Principals of Anesthesia

Question 1

Anesthesia Definition

Answer 1

Anesthesiais a state of reversible loss of sensation and unconsciousness

There are many agents, including alcohol, which will achieve some level of anesthesia

Question 2

Stages of Anesthesia

Answer 2

Stage 1-Analgesia

Stage 2- Delirium/Excitement

Stage 3-Surgical Anesthesia

Stage 4-Impending Death

Question 3

Stage 1 of Anesthesia

Answer 3

Analgesia

Induction Phase

Beginning of drowsiness to the loss of the eyelash-flick response

Question 4

Stage 2 of Anesthesia

Answer 4

Delirium/Excitement

Agitation, irregular respirations, delirium, salivation, dilated pupils, leading to regular (or brain stem) respirations

Potentially dangerous laryngospasm, vomiting, HTN, tachycardia

Want to move the patient out of this phase as fast as possible

Question 5

Stage 3 of Anesthesia

Answer 5

Surgical Anesthesia

This is where the work get done

There is four planes in this stage

Question 6

Stage 4 Anesthesia

Answer 6

Impending Death/Overdose

Circulatory collapse signifies overdoes/medullary dysfunction

Question 7

Planes of Stage 3 (Surgical Anesthesia)

Answer 7

Plane 1: From the return of regular respiration to the cessation of REM

Plane 2: From the cessation of REM to onset of paralysis of the intercostal muscles

Plane 3: From partial intercostal to full intercostal paralysis

Plane 4: From full intercostal paralysis to full diaphragmatic paralysis, and therefore apnea

Question 8

eyelash-flick response

Answer 8

When you brush the eyelash to see if the eyelid moves

Question 9

General Anethesia Functions

Answer 9

Unconsciousness-Patient may well be oblivious to all sensation but autonomic reflex to pain may still occur

Analgesia-Areflexia-Reaction to pain, tachycardia, diaphoresis, etc. will all be reduced or absent

Muscle Relaxation-Surgery on extremities will require minimal relaxation where thoracic/abdominal requires profound relaxation of all muscle groups

Question 10

Sedation

Answer 10

CNS depression and drowsiness;

Unlikely to be aware of surroundings

Question 11

Nociception

Answer 11

Neural process of encoding noxious stimuli, does not require consciousness

Question 12

Balanced anesthesia

Answer 12

Induced by use of multiple drugs targets to attenuate individual components of anesthesia

Question 13

What would result from delivering atmospheric air for anesthesia?

Answer 13

Hypoxia- due to hypoventilation and V/Q mismatch caused by anesthetics

Question 14

Metabolic O2 requirement

Answer 14

5-10mL/kg/min

Represents the minimum O2 flow required

Question 15

Yellow Cylinders

Answer 15

Medical Air