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Anesthesia Pharmacology > Lecture 1 History of Anesthesia Test 1 > Flashcards

Lecture 1 History of Anesthesia Test 1 Flashcards

1
Q

What is Anesthesia?

A

Artificially induced loss of the ability to feel pain/ lack sensation or feeling to permit the performance of surgery.

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2
Q

What is General Anesthesia?

A

A legal drug-induced loss of consciousness, not arousable even under painful stimuli.
Independent ventilatory function impared.

Maintain patent airway, PPV, CV support

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3
Q

What is Regional Anesthesia?

A

Insensibility is caused by interrupting the sensory nerve conduction of a particular region of the body. (Peripheral, Spinal, Epidural).

The level of consciousness is unchanged, the airway is protected.

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4
Q

What are the three spectrums of sedation?

A

Minimal, Moderate, and Deep

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5
Q

Under minimal sedation what is the patient’s
Responsiveness:
Airway condition:
Spontaneous Ventilation condition:
CV function:

A

Under minimal sedation what is the patient’s
Responsiveness: To verbal commands
Airway condition: Unaffected
Spontaneous Ventilation condition: Unaffected
CV function: Unaffected

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6
Q

Under moderate sedation what is the patient’s
Responsiveness:
Airway condition:
Spontaneous Ventilation condition:
CV function:

A

Under moderate sedation what is the patient’s
Responsiveness: To verbal and touch
Airway condition: No assistance is needed
Spontaneous Ventilation condition: Adequate
CV function: Usually maintained.

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7
Q

Under deep sedation what is the patient’s
Responsiveness:
Airway condition:
Spontaneous Ventilation condition:
CV function:

A

Under deep sedation what is the patient’s
Responsiveness: After repeated painful stimuli
Airway condition: Assistance might be required
Spontaneous Ventilation condition: Possibly inadequate
CV function: Usually maintained

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8
Q

During the time of ______________ (person). The most important person in the operating room was the surgeon. The patient was to do everything they could to make it easy on the surgeon.

A

Hippocrates

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9
Q

Who wrote the Materia Medica?

What is the Materia Medica?

A

Dioscorides

First pharmacology book, 5 volumes long, 360 medical properties.

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10
Q

What human-shaped plant was used as a hallucinogenic and believed to have magical properties?

A

Mandragora

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11
Q

What was the main method of delivering anesthetics during the middle ages?

A

Soporific sponges

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12
Q

Who combined sulfuric acid and ethyl alcohol to make Diethyl Ether and tested it on chickens?

A

Valerius Cordus

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13
Q

Who created IV access using a goose quill and tested the administration of alcohol in a dog’s vein?

A

Sir Christopher Wren
Robert Boyle

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14
Q

Who discovered Oxygen, Nitrous Oxide, and Photosynthesis?

A

Joseph Priestly

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15
Q

Who discovered our elements (K+, Na+, Ca2+, Mg2+) and suggested the use of nitrous for surgical pain control?

A

Humphry Davy

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16
Q

Who was a dentist known for using nitrous on their patients that experience no recall of pain/injury?

A

Horace Wells
-Self administered for tooth extraction
-arranged administration of nitrous for amputation at Mass general

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17
Q

Who was the Chicago surgeon to first administer nitrous with oxygen without cyanosis?

A

Andrews

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18
Q

Who was the first person to develop the first anesthesia machine with nitrous and oxygen?

A

Hewitt

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19
Q

Who was the doctor that delivered ether for a patient with 2 vascular neck tumors?

A

Crawford Long

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20
Q

Which dentist used ether for denture fittings?

A

William Morton

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21
Q

What year was the first successful public demonstration of ether? The patient was motionless and had no recall.

Who performed this procedure at Mass General?

A

1846

Letheon spread to England in 60 days

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22
Q

Who developed a process for purifying ether and founded a pharmaceutical from this?

A

Robinson Squibb

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23
Q

Name 4 disadvantages of ether.

A

Flammable
Prolonged induction
Bad Odor
N/V (high incidence)

24
Q

What anesthetic was independently discovered in 1831 in the US, France, Germany, and Great Britain?

A

Chloroform

25
Q

Who was an obstetrician in Scotland that defined pain and justified the use of anesthetics from a quote from Genesis?

A

Sir James Simpson

26
Q

Who was a full-time anesthetist that discovered epidemiology when traced cholera outbreak to a water source

A

John Snow

also attended queen victorias births

27
Q

Due to the big number of deaths from chloroform, the ____________ Commission met to discuss the use of this anesthetic.

