The Anesthetic Plan for Healthy Patients Flashcards
What is the most commom complication associated with anesthesia?
Postoperative nausea and vomiting
RIsk factors for postoperative nausea and vomiting associated with the patient
- Female gender
- History of postoperative nausea and vomiting or motion sickness
- Obesity
- Non smoking
- Younger age
- HIgh preoperative ansiety level
- Delayed gastric emptying
Surgical risk factors for postoperative nausea and vomiting
- Longer duration
- Gynecologic surgery
- Laparoscopic surgery
- Middle ear surgery
Anesthetic risk factors for postoperative nausea and vomiting
- Nitrous oxide
- Gastric distention
- Opiode use
- Reversal of neumuscular blockade
Deficiency of which enzime is usually identified when an anesthetized patient has prolonged recovery from the depolarizing neuromuscular blocking agent succinylcholine
Pseudocholinesterase (butyrylcholinesterase)
If general anesthesia is being contemplated when aspiration risk exists, the anesthetic plan is altered in two ways:
- Prophylactic antiaspiration measures should be taken (gastric motility drugs, pharmacologic stomach acid reduction, and rapid sequence induction).
- A laryngeal mask airway should not be used.
Common uses, pharmacological effects and potential perioperative complications associated with the use of echinacea (purple conneflower)
Common uses: treat viral infections
Pharmacological effects: immune system stimulation
Potential perioperative complications: reduced effectiviness of immunosuppressants. Infection with long term use. Potential hepatotoxicity
Common uses, pharmacological effects and potential perioperative complications associated with the use of ephedra (ma huang)
Common uses: weight loss, athletic performance
Pharmacological effects: indirectly and directly acting sympathomimetic
Potential perioperative complications: dose-dependent increase in heart rate and blood presure with potential perioperative myocardial infarction and stroke. Arrhytmias with halotane. Tachyphylaxis with intraoperative ephedrine
Common uses, pharmacological effects and potential perioperative complications associated with the use of garlic
Common uses: antihypertensive, antithrombus forming
Pharmacological effects: inhibits platelet aggregration
Potential perioperative complications: concerns for perioperative bleeding
Common uses, pharmacological effects and potential perioperative complications associated with the use of ginkgo biloba (maidenhair tree)
Common uses: circulatory stimulant
Pharmacological effects: inhibits platelet
Potential perioperative complications: concerns for perioperative bleeding. May potentiate platelet inhibitors
Common uses, pharmacological effects and potential perioperative complications associated with the use of ginseng
Common uses: general well-being
Pharmacological effects: poorly understood
Potential perioperative complications: concerns for perioperative bleeding
Common uses, pharmacological effects and potential perioperative complications associated with the use of Piper methysticum (kava-kava)
Common uses: anxiolytic, sedative
Pharmacological effects: anxiolytic, sedative
Potential perioperative complications: potentiate sedative effects of anesthetic agents
Common uses, pharmacological effects and potential perioperative complications associated with the use of st john’s wort (erva de são joão)
Common uses: depression, anxiety
Pharmacological effects: inhibition of serotonin, noradrenalin and dopamin. P450 enzyme induction
Potential perioperative complications: decreased effectiveness of multiple medications
Common uses, pharmacological effects and potential perioperative complications associated with the use of valerian (vandal-root)
Common uses: anxiolytic and sleep aid
Pharmacological effects: sedation
Potential perioperative complications: potentiate anesthetic agents
Describe the Han scale
Mask Ventilation Scale
0 Not attempted
1 Easy mask ventilation (with and without neuromuscular block)
2 Ventilated by mask with oral airway or other adjuvant (with or without neuromuscular block)
3 Difficult mask ventilation: inadequate, unstable, or required two practitioners
4 Unable to ventilate
