Perioperative

Question 1

Name the perioperative effects of hypothermia (10)

Answer 1

• Hypoxia
• myocardial arrhythmia
• myocardial ischaemia
• Rewarming shock
• increased blood loss
• increased blood transfusion
• increased urinary nitrogen excretion
• increased duration of action of muscle relaxants
• prolonged emergence from anaesthesia
• prolonged stay in post anaesthetic recovery unit
• increased incidence wound infection
• Impaired wound healing
• increased post-op pain

Question 2

Who is “in charge” of the theatre room?

Answer 2

Scrub sister

Question 3

Name the Guedel classification of stages of anaesthesia

Answer 3

1 analgesia and amnesia induction
2. Delirium , excitement and unconsciousness (inbetween stage, risk laryngospasm )
3. Surgical anaesthesia: deep enough for stimulation
4. Respiratory paralysis, cardiovascular collapse - overdose

Question 4

Name 6 causes hyperthermia

Answer 4

(>37,5-38,3)
• drugs eg atropine
• blood transfusion reaction
• infection/sepsis
• medical disorder eg thyrotoxicosis
• malignant hyperthermia
• over - zealous warming efforts

May → heat stroke

Question 5

Benefit of trendelenberg position?

Answer 5

(Feet higher than head)
• Improve venous return to heart
• prevent aspiration of regurgitated matter

Complications: airway and facial edema, brachial plexus injury

Question 6

Benefit of ante trendelenberg position?

Answer 6

Head higher than feet
• decrease venous return to heart