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Anesthesia Pharm SP 25 > History + Lecture 1 > Flashcards

History + Lecture 1 Flashcards

1
Q

Anesthesia

A

The lack of feeling or sensation
- artificially induced loss of the ability to feel pain (ie for surgery)

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2
Q

General Anesthesia

A

Drug induced LOC.
- Not arousable even to painful stimuli
Independent ventilatory fan but often impaired

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3
Q

Regional Anesthesia

A

Insensibility caused by interrupting the sensory nerve conduction to a particular region of the body (peripheral, spinal, epidural)
-No Change in LOC
-airway maintained

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4
Q

Sedation - Minimal - Anxiolyisis

A

-responsive to verbal commands
-airway unaffected
-spon ventilation unaffected
- CV unaffected

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5
Q

Sedation- Moderate

A

Responsive to verbal/touch
Airway- no need for help
soon Ventilation- adequate
CV- usually maintained

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6
Q

Sedation Deep

A

Responsive after repeated or painful stimulus
airway may need assistance
soon ventilation - possible inadequate
CV- usually maintained

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7
Q

4000 BC to 400 BC

A

Poppy seeds, coca leaves, acupuncture , ethylene fumes, weed vapor, carotid compression

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8
Q

Hippocrates

A
  • accommodate the surgeon
    avoid sinking, moving and turning away as the patient
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9
Q

Diascorides

A
  • surgeon in Neros army
  • Made the materica media (5 volumes , 360 different things)
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10
Q

Valerius Cordus

A
  • botanist , physician
  • made diethyl ether from sulfuric acid and ethyl alcohol
  • highly flammable
    Tested on chickens
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11
Q

Sr Christopher Wren and Robert Boyle

A
  • created IV therapy using a goose quill
  • gave a dog ETOH
    Royal society of London members (“give dig a lot of ETOH through vein and he pees”)
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12
Q

Joseph Priestly

A
  • English chemist
    Discovered oxygen
    discovered nitrous oxide
    discovered photosynthesis
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13
Q

Humphry Davy

A

British Chemist
Discovered K, Na, Ca, Mag
suggested N2O for its surgical pain control!!!! (not well received at the time but good for rec)

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14
Q

Horace Walls

A

Dentist
- Supporter of N20–> showed it at Mass general for surgery and noticed its effects on forgetting pain

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15
Q

Andrews

A

Chicago surgeon
N20 and oxygen in anesthesia = no cyanosis

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16
Q

Hewitt

A

1st anesthesia machine with nitrous and oxygen

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17
Q

Crawford Long

A

Delivered ether with pt with 2 neck tumors + administered whiskey

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18
Q

William morton

A

needed ether for dentures

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19
Q

1846- Ether

A

1st successful public demonstration of ether use
- travelled across ocean in 60 days
“lucky” due to no IV, mask leak etc

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20
Q

Dr. Robinson Squibb

A

Developed process for pure ether (1856)
Made Squibb Pharmaceuticals

21
Q

Disadvantages of Ether

A

Flammable, prolonged induction, unpleasant and long lasting odor, high risk of NV

22
Q

Chloroform

A

Discovered independently in 1831 (USA, France, Germany, GB)

23
Q

Sir James Simpson

A

OB in Scotland (MAN CRUSH MONDAY!)
Defined pain as “actual or potential tissue damage”
opposed the religious thought that labor should be painful for women

24
Q

Dr. John Snow

A

Anesthetists- helped use chloroform for Queen Victoria
Discovered the epidemiology of London cholera

25
Chloroform controversy
High death rates in healthy individuals - Hyderabad commissions "safe with certain methods" --> maintained RR better - hepatotoxic in kids Fatal VIFB in light use for people due to adrenaline
26
Cocaine (multiple)
Dr. Koller- anesthestic for eye surgery Dr. Halsted- 1st regional block with coke Dr. Bier- 1st spinal with it and developed bier block
27
Sister Mary Bernard
low pay, intelligent , focused 1st anesthetist
28
Alice Magaw
Mother of anesthesia 14000+ ether cases no deaths
29
Agatha Hodgins
Opened one of the 1st N. Anesthesia schools Founded AANA Developed N20/O2 techniques
30
"Recent" anesthetics
Cyclopropane- violently explosive Halothane- hepatitis, slow onset isoflourane - Relatively safe, less NV, quicker onset than halothane
31
More "Recent" anesthetics
Desoflurane - rapid onset and offset , large quantity needed, High vapor pressure Sevoflurane- intermediate action between iso and des, unstable in lime
32
Edmund Egar
End tidal concentration correlated to movement "MAC" Research on Des
33
The Triad
Amnesia Analgesia Muscle Relaxation
34
Amnesia
Stimulate inhibitory transmissions Inhibit stimulatory transmissions (GABA, ACH)
35
Analgesia
Morphine - from opium Initially not in favor due o high death rate synthetic derivatives--> fent Nowadays meds (narcotics, COX inhibitors, Gabapentin, Tylenol, Peripheral nerve blocks)
36
Muscle Relaxation
Curare- 1942 Decreased amount of anesthesia needed due to relaxation (decreased mortality)
37
Balanced or Stress free anesthesia
muscle relaxation, amnesia, analgesia, HOMEOSTASIS
38
George Crile
Cleveland clinic Light N20/ O2 anesthesia local infiltration of procaine
39
Harvey Cushing
regional blocks prior to emergence from ether anesthetic records - BP/HR measurements
40
Phases of Anesthesia
Preoperative period induction of anesthesia maintenance of anesthesia emergence from anesthesia Post op period
41
Induction of anesthesia
etomidate, ketamine, propofol, narcotics
42
Pre op period
Benzos, H2 blockers, bronchodilators
43
Maintenance of anesthesia
inhalation drugs, NMB, pressers, blockers
44
Emergence from anesthesia
NMB reversal, local anesthesia
45
Stages of anesthesia
Stage I: beginning of induction of general anesthesia to loss of consciousness Stage II: loss of consciousness to onset of automatic breathing Stage III: onset of automatic respiration to respiratory paralysis (surgical plane) Stage IV: stoppage of respiration till death
46
Stage 1
1st plane: no amnesia or analgesia 2nd plane: amnestic but only partially analgesic 3rd plane: complete analgesia and amnesia
47
Stage 2
eyelash reflex disappears coughing, vomiting, struggling may occur irregular respirations with breath-holding
48
Stage 3
1st plane: automatic respiration to cessation of eyeball movements 2nd plane: cessation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increases 3rd plane: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle relaxants 4th plane: complete intercostal paralysis to diaphragmatic paralysis (apnea)
49

Anesthesia Pharm SP 25 (2 decks)

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