Understanding Anesthesiology - The Global Regional Anesthesia ...

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Aspiration Aspiration is the inhalation of stomach contents. Aspiration can cause pneumonia. At its most serious, aspiration can lead to acute respiratory distress syndrome (ARDS) and noncardiogenic pulmonary edema. Patients at risk of aspiration during anesthesia include: • Patients who are improperly fasted. • Patients with compromised gastroesophageal sphincter (history of gastroesophageal reflux disease, pregnancy, diabetes mellitus). • Patients with decreased gastric emptying (diabetes mellitus, pregnancy, patients receiving opioids, trauma patients, patients with bowel obstruction, patients receiving medications that slow motility). Related Glossary Terms Clear fluids, Cough reflex, Cricoid cartilage, Epiglottis, Intubation, Laryngeal mask airway (LMA), Laryngospasm, NPO, Pre-medication, Rapid sequence induction, Right mainstem bronchus, Sellick’s maneuver, Sodium citrate, Subglottis Index Find Term Chapter 1 - Airway Management Chapter 1 - Airway Management Chapter 1 - Airway Management Chapter 1 - Airway Management Chapter 1 - Airway Management Chapter 2 - Pre-operative Evaluation Chapter 2 - Pre-operative Evaluation Chapter 3 - General Anesthesia Chapter 3 - General Anesthesia Chapter 3 - General Anesthesia Chapter 4 - Recovery Chapter 4 - Recovery Chapter 5 - Obstetrical Anesthesia Chapter 5 - Obstetrical Anesthesia Chapter 5 - Pediatric Anesthesia
Atracurium Class Nondepolarizing skeletal muscle relaxant (NDMR); short-acting Mechanism of Action Competitive inhibitor at the acetylcholine receptors of the post-synaptic cleft of the neuromuscular junction. Dose Intubation : 0.5-0.6 mg/kg IV Maintenance bolus: 0.1-0.3 mg/kg IV Onset 3-4 minutes Duration 20-35 minutes Elimination Hoffman elimination, ester hydrolysis Effects MSK The neuromuscular blockade effects of non-depolarizing muscle relaxants are potentiated by succinylcholine, volatile anesthetics, aminoglycosides, lithium, loop diuretics, lidocaine, magnesium, lithium, ganglionic blockers, hypothermia, hypokalemia and respiratory acidosis. Enhanced neuromuscular blockade is seen in patients with myasthenia gravis or myopathies. The effects of NDMR are antagonized by cholinesterase inhibitors. Increased resistance to NDMR is seen in patients on theophylline, burn patients and those with paresis or paralysis. Misc. Histamine release may occur with rapid administration or higher dosages. Produces an excitatory metabolite called laudanosine. Muscle relaxants are the most common cause of anaphylactoid reactions under general anesthesia. Related Glossary Terms Anticholinesterase, Cis-Atracurium, Laudanosine, Neuromuscular junction, Nondepolarizing muscle relaxants, Pancuronium, Peripheral nerve stimulator, Residual block, Rocuronium, Urticaria Index Find Term Chapter 3 - General Anesthesia Chapter 6 - Drug Finder Chapter 6 - Muscle Relaxants
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1 ST EDITION Understanding Anesthes
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Preface ii
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GETTING THE MOST FROM YOUR IBOOK Th
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ACKNOWLEDGEMENTS Many individuals s
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THE ROLE OF THE ANESTHESIOLOGIST Dr
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CHAPTER 1 The ABC’s In this chapt
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There are many different laryngeal
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• Mouth opening: Three fingerbrea
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A patient who is deemed to be at ri
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Movie 1.1 Intubation technique The
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After intubation, correct placement
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The Difficult Airway Airway mismana
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volume, then the surgery should be
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Vascular Access Peripheral venous a
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Interactive 1.1 Body water distribu
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Complications of transfusion are nu
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CHAPTER 2 The Pre-operative Phase I
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are known to have cardiac disease o
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Premedication Pre-medication can in
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SECTION 2 Anesthetic Equipment and
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Monitoring The purpose of monitorin
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SECTION 3 Chapter 2 Review Review 2
