ppt 12 Anesthesiology Flashcards
What is the definition of anesthesia?
Anesthesia is the process of blocking the perception of pain and other sensations. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience.
What are the 3 types of anesthesia?
- General
- Local
- Regional
Describe general anesthesia.
reversible loss of consciousness
Choice of drugs:
Total IV anesthesia
Balanced anesthetic
Airway and Ventilation control: Oral and nasal airways Mask anesthesia LMA Endotracheal intubation
Describe local anesthesia.
reversible loss of sensation in a (small) part of the body by localized administration of anesthetic drugs at the affected site.
Describe regional anesthesia.
focus on these according to Bob’s review
reversible loss of sensation and possibly movement in a region of the body by selective blockade of sections of the spinal cord or nerves supplying the region
Epidural Anesthesia
Spinal Anesthesia
Regional Block
Bier Block
What are the goals of anesthesia?
Analgesia Sedation Reversible loss of consciousness Amnesia Muscle relaxation Hemodynamic stability Fast recovery
Describe the continuum of sedation.
just review - not specifically mentioned in Bob’s review
1.Minimal sedation (anxiolysis)
Normal response to verbal commands
Normal cardiovascular and respiratory status
2. Moderate sedation (conscious sedation)
Purposeful response to verbal commands
Maintained airway, ventilation, cv-status
3. Deep sedation
Pt cannot be easily aroused
Purposeful response to repeat or painful stimulation
Airway and ventilation may be impaired
Cardiovascular-status maintained
4. General anesthesia
Loss of consciousness
Airway and ventilation may need to be secured and maintained
Cardiovascular-status may be impaired
Epidural anesthesia effects:
Block of sensation of affected dermatomes Motor block of affected dermatomes Block of pain Block of sympathetic response Block of vagal response
Epidural anesthesia contraindications:
Relative contraindications:
Patient unable to comprehend procedure
Prior back surgery or back pain
Fixed cardiac output states (AS)
Absolute contraindications: Patient refusal Infection of skin Sepsis Patient anticoagulated Increased intracranial pressure
Positives of Epidural Anesthesia:
Positives: Patient awake No depression of baby Postoperative analgesia Postoperative breathing Less risk of thrombosis Earlier intestinal motility No intubation
Negatives of Epidural Anesthesia:
Negatives: Failure of block Bleeding Infection Wet tap Bradycardia Hypotension Breathing difficulty
Spinal anesthesia effects:
One shot Continuous spinal anesthesia Bilateral block Unilateral block Speed of onset Possibility of high spinal
Spinal anestesia contraindications:
Same as for epidural anesthesia
Additional risk for heart failure patients
due to increase in preload as block weans
Additional risk of sympathetic activation when block wears off
Risk if muscle relaxation is needed
Names the types of Regional Blocks.
- Peripheral nerve blocks
- Brachial plexus block
- Interscalene
- Infraclavicular
- Lumbar plexus block
- Continuous Nerve Sheath catheter
Good Job!
Make sure you also check out the reading =)
