Surg 102 Chapter 24 (B&K)--Part 1 Flashcards
Anesthesia is a specialty that requires knowledge of _____, _____, _____, and _____.
biochemistry, clinical pharmacology, cardiology, and respiratory physiology
The American Society of Anesthesiologists (ASA) was founded in _____.
1905
Selection of anesthesia in made by the _____ in consultation with the _____ and the _____.
anesthesia provider, surgeon, patient
Choosing the safest anesthesia agent and technique is a decision predicated on thorough _____, _____, and _____.
knowledge, sound judgement, and evaluation of each individual situation
Selection of anesthesia should be based on the following characteristics:
- provide maximum safety for the patient
- provide optimal operating conditions for the surgeon
- provide patient comfort
- have a low index of toxicity
- provide potent, predictable analgesia extending into the postoperative period
- produce adequate muscle relaxation
- provide amnesia
- have a rapid onset and easy reversibility
- produce minimum side effects
The patient’s ability to tolerate stress and adverse effects of anesthesia and the surgical procedure depends on _____; _____; and function of the _____, _____, _____, and _____.
respiration; circulation; and function of the liver, kidneys, endocrine system, and central nervous system (CNS)
The following factors are important to the patient’s ability to tolerate stress and adverse effects of anesthesia:
- age, size, and weight
- physical, mental, and emotional status
- presence of complicating systemic disease or concurrent drug therapy
- presence of infection at the site of the surgical procedure
- anticipated procedure
- position required for the procedure
- type and expected length of procedure
- local or systemic toxicity of the agent
- expertise of the anesthesia provider
- preference of the surgeon and patient
Both the _____ and _____ play essential roles in clinical anesthesia.
central and autonomic nervous systems
The effect of anesthetic drugs is one of _____.
progressive depression of the CNS
The anesthesia state involves control of _____, _____, _____, and _____.
motor, sensory, mental, and reflex functions
Specific drugs are used to achieve the desired results: _____, _____, and _____.
amnesia, analgesia, and muscle relaxation
ASA developed the taxonomy for classifying patients by physical status from class I, the _____, to class VI, the _____.
lowest risk, highest risk
ASA Class I includes:
relatively healthy patients with localized pathologic processes
ASA Class II includes:
mild systemic diseases (diabetes mellitus)
ASA Class III includes:
severe systemic disease that limits activity but is not totally incapacitating (COPD or hypertension)
ASA Class IV includes:
an incapacitating disease that is a constant threat to life (cardiovascular and renal disease)
ASA Class V includes:
moribund patients who are not expected to survive 24 hours with or without the surgical procedure. Operation is intended to save their life or a resuscitative measure
ASA Class VI includes:
declared brain dead but whose organs will be removed for donor purposes.
Minimal or light sedation (anxiolysis):
- patients respond normally to verbal command
- cognitive function and coordination may be impaired
- ventilatory and cardiovascular functions are unaffected
Moderate sedation/analgesia:
- a drug-induced depression of consciousness
- can respond purposefully to verbal commands
- no interventions are required to maintain a patent airway
- spontaneous ventilation is adequate