Inhaled Anesthetics, NMBD

Question 1

Halothane
Blood:Gas Partition Coefficient
MAC
Vapor Pressure

Answer 1

B:G = 2.54
MAC = 0.75%
Vapor Pressure = 243 torr

Question 2

Enflurane
Blood:Gas Partition Coefficient
MAC
Vapor Pressure

Answer 2

B:G = 1.90
MAC = 1.63%
Vapor Pressure = 175 torr

Question 3

Isoflurane
Blood:Gas Partition Coefficient
MAC
Vapor Pressure

Answer 3

B:G = 1.46
MAC = 1.17%
Vapor Pressure = 238 torr

Question 4

Nitrous Oxide
Blood:Gas Partition Coefficient
MAC

Answer 4

B:G = 0.46
MAC = 104%

Question 5

Desflurane
Blood:Gas Partition Coefficient
MAC
Vapor Pressure

Answer 5

B:G = 0.42
MAC = 6.6%
Vapor Pressure = 669 torr

Question 6

Sevoflurane
Blood:Gas Partition Coefficient
MAC
Vapor Pressure

Answer 6

B:G = 0.69
MAC = 1.8%
Vapor Pressure = 157 torr

Question 7

1 Hz/second decreasing to 0.1 Hz q 10 seconds

Answer 7

Single Twitch

Question 8

3 short bursts followed by 3 short bursts
Uses 50 Hz

Answer 8

Double Burst

Question 9

4 stimuli at 2 Hz in ½ second

Answer 9

Train of Four

Question 10

Very rapid, 50 Hz for 5 seconds – Continuous

Answer 10

Tetanic Stimulation

Question 11

Single twitch 3 seconds after tetanic stimulation

Answer 11

Post-Tetanic Stimulation

Question 12

Succinylcholine:
Dose
Onset
Duration

Answer 12

1 - 1.5 mg /kg IV
Onset - 30 to 60 seconds
Duration - 3 to 5 minutes

Question 13

Lower Dibucaine # indicates what?

Answer 13

Prolonged Succinylcholine effects - No butyrylcholinesterase

Question 14

High Dibucaine # indicates what?

Answer 14

Normal response to Succinylcholine

Question 15

Dantrolene
Use
Dose
Max dose

Answer 15

Malignant Hyperthermia
2 mg/kg IV
Max dose 10 mg/kg IV

Question 16

MACawake

Answer 16

0.3-0.5 MAC

Question 17

MAC-BAR

Answer 17

1.7-2.0 MAC

Question 18

For each decade above 50 years old, MAC decreases by..

Answer 18

6%

Question 19

Pancuronium (Pavulon)
Intubating Dose:
Onset:
Duration:
Short or long-acting?

Answer 19

Intubating Dose: 0.1 mg/kg
Onset: 3-5 mins
Duration: 60-90 mins
Most common long-acting NMBD

Question 20

What are the four intermediate-acting NMBDs?

Answer 20

Vecuronium
Rocuronium
Cisatracurium
Atracurium

Question 21

Vecuronium (Norcuron)
Intubating Dose:
Onset:
Duration:

Answer 21

Intubating Dose: 0.1 mg/kg
Onset: 3-5 mins
Duration: 20-35 mins

Question 22

Rocuronium (Zemuron)
Intubating Dose:
Onset:
Duration:

Answer 22

Intubating Dose: 0.6 mg/kg or 1.2 mg/kg
Onset: 3-5 mins; 1-2 mins with a larger dose
Duration: 20-35 mins

Question 23

Cisatracurium (Nimbex)
Intubating Dose:
Onset:
Duration:

Answer 23

Intubating Dose: 0.1 mg/kg
Onset: 3-5 mins
Duration: 20-35 mins

Question 24

Mivacurium (Mivacron)
Intubating Dose:
Onset:
Duration:

Answer 24

Intubating Dose: 0.15 mg/kg
Onset: 2-3 mins
Duration: 12-20 mins

Not used much anymore - “move-a-curium”

Question 25

What muscle are the best indicators of diaphragmatic and laryngeal neuromuscular blockade?

Answer 25

Orbicularis Oculi & Corrugator Supercilli (Facial nerve)

Question 26

What muscle is most resistant to neuromuscular blockade?

Answer 26

Diaphragm

Question 27

What muscle is the gold standard for determination of NMB recovery?

Answer 27

Adductor Pollicis (ulnar nerve)

Question 28

What four factors determine how much a muscle is subject to neuromuscular blockade?

Answer 28

• # of presynaptic ACh vesicles
• # of postsynaptic ACh receptors
• Blood flow to muscle
• NMB potency

Question 29

Faster onset of neuromuscular blockade to a muscle means that that muscle experiences a ____ recovery.

Answer 29

Slower