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31 Cards in this Set
- Front
- Back
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Procedure used to treat nocturnal upper airway obstruction
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adenotonsillectomy
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procedure performed for recurrent or chronic rhino sinusitis or adenoiditis and recurrent otitis media
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adenoidectomy
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What procedure is indicated for recurrent pharyngotonsillitis, chronic tonsillitis, hemorrhagic tonsillitis, peritonsillar abcess, streptococcal carriage, dysphagia, abnormal dentofacial growth, halitosis and suspicion of malignant disease
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tonsillectomy
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What are the anesthetic implications of T & A
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-Preop anxiolytics
- inhalation induction with CPAP and oral airway -opioids, dexamethasone + antiemetics - maintain a low FIO2 - Do not blindly sx airway -either deep extubation or when the child is almost awake - vigilant postop monitoring!! |
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What are some preoperative considerations for a patient having a T & A
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H & P / Exam
-coagulation status -make sure no ASA in last 10 days - assess for loose teeth. |
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typically caused by infections that originate in the tonsil and spread to the peritonsillar space
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peritonsillar abcess
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Where is the peritonsillar space located?
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between the tonsillar capsule and the superior constrictor muscle
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A peritonsillar abcess rarely invades?
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the posterior tonsillar pillar
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A patient presenting with peritonsillar abcess will have what S/S
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-severe sore throat
-difficulty swallowing -high fever -progressive difficulty opening mouth |
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What are some anesthetic considerations in a patient with a pertonsillar abcess
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- airway assessment
-you can use GETA on a spont breathing anesthetized pt. or sedation with topical LA or LA infiltrated at the site -"avoid N2O during induction" -will need 2 lg bore sx catheters and tonsil suction tips |
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What are the anesthetic considerations for Laser surgery?
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- eye protection for everyone
-special high-efficiency mask -Metal ETT (non-flamable) -Maintain low FIO2 and avoid N2O) ...it's combustible |
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What are 3 forms of airway management with Laser surgery
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-spont ventilation
-ETT -manual jet ventilation |
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what are the 4 "E's" for handling and airway "fire"
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-extract, eliminate, extinguish, evaluate
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is a disorder of breathing during sleep characterized by prolonged partial upper airway obs or intermittent complete obs that disrupts normal sleep-time breathing and normal sleep patterns
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OSA
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What is the most common cause of OSA in children
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adenotonsillar hypertrophy
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What is often the cure for childhood OSA
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tonsillectomy with or without adenoidectomy
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What are the symptoms of OSA
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nocturnal snoring
breathing pauses gasping use of accessory muscles Enuresis excessive sweating |
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what is considered to be "reversible sequelae of OSA"
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-failure to thrive
-neurocognitive deficits -PHTN -Cor Pulmonale |
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Eye drops contain?
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-anticholinergics and phenylephrine
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Glaucoma treating agents include?
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-betablockers
-parasympatomimetic agents |
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What anesthetic agents do you want to avoid with eye surgery b/c of the potential to increase IOP
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-Sux
-Ketamine -direct laryngoscopy |
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what is a common s/e of eye surgery
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PONV
*treat with multimodal Rx |
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The ocular crainal reflex involves which two nerves
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trigeminal and vagus
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what happens when the ocular cranial reflex is stimulated
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bradycardic response
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surgical correction of what condition involves isolation of one or more of the extra ocular muscles with subsequent recession or resection or the muscle
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strabismus
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What S/E from Sux is 4 times greater for this surgical population (strabismus)
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masseter muscle rigidity
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In which surgical procedure is a small bowman probe inserted into the nasolacrimal duct.
And once inserted, what does the probe pierce.... |
Lacrimal duct probing
pierces the valve of hasner |
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What anesthetic technique is typically used d/t the short procedure time (5-10 mins)
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mask ventilation
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What anesthetic technique is used for cataract surgery
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GETA with paralytics
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What analgesia is typically used to treat patients with cararacts
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tylenol
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What should you monitor for during the postop period for a pt who has had cataract surgery
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postop apnea.....
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