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51 Cards in this Set
- Front
- Back
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Will inhaled anesthetics cause burst suppression
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yes
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At what MAC level does impaired cognition begin at
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0.2 MAC
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Best inhaled anesthetic for burst suppression; dose
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Iso; 1.5 MAC
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When do volatile inhaled anesthetics increase CBF
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Above 1 MAC
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What is NO affect on neuro
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uncoupled increase in O2 demand
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What does inhaled anesthetic do to VO2
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decreases
especially the heart |
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When does des inhibit global autoregulation in the brain
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0.5 MAC
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When do iso and sevo inhibit global autoregulation in the brain
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1.5 MAC
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When do iso, sevo, des, begin to inhibit local vasogenic response in the brain
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1 MAC
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What do volatile agents do to SSEP; how do we treat this
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dose dependent decrease
keep patient on a steady dose |
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N2O affect on the heart
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increases SNS outflow
mydriasis increased temp increased RAP Increase SVR and PVR |
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N2O plus opioids affect on the heart
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decreased BP, CO,
increased LVEDP, SVR |
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Inhaled anesthetic that doesn't increase CVP
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Sevo
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Inhaled anesthetic that increases HR the most
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Des
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What areas do inhaled anesthetics increase blood flow to
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Brain
Skin Skeletal muscle |
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Which areas do inhaled anesthetics decrease blood flow to
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Kidney
Liver Splanchnic- GI, pancreas |
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What do inhaled anesthetics do to baroreceptors
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depress
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Inhaled agent that causes the longest depression of baroreceptors
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Iso
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In what case will you use nitrous with a HTN patient; at what dose
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obese; less than 50%
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Total allowable dose of epinephrine with gases
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6-7.5mcg/kg
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What precautions must be taken when administering inhaled anesthetics to pts with aortic stenosis
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must make sure to maintain the SVR in order to perfuse coronaries
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Inhaled anesthetic that should not be given during accessory pathway ablation surgery
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Iso
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What are the six affects of inhaled anesthetics on circulation
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direct myocardial depression
central SNS inhibition Decreased cAMP Decreased SA node(dec Ca influx) Decreases carotid baroreceptors Peripheral ganglionic blockade |
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What does N2O do to respirations when added to a volatile anesthetic
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Decreases resp. depressant affects
respiratory protective |
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Least resp depressant of the volatile inhaled anesthetics
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Sevo
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Metabolism of Sevo
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5%
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Metabolism of Des
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0.02%
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Metabolism of Iso
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0.2%
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Metabolism of N2O
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0.004%
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Enzyme inducing drugs that will increase de-fluorination
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Phenobarbital
Phenytoin Isoniazid |
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Inhaled anesthetic that undergoes reductive metabolism in the GI tract
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N2O
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Best measure of hypoxic liver damage
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GST
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What does an early peak of GST indicate
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hypoxia during surgery
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What does a late peak of GST indicate
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autoimmune response
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Best indicator for low perfusion during surgery
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low urine output
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What are four signs of fluoride induced nephrotoxicity
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Polyuria (inability to concentrate urine)
Hyperosmolarity of blood Increased Cr/BUN Fluoride >50 mmol |
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What is the only inhaled anesthetic with the potential to cause fluoride induced nephrotoxicity
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Sevo
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What are 5 factors to measure in the urine if FIN after Sevo is suspected
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NAG
Alpha GST Pi GST Glycosuria Proteinuria |
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What is the flow precaution with Sevo
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no more than 2 MAC hours at one liter flows
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What are anesthetics affects on uterine muscle tone
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dose dependent relaxation
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Inhaled anesthetics may decrease the activity of these two B-12 dependent enzymes
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methionine-myelin
Thymidylate- DNA |
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What does inhaled anesthesia do to EEG waves
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decreases frequency and amplitude
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Do trace gases in the room cause mental impairment
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no
not until 0.2 MAC |
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When does decreased cerebral oxygen demand begin when administering inhaled anesthesia
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0.4 MAC
along with amnesia |
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Dose range of inhaled anesthesia at which amnesia begins
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0.3-0.5 MAC
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What do inhaled anesthetics do to CBF
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Increase CBF
luxury perfusion |
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When is EEG isoelectric with inhaled anesthetics
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2 MAC
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Regulates global blood flow
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autoregulation
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Regulates local blood flow
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CO2 reactivity
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Why is stroke volume decreased with the administration of inhaled anesthesia
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decreased SVR= decreased venous return
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Why is CVP increased with the administration of inhaled anesthesia
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because of fluid backing up from myocardial depression
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