A

Hyderabad

28
Q

Who proved that children got hepatotoxicity from chloroform?

A

Guthrie

29
Q

Who discovered that receiving a light amount of chloroform stimulated the ANS and can lead to V-fib in animals?

A

Levy

30
Q

Which doctor used cocaine as an anesthetic for eye surgery?

A

Dr. Koller

31
Q

Which doctor first used cocaine as a regional mandibular nerve block?

A

Dr. Halsted

32
Q

Which doctor first used cocaine as a spinal anesthetic?

A

Dr. Bier

33
Q

Who was the first nurse anesthetist?

A

Sister Mary Bernard

34
Q

Who was the mother of anesthesia that had 14,000 anesthetic cases without a single death?

A

Alice Magaw

35
Q

Who opened one of the first nurse anesthetist schools and founded the AANA?

A

Agatha Hodgins

36
Q

What anesthetic was introduced in 1934 that was violently explosive?

A

Cyclopropane

37
Q

What anesthetic was introduced in 1956 had a slow onset and many patients developed hepatitis from this?

A

Halothane

38
Q

Which anesthetic was introduced in 1981 that is relatively safe and patients experience less N/V. Due to the slow onset, this drug is not typically used for outpatient procedures.

A

Isoflurane

39
Q

Which anesthetic has rapid uptake and distribution (most rapid onset and offset), high vapor pressure, and requires a large quantity to achieve anesthesia?

A

Desflurane

Great for outpatient surgery

40
Q

Who was the doctor known for his experimentation on desflurane? Discovered end-tidal concentration correlated to movement and determined the concentration of MAC.

A

Edmund Egar

41
Q

Which anesthetic has an intermediate action between isoflurane and desflurane? Considered to be unstable in soda lime and toxic degradation product concerns.

A

Sevoflurane

The latest anesthetic, great for asthmatics no airway irritation

42
Q

What is the anesthesia triad?

A

Amnesia
Analgesia
Muscle Relaxation

43
Q

What are two ways our drugs can cause amnesia?

A

Stimulate inhibitory transmissions
Inhibit stimulatory transmission
through GABA and Ach

44
Q

What drugs are used in multi-modal pain relief?

A

Cyclooxygenase Inhibitor
Peripheral Nerve Blocks
Acetaminophen
Narcotics (Limited)
Gabapentin

C PANG

45
Q

What will decrease the amount of anesthetic needed due to relaxation?

A

Muscle relaxant

Curare plant from South America

46
Q

Which doctor is responsible for 3 deaths in one operation?

A

Dr. Liston

47
Q

Which doctor worked in the Cleveland Clinic and used light nitrous/oxygen anesthesia and local infiltration of procaine?
He was a forerunner of preemptive analgesia.

A

George Crile

48
Q

Who administered regional blocks prior to emergence from ether and developed early anesthetic records, BP/HR measurements.

A

Harvey Cushing

49
Q

What is neuroleptic anesthesia?

A

The use of high doses of amnestics (Haldo, droperidol). Block autonomic and endocrine responses to stress.

High incidences of awareness, dysphoria, extrapyramidal movements

50
Q

Which doctor developed a reference chart for the stages of anesthesia, using pictures and words.

A

Dr. Guedel

51
Q

What is the first stage of anesthesia?

What are the 3 planes involved in stage 1?

A

Stage 1: Beginning of induction of general anesthesia to loss of consciousness

1st plane: no amnesia or analgeis
2nd plane: amnesia, but only partial analgesia
3rd plane: complete amnesia and analgesia

52
Q

What is the second stage of anesthesia?

What happens here?

A

Stage 2: Loss of consciousness to the onset of automatic breathing.

Eyelash reflex disappears
Coughing, vomiting, and struggling may occur
Irregular respiration with breath-holding

Highest chance of aspiration in this stage

53
Q

Extubation during which stage of anesthesia will result in bronchospasm?

A

Stage 2

54
Q

What is the third stage of anesthesia?

What are the 4 planes in stage 3?

A

Stage 3: Onset of automatic respiration to respiratory paralysis (surgical plane)

Plane 1: Automatic respiration to the cessation of eyeball movements
Plane 2: Cessation of eyeball movements to the beginning of intercostal muscle paralysis; secretion of tears increase
Plane 3: Beginning to complete intercostal muscle paralysis; pupils dilate; desire plane before NMB.
Plane 4: Complete intercostal paralysis to diaphragmatic paralysis (apnea).

55
Q

What is the fourth stage of anesthesia?

A

Stoppage of respiration till death

Too much anesthetics given

Anesthesia Pharmacology (20 decks)

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