General Anesthesia Flashcards
General anesthesia components
hypnosis, areflexia, amnesia, analgesia, +/- muscle relaxation
Unconsciousness
propofol, volatile anesthetics
amnesia
midazolam, propofol, volatile anesthetics not so much
analgesia
fentanyl, NO
Immobility
volatile inhaled anesthetics, succinylcholine, rocuronium
Respiratory depression and airway obstruction
Propofol, inhaled anesthetics, Fentanyl
Seizure activity
The use of some anesthetics is discouraged in patients with epilepsy (ex: Etomidate, Enflurane, Sevoflurane
CV instability
general anesthetics such as Propofol and volatile inhaled anesthetics, spinal anesthesia, epidural anesthesia)
Most anesthetics are vasodilators
Common Emergency Drugs
Oxygen, Ephedrine (raise BP), Phenylephrine (raise BP), Atropine (raise HR), Lidocaine
Ephedrine
Clinical use – increase BP and HR
Correcting for side effects – titrate carefully, increases BP/HR/arrhythmias
Phenylephrine
Clinical use – increase BP
Clearance – MAO and hepatic metabolism
Correcting for side effects – titrate carefully, increases BP/decreases HR
Atropine
Clinical uses – increase HR and BP
Correcting for side effects – psychosis with OD, paradoxical bradycardia with underdose
Lidocaine
Clinical uses – local anesthetic, reverse arrhythmias (PVCs)
Clearance – redistribution (to muscle/fat), hepatic metabolism
Correcting for side effects – reverse systemic toxicity, seizures
Common Pre-Induction Drugs
Lidocaine (SQ before IV), Midazolam, Fentanyl, Antibiotic
Midazolam
Clinical uses – sedative/hypnotic, reversal of anxiety, amnestic
benzodiazepine antagonist, antidote for Midazolam OD
Fentanyl
Flumazenil
Fentanyl
opioid agonist
Clinical uses – analgesia (pain relief), anesthetic agent
opioid antagonist
Naloxone
Common Drugs for Induction of Anesthesia
Oxygen, Propofol, Succinylcholine
Propofol
Clinical use – rapid IV induction of anesthesia
Succinylcholine
Classification – depolarizing (non-competitive) NMJ blocker
Clinical use – rapid muscle relaxation for intubation
Common Drugs for Maintenance of Anesthesia
Oxygen, inhalational anesthetics (NO/Isoflurane/Sevoflurane/Desflurane), Fentanyl, Vecuronium
Inhalational anesthetics
Classification – NO and volatile inhaled anesthetics (Iso/Des/Sevo)
Clinical use – maintenance of anesthesia after induction
Vecurononium
Classification – competitive (non-depolarizing) NMJ blocker
Clinical use – muscle relaxation
Common Drugs for Emergence from Anesthesia
Oxygen, Neostigmine, Glycopyrrolate, Ketorolac, Morphine
Neostigmine
Clinical use – reversal of NMJ blockade
Ketorolac
Classification – NSAID
Clinical use – analgesic (IV or IM)
Morphine
Classification – opioid agonist
Clinical use – analgesia
