Vascular Surgery for Anesthesia

Question 1

Increased arterial BP _______ clamp.

Answer 1

ABOVE

Question 2

Decreased arterial BP _______ clamp.

Answer 2

BELOW

Question 3

Hemodynamic changes Aortic cross clamping: ______ in after load, leads to ______ left ventricular myocardial wall tension = _________ myocardial oxygen demand.
Increase in _____.
Increase in _____.

Answer 3

Increase in AFTERLOAD leads to increased left ventricular myocardial wall tension = increased myocardial oxygen demand

MAP
SVR

Question 4

Increased arterial blood pressure above the clamp =

Answer 4

Decrease total body oxygen consumption

Question 5

Decreased arterial blood pressure below the clamp =

Answer 5

Decreased total body carbon dioxide production

Question 6

Increased wall motion abnormalities and left ventricular wall tension =

Answer 6

increased mixed venous oxygen saturation (MvO2)

Question 7

Decreased EF and CO =

Answer 7

Decreased total body oxygen extraction

Question 8

_____ and ______ environment below the clamp.

Answer 8

Hypoxic and Ishcemic

Question 9

Unclamping: decreased arterial BP and increased lactate. Interventions:

Answer 9

decrease anesthetic depth

Question 10

Decreased myocardial contractility and increased total body consumption of O2. Intervention:

Answer 10

Decrease vasodilators

Question 11

Decreased SVR and MvO2. Intervention:

Answer 11

Increase fluids

Question 12

Decreased CVP and increased prostaglandins. Intervention:

Answer 12

increased vasoconstrictor drugs

Question 13

Unclamping: Decrease preload
Intervention:

Answer 13

reapply cross clamp for severe hypotension

Question 14

Decrease CO and Increased myocardial depressant factors from unclamping. Intervention:

Answer 14

consider administering mannitol and sodium bicarb