Special Situations Flashcards
What is the most common electrolyte abnormality in brain dead organ donors?
hypernatremia
What induction agent is helpful in patients with previously failed ECT due to short seizure duration?
etomidate increases seizure duration
What is the cardiovascular response to ECT?
Early parasympathetic response lasting ~10 seconds
Late and prolonged sympathetic response
Why is methohexital ideal for ECT?
Short duration
Does not raise seizure threshold
When do lidocaine levels peak after tumescent solution is used for liposuction?
6 hours after administration
What is the maximum dose of lidocaine in tumescent anesthesia?
35-55 mg/kg
How does obesity lead to eccentric LVH?
LVEDV increases to increase SV and, thus, CO to perfuse a larger body
What happens to the volume of distrubution for lipophilic and hydrophilic drugs in obese patients?
both increase, but a larger increase is seen for lipophilic drugs (e.g., midazolam, fentanyl, barbiturates)
How should propofol infusions be dosed in obese patients?
induction dose based on ideal body weight
infusion dose based on total body weight
Why do elderly patients tend to have lower HR?
decreased adrenergic receptor sensitivity
increased vagal tone
Why do elderly patients develop diastolic dysfuntion?
increased SVR due to arterial stiffness leads to LVH and a less compliant LV
What happens to the normal value of PaO2 in elderly patients?
PaO2 = 110 - (age x 0.4)
How is the duration of epidural anesthsia affected in the elderly? Spinal anesthesia?
epidural anesthesia is higher and denser but has a similar duration
spinal anesthesia lasts longer
What are the components of the Aldrete recovery score in PACU?
oxygen saturation
respirations
circulation
consciousness
activity
