General Anesthetics

Question 0

Halothane

Answer 0

Inhaled anesthetic - slow induction, for maintenance
Vent depression (intubate), dec secretions, bronchodilator, vasodilator. Decreases: secretions, BP, CO, renal bf. Inc ICP, arrhythmias (cardiac sensitization). Relaxes uterus.
Risk of hepatitis (autoimm rxn to met), miscarriage, malignant hyperthermia.

Question 1

Nitrous oxide

Answer 1

Inhaled -Analgesia & euphoria not anesthesia (MAC too high)
low solubility/fast induction, dec hypotension- combined
little resp depression, no liver/kidney tox, no cardiac depression
+N/V post-op (pretx)
Diffusion hypoxia risk, trapped N2- so use in combo.
Chronic: peripheral neuropathy (dentist), megaloblastic anemia.

Question 2

Enflurane

Answer 2

Inhaled anesthetic
Faster than halothane,no cardiac sensitization
Can give seizures, renal tox

Question 3

Isoflurane

Answer 3

Inhaled anesthetic- Low tox but pungent
rapid induction (but irritates- not good)
Low tox: dec bp, Inc HR, resp depression, less inc ICP (choice for neurosx), relaxes muscles & uterus.

Question 4

Sevoflurane

Answer 4

Inhaled anesthetic
Rapid induction/recovery- low airway irritation
low tox: often for children/outpt, safest CV
Inc CBF (limited w/ hyperventilation)
Low blood/gas- don’t need to use N2O w/ it

Question 5

Desflurane

Answer 5

Inhaled anesthetic - very low blood/gas
Rapid, easy controlled
too pungent for induction - irritates
Low tox: dec BP, inc HR, inc ICP (hyperventilate), resp depression, mm relax. Not as pop as sevoflurane

Question 6

Thiopental

Answer 6

Barbiturate - IV anesthetic
Short rapid, little analgesia
CI: porphyria

Question 7

Midazolam

Answer 7

Benzodiazepine- IV, preanesthetic, induction
Short procedures w/ opioids
Amnesia, short acting, reversed w/ flumazenil

Question 8

Propofol

Answer 8

IV anesthetic - the best, outpt
RAPID induction and FAST recovery
Tox: profound resp depression (esp w/ opioids), dec BP, dec: CBF, met, ICP (neurosx), anaphylaxis (albumin)
Least likely to cause vomiting, inject w/ lidocaine (painful)

Question 9

Etomidate

Answer 9

IV anesthetic - facilitates GABA
fast, short
used for induction in pt w/ hypotension
causes hicups

Question 10

Ketamine

Answer 10

IV anesthetic - NMDA blocker
Dissociative anesthesia, potent analgesia, rapid
Inc HR, inc BP, no N/V (ok in emergencies)
Emergence delirium- adults (give w/ benzos), ok in children/vet
Date rape/abuse drug

Question 11

Atropine

Answer 11

Adjunct anesthetic

Question 12

Glycopyrrolate

Answer 12

Adjunct anesthetic

Question 13

Preanesthesia/short procedure anesthesia

Answer 13

benzodiazepine (Midazolam), opioids

Question 14

Induction of anesthesia

Answer 14

Thiopental, midazolam, propofol

Question 15

Maintenance of anesthesia

Answer 15

Popofol, inhaled anesthetics, N2O, opioids