Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
48 Cards in this Set
- Front
- Back
|
what are the phases of anesthesia
|
induction
maintenance emergence |
|
|
what phase involves going from consciousness to unconsciousness
|
induction
|
|
|
what phase is a period of unconsciousness under anesthesia
|
maintenance
|
|
|
what phase is a period of recovery after anesthetsia
|
emergence
|
|
|
what are inhaled anethetics typically used for
|
maintenance
|
|
|
what are the most widely used inhaled anethetics
|
isoflurane
desflurance sevoflurance |
|
|
what vaporizers are used to administer inhaled anesthetics
|
plenum (positive pressure gas mixture, controllable, requires gas tank)
drawover (negative pressure, poorly controlled, no equipment required) |
|
|
what are the classes of IV anesthetics
|
barbituates
benzodiazepines propofol ketamine opiod analgesics sedative hypnotics |
|
|
when used in combination what are IV and Inhaled anesthetics for
|
Inhaled = induction
IV = maintenence |
|
|
what are the stages of anesthesia
|
analgesia
excitement surgical anesthesia medullary depression |
|
|
what occurs in stage 1 of anesthesia
|
pt receives anesthetic and will go under initially w/o amnesia but as deep analgesia amenesia occurs
|
|
|
what occurs in stage 2 of anesthesia
|
pt suffers amnesia and doesn't remember anything past this stage
|
|
|
in what stage may the pt exhibit delirious behavior and vocalize
|
stage 2
|
|
|
in what stage of anesthesia does the pt have irregular respiration (changes in volume rate)
|
stage 2 due to inhibitory neurons being suppressed and a global increase in excitatory neurons
|
|
|
what is the desirable stage for most anesthesia
|
stage 3
|
|
|
what occurs in stage 3 of anesthesia
|
pt resumes regular respiration
occurlar movements, eye reflexes, pupil size |
|
|
what occurs in stage 4
|
severe depression of CNS
collapse of respiratory and circulatory support |
|
|
what stage of anesthesia can the pt die and do you want to avoidq
|
stage 4
|
|
|
what stages of anesthesia are heavy and light
|
light = stage 1/2
heavy = stage 3/4 |
|
|
how can you see the depth of anesthesia
|
loss of motor and autonomic responses to noxious stimuli (squeeze trapezius muscle)
breathing pattern |
|
|
what is used when general anesthesia is not required or can not be performeed
|
monitored anesthesia care and conscious sedation
|
|
|
what does monitoredl anesthesia and conscious sedation care refer to
|
pt may or may not be aware of what's going on
|
|
|
what are examples of monitored anesthesia care
|
propofol infusion for sedation
opioid analgesic or ketamine for analgesia premedication w/ midazolam for anxiolysis usually amnesic |
|
|
what is unique about conscious sedation
|
pt responsive to verbal commands
usually not amnesic |
|
|
what are the most popular inhaled anesthetics
|
desflurane
sevoflurane |
|
|
what are inhaled anesthetics mostly used for now
|
amublatory surgery
|
|
|
what are the properties of an ideal agent
|
rapid onset
short duration |
|
|
why is Halothane not an ideal agent
|
slow onset (takes time to put pt down)
metabolic breakdown may lead to hepatitis |
|
|
what are the issues w/ desflurane and sevoflurane
|
desflurane has a pungent odor
sevorflurane is unstable and may be hepatotoxic and nephrotoxic |
|
|
what is the most important factor governing uptake, onset, and distribution of inhaled anesthetics
|
solubility
|
|
|
what influences the transfer of inhaled anesthetics from the lung to blood
|
solubility
|
|
|
what does the blood:gas partition indicate
|
anesthetics affinity for blood (the higher the number the more affinity a compound has for staying in blood)
|
|
|
what are the solubility properties of Nitrous oxide and desflourane
|
low solubility and equilibrate rapidly w/ the brain (you breathe them in and they go into the blood quickly and rapidly exit blood into brain therefore VERY FAST ACTING)
|
|
|
what are the solubility properties of isoflurane, halothane
|
high solubility and equilibrate slowly w/ the brain
|
|
|
what can be done for drugs that have high solubility and equilibrate slowly w/ the brain
|
loading
|
|
|
how do anesthetics effect pulmonary ventilation
|
soluble agents(halothane isoflurane) accumulate faster w/ increased ventilation
insoluble compounds have limited effects so it doesn't matter if you increase ventilation |
|
|
how does pulmonary blood flow impact anesthetics
|
someone w/ decrease CO or impaired heart function if given a very soluble drug like halothane/isoflurane it will rise very quickly
|
|
|
why must caution be given when using inhaled anesthetics in relationship to pulmonary ventilation
|
at a given pumonary ventilation rate soluble agents rise very quickly and will decrease CO
|
|
|
what does recovery time of inhaled anesthetics depend on
|
rate of elimination of anesthetics from the brain
|
|
|
what is the most important factor in recovery time from inhaled anesthetics
|
blood;gas partition coefficient
insoluble agents was out rapidly |
|
|
what are the differences in recovery phase and induction of anesthesia
|
in recovery:
can't get ride of gas faster may take longer to recover in obese pt |
|
|
what is the major mode of elimination of inhaled anesthetics
|
lungs
|
|
|
what inhaled anesthetic is metabolised hepatically
|
halothane
|
|
|
what determines relative potency of a inhaled anesthetic
|
MAC
|
|
|
what is MAC
|
% of anesthetic gas as a component of atmospheric pressure
how much gas needed for immobility in 50% of pts when exposed to noxious stimuli |
|
|
would you use more or less drug if dealing w/ elderly pt w/ hypothermia, IV drugs
|
less drug
|
|
|
would you use more or less drug if if dealilng w/ pt who abuses drugs, alcohol abuse, pregnant
|
more drug
|
|
|
would you use more or less drug based on pt sex, weight, height
|
no effect
|
