General And Local Anesthesia

Front 1

4 Criteria for general anesthesia

Back 1

amnesia, analgesia, hypnosis, muscle relaxation

Front 2

balanced anesthesia

Back 2

uses a combination of drugs to maximize effects wih minimal doses.
Different combinations of drugs may be used for different operations

Front 3

Stages of General Anesthesia

Back 3

Stage 1: Analgesia
Stage 2: Excitement (can be blocked by premedications)
Stage 3: Surgical anesthesia (regular breathing, longer expiration, shallow breathing, diaphragm only
Stage 4: Breathing and heart stops (toxic)

Front 4

Nitrous oxide

Back 4

Laughing gas-
used as an adjunct with other anesthetics.
Isoflurane (prototype)

Front 5

Anesthetic Potency

Back 5

Potency measured as MAC- minimal alveolar concentration or the concentration at which 50% of patients feel no pain.

Front 6

Rate of Onset and Recovery

Back 6

Rate of onset and recovery from inhaled anesthetics is controlled by solubility in blood. The lower the solubility, the faster the onset and recovery.

Front 7

Isoflurane

Back 7

Indication: Inhalation anestetic, reduces pain sensitivity.
Side effects: Hypotension, -temp, respiratory and cardiovascular depression, malignant hyperthermia.
Post operative effects delirium, shivering, hallucination, confusion, increased excitability.
Drug interactions many inhaled anesthetics predispose the heart to arrhythmias when stimulated by epinephrine.
Many anesthetics increase intracranial pressure, contraindicated in patients with increased pressure.

Front 8

Nitrous Oxide effects on: Sensitation of the myocardium to action of epinephrine, respirations, blood pressure.

Back 8

little effects

Front 9

Propofol

Back 9

Indication: IV anesthetic
Contraindicated during pregnancy, use causion with patients with seizures, cardiac disease, or high intra-cranial pressure. Common adverse effect is N/V, most serious: Apnea or anaphylaxis.

Front 10

Tubocurarine

Back 10

Long lasting muscle paralysis. Nicotinic Antagonist and Nondepolarizing Neuromuscular Blocker
Used IV only

Front 11

Succinylcholine

Back 11

Nicotinic Agonist and depolrizing neurmuscular blocker
Indications: used in surgery to prodce a relatively short paralysis. IV or IM only. (Used to prevent convulsions during ECT)
Adverse Efects: broken down by plasma cholinesterases, but some patients have abnormal plasma cholinesterase, leading to prolonged apnea. Histamine release can lower blood pressure or cause anaphylactic shock.
Initially causes muscle contractions before paralysis sets in, and will therefore often cause postoperative aches and pains.
*Can cause malignant hyperthermia, which is treated with dentrolene.

Front 12

Lidocaine

Back 12

Indication: Local Anesthetic
Blocking sodium channels. Blocking pain receptors in awake patients.
smaller pain conducting nerve fibers are usually blocked first, higher doses will cause muscle paralysis as well.

Front 13

Local Anesthesia used with Epinephrine

Back 13

Vasodilating local anesthetics can be prevented by co-administration of the vasoconstrictor epinephrine. This can prolong the local anesthetic effect. *NOT to be used in end artery areas