intraoperative complications Flashcards
What is the best estimate of body temperature?
Esophageal or rectal temperature
How does anesthesia impair thermoregulation
vasodilated core vessels transfer heat to skin -> heat lost to environment
normally: core vessels vasoconstricted compared to skin
Temp value defining hypothermia versus hyperthermia
hypo = < 98ºF
hyper = > 102.5º
best = esophageal or rectal temps
What is NOT appropriate to use at a sole monitor duing anesthesia and why?
ECG: only tells you electrical activity, nothing about forward flow, BP, etc.
Anticipated problem list for anesthetized patients (6)
How to identify/treat hypoventilation
- ID: RR, chest excursions, ETCO2
- Tx: adjust anesthetic depth, manual/mechanical ventilation
How to identify/treat hypothermia
ID: rectal/esoph. temp
tx: minimize the loss; active warming
How to identify/treat bradycardia
ID: HR
Tx: anticholinergics, sympathomimetic drugs
How to identify/treat hypotension
ID: invasive vs non-invasive sx determines method (doppler, oscillometric versus arterial line)
Tx: adjust anes. depth, fluid bolus, sympathomimmetic drugs (dopamine, dobutamine)
How to identify/treat pain
ID: sympathetic stimulation from sx stimulation
Tx: systemic analgesics
Hypotension value
< 70mmHg
