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Anesthesia Pharmacology > History of Anesthesia > Flashcards

History of Anesthesia Flashcards

Test 1

1
Q

Anesthesia is the lack of ______

A

feeling/sensation

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2
Q

What defines General Anesthesia?

A

A drug induced loss of consciousness ONLY

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3
Q

What are the types of regional anesthesia?

A

Peripheral
Spinal
Epidural

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4
Q

What are the 3 categories of sedation? What things are effected?

A

Minimal (Anxiolysis): This is usually versed in preop. nothing is usually effected, BUT CAN BE.

Moderate: Able to still respond to verbal commands/touch; ventilation = adequate; CVS = usually maintained

Deep: Responsive after repeated/painful stimulation; may need assistance maintaining airway and ventilating; CVS = usually maintained

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5
Q

Acupuncture is associated with _______

A

Asian culture

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6
Q

____________ below Apollo’s temple were used to predict the future

A

Ethylene fumes

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7
Q

___________ was used to temporarily get people to forget painful stimulus

A

carotid compression

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8
Q

Significance: Hippocrates

A

Wanted pt to stop moving to specifically accommodate to surgeon

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9
Q

Significance: Dioscorides

A

1st pharm book:
Materia Medica

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10
Q

What was the 1st pharm book? Describe it

A

Materia Medica

Focused on plants, animals, mineral products
360 medical properties

5 volumes

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11
Q

Significance: Mandragor & wine

A

Hallucinogenic
Human shaped
“magical properties”

Dioscorides had alot of details about this in materia medica

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12
Q

What was used as a reversal agent for inhaled substances in the Middle Ages?

A

inhaled vinegar

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13
Q

What was the 1st true inhalation vapor?

A

Diethyl ether

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14
Q

Significance: Valerius Cordus

A

-Made Diethyl Ether which was very flammable
–Used for recreation dt whiskey tax
-German botanist, physician

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15
Q

Significance: Sir Christopher Wren & Robert Boyle

A

Created IV using goose quill
-used bladder as IV bag
-member of royal society of London members
-learned about metabolism

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16
Q

Significance: Joseph Priestly

A

-Discovered o2, nitrous oxide
-discovered photosynthesis

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17
Q

Significance: Humphry Davy

A

Discovered K, Na, Ca, Mg
-suggested nitrous oxide for pain control

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18
Q

Significance: Horace Wells

A

Dentist
-used nitrous oxide and realized pts had no recall of pain/injury
-self administered for tooth extraction

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19
Q

Significance: Andrews

A

chicago surgeon
-1st person to mix nitrous w/ o2 to prevent hypoxia

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20
Q

Significance: Hewitt

A

1st anesthesia machine with nitrous/oxygen

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21
Q

Significance: Crawford Long

A

Used ether for pt with 2 vascular neck tumors

22
Q

Significance: William Morton

A

Dentist
-Used ether for denture fittings

23
Q

Significance: Robinson Squibb

A

Developed process for pure ether

24
Q

The 1st public demonstration of ether was in _____

A

1846

25
Q

Significance: James Simpson

A

OB doctor
-Didnt want women to have pain during childbirth
-defined pain as “actual or potential tissue damage”

26
Q

Significance: John Snow

A

Anesthetist
-Treated Queen Victoria
-discovered epidemiology when he traced London cholera outbreak to water supply

27
Q

What are considerations with chloroform?

A

Causes hepatotoxicity in children
-light chloroform increases adrenaline –>fatal vtach (deep prevents this)

28
Q

Significance: Levy

A

-light chloroform increases adrenaline –>fatal vtach (deep prevents this)

29
Q

Significance: Guthrie

A

Causes hepatotoxicity in children

30
Q

Significance: Koller

A

Ophthalmologist
-used anesthesia for eye sx

31
Q

Significance: Halsted

A

1st regional (mandibular) nerve block w/ cocaine

32
Q

Significance: August Bier

A

1st spinal w/ cocaine

33
Q

Significance: Mary Bernard

A

1st nurse anesthetist

34
Q

Significance: Alice Magaw

A

“Mother of Anesthesia”
14000 ether cases without death

35
Q

Significance: Agatha Hodgin

A

Opened 1st CRNA school in france
Founded AANA

36
Q

Compare: Cyclopropane
Halothane
isoflurane

A

Cyclopropane: violently explosive

Halothane: cause hepatitis; slow onset/emergence

Isoflurane: relatively safe; less in/V than halothane; quicker onset

37
Q

Significance: Desflurane

A

Rapid uptake and distribution(most rapid onset/offset)
-large quantity needed to achieve anesthesia = expensive

38
Q

Significance: Edmund Egar

A

Anesthesiologist
-experimented w/ Desflurane
-end-tidal concentration correlated to movement

39
Q

Significance: sevoflurane

A

-intermediate action between isoflurane & desflurane
unstable and lime soda
-doesn’t irritate airway

LAST NEW INHALED ANESTHETIC CREATED

40
Q

What is the triad that we want to create in anesthesia consist of? What is this called?

A

Amnesia
Analgesia
Muscle relaxation

“balanced anesthesia”

41
Q

Curare is a ______neuromusclar blocker. ________ is based off this drug.

A

Non-depolarizing

Succs

42
Q

Significance: Liston

A

Sx longer than 20 mins = death
-Killed 3 people in 1 operation (1 pt & 2 assistants)

43
Q

Significance: George Crile

A

local infiltration of procaine
-has instrument named after him

44
Q

Significance: Harvey Cushing

A

big on data collection
- anesthetic records
-BP/HR measurements

45
Q

What are the 5 phases of anesthesia?

A
  1. Preoperative
  2. Induction.
  3. Maintenance.
  4. Emergence.
  5. Postoperative.
46
Q

How many stages are there in anesthesia?

A

4

47
Q

What is stage 1 of anesthesia?

A

Beginning of induction to loss of consciousness:

1st plane: no meds

2nd plane: amnestic; partially analgesic

3rd plane: Loss of conscioisness (complete analgesia/amnesia)

48
Q

What is stage 2 of anesthesia?

A

Loss of consciousness to onset of automatic breathing

-eyelash reflex disappears
-coughing, vomiting and irregular respirations may occur

49
Q

What are considerations do we need to have during stage 2 of anesthesia?

A

Risk for aspiration
-risk for Laryngospasm
- decreased HR/CO

want to get out this stage as quickly as possible
no stimulation during this stage

50
Q

What is stage 3 of anesthesia?

A

Onset of automatic respirations to respiratory paralysis

1st plane: automatic respiration to sensation of eyeball movements

2nd: sensation of eyeball movements to beginning of intercostal muscle paralysis; secretion of tears increase

3rd: beginning to completion of intercostal muscle paralysis; pupils dilate; desired plane prior to muscle relaxant

4th: complete intercostal paralysis to diaphragm paralysis

51
Q

What stage are we able to begin surgery in?

A

Stage 3

52
Q

What is stage 4 of anesthesia?

A

Stoppage of respiration till death

don’t want to get here; sedation too deep

Anesthesia Pharmacology (4 decks)

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