General Anesthetics

Question 1

Stages of Anesthesia

Answer 1

Analgesia - NO PAIN
Disinhibition - NO MEMORY
Surgical anesthesia - NO CONSCIOUSNESS
Medullary depression - NO BREATHING AND PULSE

Question 2

Defined as the alveolar concn required to eliminate the response to a standardized painful stimulus in 50% of patients

MOST INHALED ANESTHETICS are BRONCHODILATORS

Answer 2

Minimum alveolar anesthetic concn (MAC)

MAC values of anesthetics are additive

LEAST potency: Nitrous oxide (incomplete anesth, rapid)
HIGHEST potency: Methoxyflurane (very slow onset and recovery)

Question 3

General inhalational anesthetic used in minor surgery and dental procedures which causes EUPHORIA (laughing gas) and upon prolonged exposure, megaloblastic anemia

Answer 3

Nitrous oxide

LOWEST potency (highest MAC) and LEAST cardiotoxicity

Question 4

General inhalational anesthetic used in general anesthesia known to cause BRONCHOSPASM and peripheral vasodilation

Answer 4

Desflurane

Di makahinga si Des!

Question 5

General inhalational anesthetic used in general anesthesia which may cause peripheral vasodilation and RENAL INSUFFICIENCY

Answer 5

Sevoflurane

Question 6

General inhalational anesthetic used in general anesthesia which may cause CATECHOLAMINE-RELATED ARRHYTHMIAS and peripheral vasodilation

Answer 6

Isoflurane

Question 7

General inhalational anesthetic used in general anesthesia which may cause SPIKE AND WAVE ACTIVITY and MUSCLE TWITCHING

Answer 7

Enflurane

Question 8

General inhalational anesthetic used in general anesthesia which may cause POSTOPERATIVE HEPATITIS

Answer 8

Halothane

Question 9

General inhalational anesthetic used in general anesthesia which may cause RENAL INSUFFICIENCY

Answer 9

Methoxyflurane

HIGHEST potency (lowest MAC)

Question 10

General intravenous anesthetic/ultrashort-acting barbiturate used in ANESTHESIA INDUCTION and increased ICP

Answer 10

Thiopental

TAYO agad (ultrashort-acting)

Question 11

General intravenous anesthetic/short-acting BZD used in ACUTE anxiety, panic attacks, PRE-OP SEDATION and anesthesia induction

AE: anterograde amnesia, UNWANTED DAYTIME SEDATION, rebound insomnia/anxiety

Answer 11

Midazolam

SimD: brotizolam, triazolam, oxazepam, etizolam

additive CNS depression with Ethanol

Question 12

General intravenous anesthetic used in DISSOCIATIVE ANESTHESIA (analgesia, amnesia and catatonia but with retained consciousness)

AE: EMERGENCE DELIRIUM, CVS STIMULATION, inc ICP

Answer 12

Ketamine

BZD used to reduce emergence delirium

DissoKiative anesthesia

Question 13

General intravenous anesthetic used in general anesthesia for patients with limited cardiac or respiratory reserve

AE: PAIN ON INJECTION, MYOCLONUS, ADRENOCORTICAL SUPPRESSION, postop N&V

Answer 13

Etomidate

No analgesic properties

MASAKIT ETO! (pain on injection)

Question 14

General intravenous anesthetic/OPIOID analgesic used in general anesthesia which may cause RESP DEPRESSION, CHEST WALL RIGIDITY and CONSTIPATION

Answer 14

Fentanyl

Antidote: NALOXONE
Neuroleptanesthesia achieved by combining
FENTANYL + DROPERIDOL + NITROUS OXIDE

Question 15

General intravenous anesthetic used in general anesthesia and PROLONGED SEDATION
also KNOWN as MILK OF AMNESIA

AE: bradycardia, hypotension, pain on injection, PRIAPISM

Answer 15

Propofol

SimD: Frospropofol

Propofol for PROlonged sedation