General Anesthesia Flashcards
What’s is local contraindications of inhalation anesthesia ?
Local Nasal obstruction, e.g. polyps, heavy cold,
intolerance of mask, lack of seal to mask (e.g. moustache),
operative procedures to upper anterior teeth (obstructed by mask).
What’s is general contraindications of inhalation anesthesia ?
Severe respiratory disease,
active neurological disease such as multiple sclerosis (MS), deafness, severe mental or physical impairment.
What’s is ketamine effects ?
– Dissociative anesthetic
– NMDA-receptor antagonist
– Induction of anesthesia
– Emergent delirium, hallucinations
– Cardiovascular stimulation
– ↑intracranialpressure
What’s ketamine effects on respiratory ?
Preserve upper airways musculature tone
Minimize obstruction and hypopnea + apnea
Maintain pharyngeal and laryngeal reflexes and
Swallow , cough , decrease risk af aspiration
Why ketamine is a first. choice ?
Due to respiratory effects and relaxing of bronchial smooth muscles , and dialation
Wheezing maraymel during anesthesia
Other drugs do the opposite
What’s ketamine disadvantage?
⬆️ intraocular pressure and intracranial
⬆️ BP , HR
Dissociative
Abatagonist of glumatic acid
Stimulus of dreams and hullications , delirium
What’s is medazolam uses ?
Benzodiazepine used for:
o Preoperative sedation
o Anterograde amnesia
o Anaxiolysis
Induction
o Outpatient surgery
What’s midazolam disadvantage?
Respiratory depression
What’s is the Contraindications to outpatient general anaesthesia ?
● Medically unfit, particularly:
– cardiovascular or respiratory problems
– recent exposure to infectious fevers
– medication which may interact, e.g. monoamine oxidase
inhibitors, antihypertensives
● Not starved (at least 4 hours without food or drink is essential)
● Unaccompanied
● No valid consent
● Severe alcohol or drug abuse problems
● Pregnancy
● Trismus (would require inpatient facilities with fibreoptic
technique for intubation).
We don’t give general anesthesia to ?
Systemic problems inhibit elimination
Respiratory , liver , kindney , urinary..
Infectious diseaeses in early stages
Exudative diasthesis
What’s general anesthesia indication ?
Emergency of odontogenic and non-odontogenic infections , espicially early stages ( ABCESS , periodontitis … )
Santa I’ve inervation
Extraction
What’s happen to the patient when we give NLA ?
Anxiety, motor activity, and sensitivity to painful stimuli are reduced;
the person is quiet and indifferent to surroundings and is able to respond to commands.
Which drugs for general anesthesia ?
flunitrazepam, propofol and ketamine , medazolam , fentanyl
Patients with dental restorative or surgical needs for whom local anesthesia is ineffective because ?
of acute infection, anatomic variations, or allergy
which patients are more difficult to sedate ?
currently taking oral benzodiazepines
