Taxonomy of Anesthesia

Question 1

Meaning of anaisthsia

Answer 1

Lack of sensation

Question 2

What is anesthesia

Answer 2

a drug induced reversible depression of the CNS resulting in loss of response to and perception of all stimuli

Question 3

Anesthesia is a

Answer 3

deafferented state

Question 4

Amnesia and unconciousness are

Answer 4

equally important

Question 5

Do all general anesthetics do produce equal depression of sensation?

Answer 5

No

Question 6

Anesthesia

Answer 6

total of partial loss of sensation induced by a disease stat injury, accupuncture, trauma, anesthetics (iNO) to local or general insensibility to pain w/ or w/o a loss of consciousness

Question 7

Analgesia

Answer 7

dampening or absence of pain without LOC

Question 8

Components of General Anesthesia

Answer 8

amnesia, analgesia, unconsciousness, immobility, areflexia

Question 9

areflexia

Answer 9

attenuation of autonomic responses to noxious stimulation

Question 10

Components of Anesthesia

Answer 10

analgesia
amnesia
areflexia

Question 11

Types of Anesthesia

Answer 11

Monitored Anesthesia Care
General Anesthesia (inhalation or IV induction)
Regional- topical or infiltration, peripheral nerve block, plexus blocks, central neuraxial blocks (spinal/epidural)

Question 12

spinal Block

Answer 12

subarachnoid/intrathecal

Question 13

Epidural block

Answer 13

peridural/caudal

Question 14

Thiopental/Propofol

Answer 14

-/+ amnesia

Question 15

Benzodiazepines

Answer 15

+ amnesia

Question 16

Narcotics

Answer 16

Analgesia

+/- amnesia

Question 17

Inhalation Agents (Nitrous Oxide)

Answer 17

-/+ anaglesia and amnesia

Question 18

Isoflurane

Answer 18

+/-, +/- analgesia

-/+ muscle relaxation

Question 19

Ketamine

Answer 19

analgesia, amnesia

Question 20

Regional Technqiue

Answer 20

Analgesia, +/- muscle relaxation

Question 21

Room Preparation

Answer 21

MAchine Check and Monitors
suction (Oral and ETT size)
Or table and accessaory equipment (arm boards, stirrups)
warming devices (Fluid warmer, warming blanket, etc)
other equipment: arterial line, infusion pumps, precordial doppler, cerebral oximeter

Question 22

Airway Supplies

Answer 22

face mask
oral airways/ tongue blades
nasal airways/lubricant
laryngoscope blade
various blades
ett, stylets, 10 cc syringes
ambu bag
lma/ airway adjuncts
difficult airway and MH carts

Question 23

Other Supplies

Answer 23

IV Supplies (IV fluids, extension tubing, volume expanders)
Anesthesia Cart (fully stocked, other neccessary supplies)
Positioning Equipment
head rest, arm boards/ pads, prone pillow, axillary roll, extra pillows/padding, eye pads/ padding, lubricant, anesthesia circuit extenders

Question 24

Holding Area

Answer 24

greet patient and family
properly identify partient (armband, verbally)
reaffirm type/site of surgery
interview and re-assess
airway assessment and planning
review patient and chart for changes since interview
formulate anesthestic plan (ind for surgery/pt)
obtain anesthesia constent
lines (iv, invasive monitoring)

Question 25

Choosing the Anesthetic

Answer 25

anesthesia is patient specific, not a formula or recipe plan should promote patient stability and patient outcomes adapt plan to consider patient and surgical needs integrate: anatomical and physical findings functional status patient's medical/surgical history surgical considerations plan A, plan B, plan C

Question 26

What to consider

Answer 26

``` patient's current phsyical condition type and site of surgery surgical position costs elective or emergent surgery NPO status patient bias surgeon skill level anesthetist's skill and preference ```

Question 27

Goals for Pharamcologic Premeds

Answer 27

anxiolysis, sedation, analgesia, amnesia, antisialagoue effect, antiemetic, increase gastic fluid pH, decrease gastric fluid volume, allergic prop, antimicrobial protection

Question 28

Failure to Emerge

Answer 28

residual NMB excessive opioid or benzo administeration intraoperative CVA pre-existing conditions (CNS dx, hepatic insufficiecy, ETOH) electrolyte abnormalities acidosis hypothermia