I.V. anesthetics

Question 1

name the IV Anesthetics

(“Ivy on all damn poles”)

Answer 1

Propofol
(Introducing Prospero “fall asleep” the hypnotist)

Etomidate
(Introducing the beast from the east “THE INTIMIDATOR”)

Ketamine
(Introducing “snaKE TAMINg” nomad )

Benzodiazepines
(“Ben’s Diner”)

Thiopental
(“The ol’ quick shave”)

Question 2

Propofol

(prospero “fall asleep” the hypnotist)

Answer 2

-potentiate chloride current through the GABA-A receptor complex
(“old Cab-A behind prospero’s stand”)

-can be used for induction of anesthesia
(introducing prospero “fall asleep” the hypnotist)

-can be used for maintenance of anesthesia
(sign next to prospero says :”try to MAINTAIN your sanity!”)

-propofol cause profound vasodilation (arterial+venous)

Question 3

Etomidate

(“introducing the beast from the east the INTIMIDATOR”)

Answer 3

-potentiates chloride current through the GABA-A receptor complex
(“old Cab-A behind the INTIMIDATOR stand”)

-is an IV anesthetic for induction
(“introducing the intimidator”)

-Etomidate preserves cardiovascular stability
(“the buffy intimidator stabilizes the patient “)

Question 4

Ketamine

(“snaKE TAMINg)

Answer 4

-inhibits the NMDA receptor complex which is a glutamate receptor and ion channel
(“hitched nomadic camel”)

-can be used for induction of anesthesia
(“introducing the snaKE TAMINg nomad”)

-causes “dissociative anesthesia”
(“man looking in snakes eye causing dissociative trance”)

-can cause unpleasant emergence reactions

• vivid colorful dreams
  (“colorful steam from snakes bucket”)
• ​hallucinations
• ​out of body experiences

​-can cause cardiovascular stimulation{Incr.BP HR CO}
(“stimulated cobra’s head shaped like heart”)

Question 5

Benzodiazepines

(“Ben’s Diner”)

Answer 5

Midaz-olam ,
Loraze-pam

-IV anestheic used preoperatively

-used for conscious sedation for minor procedures such as colonoscopy
(“bowel water pump outside Ben’s Diner”)

Question 6

Barbiturates

(“Barber’s shop)

Answer 6

-Thiopental has rapid onset and short duration of action since it is highly lipid soluble
(“The Ol’ quick shave”)

-IV Anesthetic used for induction of anesthesia
(“Introducing the BARBER SWEENY PENTAL”)

Question 7

Neurolept Analgesia

Answer 7

Neuroleptanalgesia

• a state of analgesia ,sedation, muscle relaxation BUT no loss of consciousness
• Fentanyl + Droperidol
• contraindicated in parkinsonism
• useful during diagnositc procedures requiring cooperation of the patient

Neuroleptanesthesia

• Fentanyl+Dorperidol, Nitrous oxide
• addition of NO improves amnesia

Question 8

Peri-operative medications

Answer 8

Before surgery

-IV. Barbiturates - Thiopental (“the ol’ quick shave”)
-Sedative/Anxiolytic Benzodiazepine -Diazepam (“long tapering flag”)
-Antimuscarinic - parasympatholytic agent -Atropine(“alice”)
-Analgetics - Opiods (fentanyl) non opioids
—————————————————————————————————
During surgery
-NMB- Succinylcholine (depolarizing) / Curare derivatives ( non-depolarizing)
-Pressors in case of shock - Norepinephrine
—————————————————————————————————
After surgery
-If opioids were used before surgery - non-opioids should be used
-antagonism of NMB -Neostigmine
-antagonism for opioids if respiration is too slow - Naloxone