regional anesthetic example
- nerve block
- plexus
- spinal cord
what can you use to reduce anxiety pre-operatively
- benzodiazepine
-
Induction of anesthesia agents
propofol
ketamine
barbiturates
what can be used to maintain anesthetic
- inhalational NO, isoflurane,
IV propofol, opioids, muscle relaxant
what is used for “amnesia” or reducing awareness
- Benzos
what is used for “hypnosis” or sleep
- Propofol
what is used for analgesia
NSAID
opioid
aceaminophen
or regional or local
If not needed what should you avoid
muscle relaxants
2 types of muscle relaxants
non-depolarizing
succinylcholine
problems with succinylcholine
- wait for effects to wear off 10 minutes
What can you use to blunt the sympathetic response
short-acting opioids - remifentanil
short-acting B blockers - esmolol
effects of anesthetics on the CV system
- increase heart rate
- decrease contractility
- dilate veins/arteries - decrease BP
effects of anesthetics on the respiratory system
- aspiration
- airway obstruction
- increased CO2, resp depression
- ## decreased response to hypoxemia
malignant hyperthermia can be triggered by
Succinylcholine and
anesthetic vapors
what can MH lead to
- hyperthermia
- hypercarbia
- tachycardia
- arrythmias
- muscle rigidity
- hyperkalemia
acute renal failure
How do you treat MH
- give dantrolene -
DONT give calcium channel blockers
what do you need to stop 7 days prior to Sx to reduce surgical bleeding in a patient with CAD
- Plavix