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SECTION 1 Anesthetic Techniques In
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Table 9 Sedation VERBAL COGNITIVE A
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General Anesthesia General anesthes
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Epidural Anesthesia Epidural and sp
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Movie 3.1 Labour epidural insertion
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Figure 14 Sensory dermatomes tion i
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Figure 16 Anatomy relevant to spina
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cles (Figure 19).They then travel u
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SECTION 3 General Anesthesia In Thi
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amples of conditions which impair g
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and trauma surgery pose a higher ri
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Drugs for Maintenance of Anesthesia
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Contraindications to the inhaled ag
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Contraindications Opioids must not
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Table 15 Dose, onset, duration, eli
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tubation, leading to total airway o
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SECTION 1 Recovery In This Section
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Post-operative Nausea and Vomiting
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SECTION 2 Post-operative Pain Manag
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lead to a decreased stress response
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CHAPTER 5 Special Patients In this
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Successful treatment of an MH crisi
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SECTION 2 Obstetrical Anesthesia In
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There is good evidence that a labou
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SECTION 3 Pediatric Anesthesia In T
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tain types of noxious stimuli. Exam
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SECTION 4 Anesthesia Outside the Op
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Opioid agonists and antagonists •
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FENTANYL Class Synthetic opioid ana
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REMIFENTANIL Class Synthetic opioid
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MORPHINE SULFATE Class Opioid analg
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NALOXONE Class Opioid antagonist. U
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ROCURONIUM Class Non-depolarizing m
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PANCURONIUM BROMIDE Class Nondepola
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SUCCINYLCHOLINE CHLORIDE Class Depo
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SECTION 3 Anticholinesterase and An
Page 121 and 122: GLYCOPYRROLATE Class Anticholinergi
Page 123 and 124: SECTION 4 Induction Agents Drugs 1.
Page 125 and 126: SODIUM THIOPENTAL Class Short-actin
Page 127 and 128: KETAMINE Class Phencyclidine deriva
Page 129 and 130: ETOMIDATE Class Short-acting hypnot
Page 131 and 132: DESFLURANE Class Volatile inhaled a
Page 133 and 134: ISOFLURANE Class Volatile inhaled a
Page 135 and 136: SECTION 6 Anxiolytics Drugs 1. Mida
Page 137 and 138: SECTION 7 Antiemetics Drugs 1. Onda
Page 139 and 140: DIMENHYDRINATE Class Antihistamine,
Page 141 and 142: SECTION 8 Vasoactive Agents Drugs 1
Page 143 and 144: EPHEDRINE SULFATE Class Sympathomim
Page 145 and 146: SECTION 9 Local Anesthetics Drugs 1
Page 147 and 148: LIDOCAINE Class Local anesthetic. U
Page 149 and 150: KETOROLAC TROMETHAMINE Class Non-st
Page 151 and 152: DANTROLENE Dantrolene is used in th
Page 153 and 154: Acetylcholine Acetylcholine (Ach) i
Page 155 and 156: Adjunct An adjunct is something add
Page 157 and 158: Airway assessment The purpose of th
Page 159 and 160: Aldrete score Phase 1 of recovery m
Page 161 and 162: Analgesia Pain relief Related Gloss
Page 163 and 164: Antecubital fossa The antecubital f
Page 165 and 166: Anticholinesterase Anticholinestera
Page 167 and 168: Antisialagogue An antisialogogue is
Page 169 and 170: Apneic threshold Apneic threshold i
Page 171: Asepsis Asepsis is another word for
Page 175 and 176: Autonomic nervous system The autono
Page 177 and 178: Bacterial endocarditis The 2007 Ame
Page 179 and 180: Balanced anesthesia Balanced anesth
Page 181 and 182: Bier Block An intravenous regional
Page 183 and 184: Brachial plexus The brachial plexus
Page 185 and 186: Bupivacaine Class Local anesthetic.
