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17 Cards in this Set
- Front
- Back
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what is the anesthetic triad?
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1) hypnosis - sedation
2) analgesia - pain relief 3) muscle relaxation |
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what does the bispectral index look at?
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- determining point of consciousness
- around 40 is a deep hynotic state - EEG suppression |
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what is the difference between general anesthesia & sedation?
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- line is very blurry
- GA = unresponsiveness - sedation = patient remains conscious, but cognitive skills diminished (COOPERATIVE SEDATION) - like having 3 glasses of wine |
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________ is the anesthetic term for blocking near large nerve bundles to cause loss of sensation & motor function
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- regional anesthesia
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for general anesthesia, most agents are thought to work through what receptor in the brain?
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- GABA
- does not mimic natural sleep patterns |
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how do gases enter the brain?
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- enter b/c partial pressure builds up in alveoli, gas enters blood through capillaries, goes to high perfusion organs first
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the onset of action of gases is directly elated to the ______ of the gas in the brain, not the _____ of it in the brain
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- partial pressure (the volatility)
- concentration |
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if a gas is more potent use a lower or higher concentration?
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- gas is potent use lower concentration, gas is not potent use higher concentration
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what is MAC? what does it compare?
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- minimum alveolar concentration
- alveolar concentration of gas in which 50% of patients will respond to a surgical stimuli - compares potency of drugs |
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what is the main route of elimination of anesthetic gases?
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- usually not metabolized in the body
- eventually eliminated unchanged through respiratory tract |
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what are some of the CV effects of anesthetic gases?
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- myocardial depression
- impaired baroreceptor reflexes - vasodilation - increased incidence of dysrythmias |
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what are some of the respiratory effects of anesthetic gases?
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- potent bronchodilators
- respiratory depressants: decreased response to hypoxia, decreased response to hypercarbia (increased CO2) --> not hyperventilating when you should |
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isoflurane vs sevoflurane
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- isoflurane: most commonly administered anesthetic in the world, potent, noxious to inhale
- sevoflurane: less potent, not noxious to inhale, excreted rapidly - used often in pediatric cases |
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why don't we use NO?
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- MAC is way too high - very impotent - would need to be used at MAC 105%
- diffuses rapidly into air filled spaces and expands the size within that space |
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why do IV anesthetics not last that long (such as propofol)?
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- will rapidly re-distribute from the brain so that consciousness will return within 5-10 minutes
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what neurotransmitter does ketamine work through? where is it commonly used?
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- glutamate & NMDA receptor
- patients appear conscious but do not respond to sensory input - used in burn patients |
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narcotics are defined by what?
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- their ability to blunt CO2 responsiveness
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