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Anesthesia Pharmacology > Exam 1 - History of Anesthesia > Flashcards

Exam 1 - History of Anesthesia Flashcards

1
Q

What is the definition of anesthesia?

A

Lack of feeling or sensation
Artifically induced loss of the ability to feel pain

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2
Q

What is general anesthesia?

A

Drug-induced loss of conciousness
Patients are not arousable even to painful stimulation
Typically impairs independent ventilatory function requiring support

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3
Q

What is regional anesthesia?

A

Insensibility caused by interruption of sensory nerve conduction in a region of the body (peripheral, spinal, erpidural)
LOC and venilation are unaffected

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4
Q

What is sedation?

A

A spectrum of conciousness between “awake” and “unconcious”

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5
Q

Describe the three depths of sedation?

A
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6
Q

When do some believe was the first anesthetic given?

A

In the Garden of Eden when God made a deep sleep fall of upon adam when he made Eve from his rib.

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7
Q

What are thought to be some of the earliest forms of anesthesia?

A
  • Plants like poppy and coca leaves
  • Ethylene fumes beneathe Apollo’s temple
  • Cannabis vapor
  • Carotid compression (just made people unconcious temporarily)
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8
Q

What was Hippocrates known for?

A

Stated it was the patient’s responsibilty to help the operator (keep still)

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9
Q

Who was Diascorides and what was he known for?

A
  • A surgeon in Nero’s army who created the Materia Medica that consisted of 5 volumes of information on medical properties of plants, animal, and mineral products
  • Used mandragora (mandrake) and wine to anesthetize. Caused hallucinations and was thought to have magical properties.
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10
Q

What anesthetic was used in the middle ages?

A

Soporifics: sponges soaked in opium, mandrake, hemlock, and hyposcyamus (isomer of atropine)
Reversed with vinegar (ammonia vapors)

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11
Q

What is the first inhaled anesthetic?
Who discovered it?

A
  • Diethyl ether
  • Valerius Cordus, a german botanist and physician, made it from sulfuric acid and ethyl alcohol
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12
Q

Who created IV therapy?
How?

A
  • Sir Christopher Wren and Robert Boyle
  • Used a goose quill for a needle and bladder for a IV bag
  • They injected alcohol into a dog and described how it made them pee a lot
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13
Q

Who discovered nitrous oxide?

A

Joseph Priestly

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14
Q

Who discovered many important metals and suggested nitrous for surgical pain control?

A

Humphry Davy

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15
Q

What is Horace Wells known for?

A
  • He was a dentist who noticed nitrous caused amnesia and analgesia
  • He self adminstered nitrous and used it at Mass General during an amputation, but they didn’t like that the patient was still moving.
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16
Q

Who first gave nitrous with oxygen?

A

Andrews

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17
Q

Who made the first anesthesia machine with oxygen/nitrous?

A

Hewitt

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18
Q

Who used ether and whisky to remove 2 vascular neck tumors?

A

Crawford Long

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19
Q

Who used ether for anesthesia during denture fittings?

A

William Morton

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20
Q

When was the first successful public demonstration of ether?

A

1846, spread rapidly to England afterwards

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21
Q

Developed the process for pure ether and has a pharmaceutical company named after them?

A

Dr. Robinson Squibb

22
Q

What are the disadvantages of using ether?

A
  • Flammable
  • Prolonged induction and emergence
  • Unpleasant odor
  • High incidence of nausea and vomiting
23
Q

Who discovered chloroform?

A

Sir James Simpson, obstetrician

24
Q

What is Dr. John Snow known for?

A
  • He was a full time anesthetist who administered chloroform to queen victoria during birth of her two children.
  • Traced London cholera outbreak to a water source
25
Q

Why was chloroform controversial?

A
  1. Healthy individuals would die under chloroform
  2. Religious people of the time believed pain during childbirth should not relieved because it was a consequence of Eve disobeying God in the Garden of Eden
26
Q

What are the Hyderabad commissions?

A

Council that deemed chloroform safe as long as respirations were maintained.

