local and general anesthetics (exam 3) Flashcards
with local anesthetics, what will be affected?
-temp
-touch
-proprioception
-muscle tone
what is our example local anesthetic?
lidocaine
what anesthetic blocks nerve conduction, which blocks pain signal conduction
local anesthetic (lidocaine)
what are adverse effects of local anesthetic (lidocaine)
***increased effect with epinephrine
vary based on route
burning/pain at application site
n/v and shivers
what are contraindications of local anesthetic (lidocaine)
cardiac abnormalities
what are the methods of administration for local anesthetics?
topical, field block, nerve block
what method of local anesthetic administration is ointment or drops to skin/mucous membranes
topical
what are examples of topical anesthetics?
sunburn cream, sore throat spray, pain patches
what method of local anesthetic administration is a barrier around the surgical site?
field block
when would a field block local anesthetic be used?
tooth extraction
what method of local anesthetic administration is blocking a large nerve plexus?
nerve block
what are examples of nerve block local anesthetic?
epidural, spinal block
topical anesthetics take how long to work?
20 mins
what do you have to monitor when using small doses of lidocaine?
cardiac system
what is an important patient education for local anesthetics?
fall risk
what is the rational for withholding drink after local anesthetic to mouth/throat?
prevent aspiration
what is medication induced unconsciousness with loss of protective reflexes?
general anesthesia
what are the goals of general anesthesia?
-amnesia: memory loss
-analgesia: no pain
-hypnosis: unconsciousness
-immobility: muscle relax
using several drugs to reach anesthetic goal
balanced anesthesia
what are the 3 phases of general anesthesia?
1) induction
2) maintenance
3) emergence
what stage of general anesthesia is where the patient becomes unconscious
induction
what phase of general anesthesia is during the procedure?
maintenance
what meds are given during the maintenance phase of general anesthesia?
anti-emetics, opioids, or neuromuscular blocking agents
what phase of general anesthesia is where the procedure ends?
emergence
what are the 5 drug classes for balanced anesthesia?
-benzodiazepines
-analgesics
-inhaled anesthetics
-IV anesthetics
-neuromuscular blocking agents
what is our example inhaled anesthetic?
isoflurane
which general anesthetic diffuses from the lungs, effecting neurotransmitters systemically
inhaled anesthetics (isoflurane)
what general anesthetic is used for induction or maintenance of anesthesia?
inhaled anesthetics (isoflurane)
what are adverse effects of inhaled anesthetics (isoflurane)?
**malignant hyperthermia
CV/resp depression
airway irritaion
what is the antidote for malignant hyperthermia?
dantrolene
what are contraindications of inhaled anesthetics (isoflurane)
history of familial malignant hyperthermia
what is our example IV general anesthetic?
propofol
what general anesthetic causes depression of CNS and blocks perception of pain
IV anesthetic (propofol)
what general anesthetic is used for rapid induction of anesthesia (less than a minute)
IV anesthetic (propofol)
what is the recovery time for IV anesthetic (propofol)
10 mins
what are adverse effects of IV anesthetic (propofol)
pain and burning at IV site
what are contraindications of IV anesthetic (propofol)
allergy to soy, egg, or preservatives
what is our example neuromuscular blocking agent?
VECURONIUM, succinylcholine
what is used to suspend nerve impulses leading to paralysis?
neuromuscular blocking agents (vecuronium)
what is used to relax muscles during anesthesia
-also used during intubation and mechanical ventilation
neuromuscular blocking agents (vecuronium)
what are adverse effects of neuromuscular blocking agents (vecuronium)
allergic reactions
what are contraindications of neuromuscular blocking agents (vecuronium)
allergies
what are the administration routes of neuromuscular blocking agents (vecuronium)
IVP or IV drip
what is the onset of neuromuscular blocking agents (vecuronium)
3-5 mins
what is the duration of neuromuscular blocking agents (vecuronium)
25-40 mins
which adjuvant med for anesthesia is used to produce anesthesia, reduce anxiety, help sedation, and can cause hypnosis?
benzodiazepines (midazolam)
what is our example benzodiazepine as used in anesthesia?
midazolam
what is the antidote for midazolam (benzo)
flumazenil
what is our example analgesic as used in anesthesia?
fentanyl
what is our adjuvant anesthesia med that is 100x stronger than morphine used for analgesia
fentanyl
what is the antidote for fentanyl
naloxone
nurse in OR declares malignant hyperthermia emergency. which are symptoms of it?
-muscle rigidity
-bradycardia
-hypokalemia
-increased urine
muscle rigidity
pt. coming for colonoscopy will have propofol for sedation. which allergies should nurse report?
-strawberries
-peanuts
-shrimp
-eggs
eggs
