General Anesthsia

Question 1

What are the 3 phases of general anesthesia

Answer 1

1. Induction
2. Maintenance
3. Emergence

Question 2

General anesthesia

Answer 2

Reversible, drug induced state in which a pt has lost consciousness

Question 3

Characteristics of patients under anesthesia

Answer 3

-Analgesia (an absence of pain)
- A state in which amnesia occurs
- A loss of protective reflexes
- Skeletal muscle relaxation

Question 4

Theories to the mechanism of anesthetic agents

Answer 4

-Protein receptor- proposes general anesthetic affect specific proteins in the cns
- Meyer-Overton= based on the correlation bt solubility and anesthetic potency
- Endogenous endorphins (opiate like substances suppress pain

Question 5

ASA’s classification system. Anesthesia provider will classify

Answer 5

Ps1- 6

Question 6

Ps1

Answer 6

Pt is healthy with no physiologic, biochemical, or organic disease

Question 7

PS2

Answer 7

The pt has a mild systemic disease tht does not limit activity, such as BMI>30 but <40, controlled hypertension, asthma, bronchitis, diabetes, or smoking w/o copd

Question 8

PS3

Answer 8

Pt has severe systemic disease tht limits activity,but is not incapacitating, such as poorly controlled htn, history of mi, controlled heart failure,severe diabetes, or is morbidly obese

Question 9

PS4

Answer 9

Pt has severe Systemic disease tht is a constant threat to life, esrd, hepatic, pulmonary, cardiac, or endocrine system dysfunction

Question 10

Ps5

Answer 10

The pt is moribund and not expected to survive 24 hours with, or without operation.

Question 11

Ps6

Answer 11

The pt who is declared brain dead and whose organs are being removed for donor

Question 12

What ways is anesthesia given

Answer 12

IV induction allows pt to receive
Inhaled anesthetic agents through a breathing circuit and anesthesia machine. Inhaled agents are controlled using vaporizer on the anesthesia machine. Unless there is a reason not to, anesthetic are administered primarily inhaled agents

Question 13

General anesthetic agents
1. Inhalation agents

Answer 13

1. Nitrous oxide, isoflurane, desflurane, and sevoflurane

Question 14

Sevoflorane

Answer 14

Nonpungent, ideal for use in pediatric pt’s without iv access

Question 15

Barbiturates

Answer 15

Most commonly used is sodium Pentothal, sodium thiamyl, methohexital sodium. They are short acting. Does not provide analgesia

Question 16

Nonbarbiturate agents

Answer 16

Propofol used for induction and maintenance. It is lipid emulsion. It has short half life making it ideal for sedation with minimal side effects. It’s used as a preventative and rescue antiemetic.

Question 17

Étomidate

Answer 17

A nonbarbituate induction agent that has minimal effects on myocardial metabolism, cardiac output, and peripheral or pulmonary circulation. It is generally utilized for pts w/ cardiac history and pt’s who cannot tolerate dramatic changes in bp