27
Q

Who discovered chloroform caused hepatotoxicity in children?

A

Guthrie

28
Q

Who discovered that too light of chloroform released adrenaline and cause fatal VF in animals?

A

Levy

29
Q

Who used cocaine as an anesthetic for eye surgery?

A

Dr. Koller

30
Q

Who completed the first regional nerve block with cocaine?

A

Dr. Halsted

31
Q

Who did the first spinal with cocaine?

A

Dr. August Bier
Technique called “Bier Block”

32
Q

Who is the first nurse anesthetist?

A

Sister Mary Bernard

33
Q

Who is the mother of anesthesia?
What is she credited for?

A
  • Alice Magaw
  • Delivered 14,000 open drop ether cases without death
34
Q

What is Agatha Hodgins known for?

A
  • Opened one of the first nurse anesthesia schools
  • Developed oxygen/nitrous techniques
  • Founded the AANA
35
Q

Describe the inhaled anesthetics cyclopropane, halothane, and isoflurane?

A

Cyclopropane: violently explosive
Halothane: Caused hepatitis and had slow onset/emergence
Isoflurane: safer, less N/V, quicker onset than halothane but slower that desflurane and sevoflurane

36
Q

Describe Desflurane?

A
  • Has the most rapid onset and offset
  • Takes a large quantity to acheive anesthesia ($$$)
37
Q

Who correlated EtCO2 to movement and described MAC?

A
  • Edmund Egar
38
Q

Describe Sevoflurane?

A
  • Intermediate action between isoflurane and desflurane
  • Last new inhaled anesthetic
  • Non-irritating to airways
39
Q

What is the anesthesia triad?

A

Amnesia, Analgesia, and Muscle Relaxation

40
Q

How is amnesia acheived?

A

Stimulating inhibitory transmission or Inhibiting stimulatory transmissions via GABA and ACh

41
Q

What is the first musle relaxant?
How did it affect anesthesia?

A

Curare
Decreased the amount of anesthetic needed and decreased mortality

42
Q

What is balanced or stress free anesthesia?

A
  1. Muscle relaxation
  2. Amnesia
  3. Homeostasis
  4. Analgesia
43
Q

Who is known for killing 3 people from one operation?

A

Dr. Liston

44
Q

Who attempted anesthetic balance by using light nitrous and oxygen and using local infilatration of procaine?

A

George Crile

45
Q

Who placed regional blocks prior to emergence from ether and kept detailed scientific anesthetic records?

A

Harvey Cushing

46
Q

What are the phases of anesthesia?

A

Preop
Induction
Maintenance
Emergence
Postop

46
Q

What is neuroplept anesthesia?

A

Using opioids, antipsychotics, and nitrous to induce anesthesia
Caused high incidence of awareness and dysphoria

47
Q

What is stage I of anesthesia and the 3 planes?

A

Beginning of induction of anesthesia to loss of conciousness
* 1st plane: no amnesia or analgesia
* 2nd plane: amnestic but only partially analgesic (versed/fentanyl)
* 3rd plane: complete analgesia and amnesia

48
Q

What is stage II of anesthesia?
What is this stage dangerous?

A

Loss of conciousness to onset of automatic breathing (ANS takes over)
* Eyelash reflex disappears
* Coughing, vomiting, and struggling may occur (risk of aspiration, bradycardia, and bronchospasm)
*Need to get through this stage as quickly as possible

49
Q

What is stage 3 of anestheisa and the 4 planes?
What plane is desired prior to administering NMB?

A

Onset of automatic breathing to respiratory paralysis (surgical plane)
* 1st plane: automatic respiration to cessation of eyeball movements
* 2nd plane: cessation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increases
* 3rd plane: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle paralysis (think 3 and 3)
* 4th plane: comple intercostal muscle paralysis to diphragmatic paralysis (apnea)

50
Q

What is stage 4 of anesthesia?

A

Apnea until death… not desirable obviously

Anesthesia Pharmacology (5 decks)

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