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What is Anesthesia
Loss of sensation with or with loss of consciousness
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What is Amnesia
Loss of memory of an event or time period
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When is amnesia needed
during general anesthesia
during MAC cases
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What drugs are used for amensia
benzodiapines (Midazolam)
Induction agents (Propofol)
Inhaled agents (Sevoflurane)
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What is analgesia
pain releif without loss of consciousness
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When is analgesia needed
Pre-op (if pt in pain)
Intra-op maintenance of General Anesthesia
During MAC, if block isn't effective
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what drugs are used for analgesia
opioids
NSAIDS (Ketorolac)
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What is anxiolysis
aprehension or fear relief
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when is anxiolysis needed
preOp
during MAC
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What drugs are used for anxiolysis
Benzodiazapines
diphenhydramine (Benadryl) - sedative quality
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What does Hypnotic mean
produces drowsiness
induce sleep
sleep like state
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When is a hypnotic needed
induction
during MAC (lower doses)
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Drugs used for Hypnotic property
propofol
etomidate
ketamine
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What are the adverse effects of anesthesia
- vasodilation
- decreased
- B?P
- HR
- RR (ventilations)
- Temp
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What are Anesthesia priorities
- Maintain adequate organ/system perfusion
- Relieve pain, anxiety, & fear
- Maintain internal milieu (temp, coag., acid/base)
- Environment that accomodates surgeon
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what are the phases Anesthesia
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What are the phases of pre-op
- 1. DAMMITS
- Drugs, Airway, Machine, Monitors, IV,
- Table, Suction
- 2. PreOp holding
- eval/consult, manage pain, IV,
- premed./anxiolytics
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What are the phases of IntraOp
Induction
Maintenance
Emergence
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What are the phases of PostOp
Recovery
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What are goals for induction
- 1. Anxiolysis
- 2. Pain relief (laryngoscope)
- 3. Local (blunt airway reflexes)
- 4. Hypnotic
- 5. Relaxant
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what sign indicates proper hypnosis (induced sleep)
no twitch from the eyelid when the eyelash is touched
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What must be done prior to injecting the relaxant to intubate
successful bag/mask ventilation
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What is requirted for ETT Intubation?
- L.A.P.I.B.E.M.O.S
- Laryngoscope
- Appropriate ETT
- PreOxygenation
- Induction
- Bag/Mask ventilation
- Eye tape
- Muscle Relaxation
- Oral airway/bite block
- Suction
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What is RSI
rapid sequence intubation
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how is RSI performed
all induction drugs given together
cricoid pressure
fasciculations (intubate when they stop)
*** no bag/mask vent
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requirements for RSI
L.A.P.I.M.E.O.S.
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What is MAC in regards to level of anesthesia
Minimum Alveolar Concentration
concentration of inhalation agent required to prevent 50% of patients from responding to painful stimuli
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what level of MAC will prevent movement in approx 95% of patients
1.3
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What is Monitored Anesthesia Care
a.k.a. MAC
twilight sedation anesthesia
may be awake or not
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what is the diference between Local and regional anesthesia
- local -- small area loss of sensation
- (numb incision site)
- regional -- large area loss of sensation
- (epidural, spinal, peripheral block)
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