, OA)

A
  1. nephrectomy
  2. esophageal
  3. open aorta
20
Q

what are the 2 regional techniques for arthroplasty surgery? (CPNB, PI)

A
  1. continuous peripheral nerve block

2. periarticular infiltration

21
Q

what are the 2 regional techniques for thoracic surgery? (TEA, ICB)

A
  1. thoracic epidural analgesia

2. intercostal block

22
Q

what are the 3 regional techniques for hernia repair? (LI, INB, TAP)

A
  1. local infiltration
  2. ilioinguinal nerve block
  3. transversus abdominis plane block
23
Q

what are the 4 regional techniques for colorectal resection? (TEA, WIWR, ILA, IVL)

A
  1. thoracic epidural analgesia
  2. wound infusion with ropivacaine
  3. intraperitoneal LA
  4. IV lidocaine
24
Q

Local anesthetic fast-track spinal anesthesia doses (mg, range):

  1. bupivacaine
  2. ropivacaine
  3. lidocaine
A
  1. 3-7 mg
  2. 5-10 mg
  3. 30-40 mg
25
Q

Local anesthetic fast-track spinal anesthesia doses (mcg, range):

  1. sufentanil
  2. fentanyl
A
  1. 5-10 mcg

2. 10-25 mcg

26
Q

what specific nerve is blocked for hernia repairs?

A

ilioinguinal nerve