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Oral surgery II 2020 > IV sedation > Flashcards

IV sedation Flashcards

1
Q

What is the minimal number of available personnel that should be around when doing sedation?

A

-Three

the operator, the assistant, and the monitor

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2
Q

The doctor must be certified how when doing sedation?

A

-ACLS

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3
Q

What happens to the airway when doing minimal sedation?

A

-It is unaffected

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4
Q

In spontaneous ventilation what occurs in minimal sedation?

A

-It is unaffected

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5
Q

What occurs with cardiovascular function in minimal sedation?

A

-It is unaffected

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6
Q

What type of responsiveness is seen in minimal sedation?

A

-Normal response to verbal stimulation

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7
Q

What is the responsiveness in moderate sedation?

A

-Purposeful response to verbal or tactile stimulation

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8
Q

What happens to the airway in moderate sedation?

A

-No intervention required

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9
Q

What type of spontaneous ventilation do you get in moderate sedation?

A

-Adequate

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10
Q

What occurs with cardiovascular function in moderate sedation?

A

-Usually maintained

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11
Q

What occurs with cardiovascular function in deep sedation?

A

-Usually maintained

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12
Q

What occurs with cardiovascular function in general anesthesia?

A

-May be impaired

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13
Q

What type of spontaneous ventilation do you get in deep sedation?

A

-May be inadequate

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14
Q

What type of spontaneous ventilation do you get in general anesthesia?

A

-Frequently inadequate

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15
Q

In deep sedation what might you need to do with the airway?

A

-You may need intervention

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16
Q

In general anesthesia what might you need to do with the airway?

A

-Intervention is often required

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17
Q

What is the responsiveness of someone under deep sedation?

A

-Purposeful response following repeated or painful stimulation

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18
Q

What is the responsiveness of someone under general anesthesia?

A

-Unarousable even with painful stimulus

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19
Q

What may accentuate hemodynamic/respiratory depression caused by sedatives and analgesics?

A

-Cardiopulmonary disease

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20
Q

If a person has cardiopulmonary disease what might that require?

A

-decreased drug dosages and EKG monitoring

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21
Q

What increases airway irritability and risk of bronchospasm during sedation?

A

-Tobacco use

22
Q

What classification system is used to asses airways?

A

-Mallampati

23
Q

If a person is a Mallampati Class I what do you see?

A
  • Soft palate
  • Uvula
  • Pillars visible
24
Q

What can you see in a Mallampati Class II?

A
  • Soft Palate

- Uvula

25
Q

What can you see in a Mallampati Class III?

A
  • Soft palate

- Base of uvula

26
Q

What can you see in a mallampati Class IV?

A

-Soft palate not visible at all

27
Q

What thyromental distance is a nonreassuring finding during airway PE?

A

-less than 3 ordinary finger breadths

28
Q

How long should you not eat before being sedated?

A
  • 8 hours if fried fatty foods/ meat

- 6 hours if a light meal

29
Q

What things are required when monitoring the pt under sedation?

A
  • Pulse oximeter
  • Sphygmomanometer
  • EKG
  • Capnography
30
Q

What is normal ETCO2?

A

35-45mmHg

31
Q

What are medications used for sedation?

A
  • Opioids
  • Benzodiazepine
  • Barbiturates
  • Propofol
  • Ketamine
  • Reversal agents
32
Q

What do opioids provide?

A
  • Analgesia

- Sedation

33
Q

Where can opioids acccumulate?

A

-Reservoirs of fate potentially producing long lasting effects

34
Q

Morphine is how many times more potent than meperidine?

A

-10 x

35
Q

Morphine is how many time less potent than hydromorphone?

A

-10 x

36
Q

Morphine is how many times less potent than fentanyl?

A

-100x

37
Q

What is the average dose of Fentanyl?

A

50-100 mcg

38
Q

What is the duration of Fentanyl?

A

-.5 to 1 hour

39
Q

What are the effects of benzodiazepines?

A
  • Amnesia
  • Anticonvulsant
  • Anxiolytic
  • Behavioral disinhibition
  • Muscle relaxant
40
Q

What might cause thrombophlebitis?

A
  • Diazepam

- Lorazepam

41
Q

What is likely to produce apnea?

A

-Midazolam

42
Q

What drug carries an increased risk of progression to deep sedation?

A

-Propofol

43
Q

What does propofol do?

A
  • Sedation
  • Amnesia
  • NO analgesia
44
Q

What is a dissociative anesthetic?

A

-Ketamine NMDA antagonist

45
Q

What is ketamine a derivative of?

A

-Phencyclidine

46
Q

T/F Ketamine is a potent pain reliever.

A

True

47
Q

What might ketamine cause?

A
  • Nystagmus
  • Vocalizations
  • Myoclonus
48
Q

What is an opioid antagonist which binds to CNS opioid receptors to displace opioid agonists?

A

-Naloxone

49
Q

What is a reversal agents that binds to GABA receptors in the CNS to reverse effects of benzodiasepines

A

-Flumazenil

50
Q

What dose of flumazenil do you need to give to reverse benzodiazepines?

A

-.1 and .2 mg

51
Q

What dose of Naloxone do you need to give to reverse opioids?

A

-.02 to .04 mg

52
Q

What sedatives have no reversal agents?

A
  • Propofol

- Ketamine

Oral surgery II 2020 (12 decks)

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