Introduction ot anesthesia Flashcards
General Anesthesia
Reversible state of unconsciousness secondary to drug effects ont he CNS
Goals of anesthesia
Produce a state of:
unconsciousness
Amnesia
Analgesia
Muscle relaxation
Approach to anesthetic Management
Preoperative patient evaluation
Preparation of equipment
Anesthetic protocol
Monitoring
Recovery
Post-anesthesia evaluation
Preoperative Evaluation
presenting complaint
why does the patient require anesthesia
Preoperative Evalulation
History
Includes all current medications
Pre-existing conditions unrelated to the current problem
Preoperative Evaulation
presenting complaint
history
physical examination
Laboratory data and imaging results
Patient problems by system
Determine ASA status
ASA
American Society of Anesthesiologist
ASA status
system for evaluating patient risk for anesthesia
ASA Classification
1
Normal healthy patient
ASA Classification
2
Patient with mild systemic disease
obesity, geriatric, cranial cruciate rupture
ASA Classification
3
Patient with moderate systemic disease that limits activity but not incapacitating
Dehydration, heart murmur, controlled diabetes, modest anemia
ASA Classification
4
Patient with severe systemic disease that is a constant threat to life
Renal failure, pneumothorax, congestive heart failure
ASA Classification
5
Moribund patient that is not expected to survive with or without the procedure
ASA Classification
E
added to any classification when an emergency procedure applies
Preoperative Evalulation
Goals
Identify any problems that may increase anesthesia risk and take any possible corrective measures
Determine if any current medications should be withheld prior to anesthesia
Always a balance between how soon should we do the procedure and how stable is the patient
Preparation of supplies and equipment
EVERYTHING you will need to anesthetize the patient:
Supplies for IV catheterization
Supplies for ET intubation
Drugs
Anesthetic machine and breathing circuit
Monitoring equipment
Anesthetic record
All should be prepared and ready BEFORE your patient is brought into the room
Premedication
Calm the patient and aid in restraint
Decreases dose of anesthetic induction drugs and agents used to maintain anesthesia
Analgesia
Minimize undesired effects of anesthetics such as: nausea, bradycardia, muscle rigidity
Anesthetic Induction
induce a state of general anesthesia
Intravenous anesthetic agents used for induction: Propofol, ketamine, ketofol, alfaxalone, etomidate
Mask or chamber induction with an inhalant anesthetic is far less common
Facilitates endotracheal intubation
Endotracheal Intubation
Advantages
Airway protection
facilitates postive pressure ventilation
Facilitates administration of inhalant anesthetic
Endotracheal intubation
Equipment
Larnygoscope
Endotracheal tube
Lubricant - water based
Endotracheal tube tie
Lidocaine spray for some species
Guide tube if difficult intubation anticipated