Page 187 and 188: Capnograph The capnograph is a moni
Page 189 and 190: Cholinesterase Cholinesterase is a
Page 191 and 192: Cis-Atracurium Class Non-depolarizi
Page 193 and 194: CO2 (carbon dioxide) absorber The C
Page 195 and 196: Competitive inhibitor Competitive i
Page 197 and 198: Cormack Lehane Cormack Cormack Leha
Page 199 and 200: Cricoid cartilage The cricoid is a
Page 201 and 202: Dantrolene Dantrolene is used in th
Page 203 and 204: Difficult airway The American Socie
Page 205 and 206: Diphenhydramine Class Antihistamine
Page 207 and 208: Dura The dura is the outermost (and
Page 209 and 210: Ephedrine Sulfate Class Sympathomim
Page 211 and 212: Epidural anesthesia In epidural ane
Page 213 and 214: Epiglottis The epiglottis is a cart
Page 215 and 216: Esophageal intubation Esophageal in
Page 217 and 218: Euvolemia Euvolemia indicates that
Page 219 and 220: Fentanyl Class Synthetic opioid ana
Page 221 and 222: Flowmeter The anesthetic flowmeter
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Forced air warming system A forced
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Functional residual capacity Functi
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Glycopyrrolate Class Anticholinergi
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Hypothermia Hypothermia indicates a
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Induction Induction is the phase of
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Intralipid Intralipid is a fat emul
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Intravenous regional anesthetic An
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Isoflurane Class Volatile inhaled a
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Ketorolac Tromethamine Class Non-st
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Laryngoscope A laryngoscope is the
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Larynx The larynx is that part of t
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Lidocaine Class Local anesthetic. U
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Local anesthetic toxicity Local ane
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MAC MAC refers to the concentration
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Magill blade A Magill blade, used i
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Maintenance fluid requirements Main
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Mallampati classification The Malla
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Mechanical ventilation Mechanical v
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Metabolic acidosis Metabolic acidos
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Morphine Sulfate Class Opioid analg
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Muscarinic Muscarinic acetylcholine
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Myoglobinuria When pathological mus
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Nasotracheal intubation Nasotrachea
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Needle cricothyrotomy A needle cric
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Neonatal opioid depression The resp
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Neuromuscular junction The neuromus
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Nicotinic Nicotinic receptors are t
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Non-depolarizing muscle relaxants T
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Ondansetron Class Seratonin ( 5-HT
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Oxygen saturation The oxygen satura
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Oxytocin Oxytocin is used in obstet
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Parturient The parturient is the pr
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Patient controlled analgesia Patien
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Peripheral nerve stimulator A perip
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Phrenic nerve The phrenic nerve, ar
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Positive pressure ventilation Posit
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Post-operative nausea and vomiting
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Pre-operative assessment Every pati
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Pre-oxygenation The purpose of pre-
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Prone In the prone position, the pa
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Pseudocholinesterase deficiency Pse
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Pulse oximeter The oxygen saturatio
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Radiculopathies Radiculopathy descr
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Re-narcotization A narcotized patie
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Recurrent laryngeal nerve The recur
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Remifentanil Class Synthetic opioid
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Reticular activating system The ret
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Rocuronium Class Non-depolarizing m
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Second stage of labour The second s
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Serotonin syndrome Serotonin syndro
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Shock Shock occurs when perfusion o
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Sodium citrate Sodium citrate is a
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Spinal anesthesia Spinal anesthesia
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Subarachnoid space The subarachnoid
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Succinylcholine Class Depolarizing
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Superior laryngeal nerve The superi
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Sympathetic nervous system The symp
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Theophylline Theophylline is a medi
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Thrombocytopenia Low platelet count
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Tidal volume Tidal volume is the vo
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Transcutaneous electrical nerve sti
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Trendelenburg The trendelenburg pos
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Urticaria Hives. Urticaria is cause
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Vagolytic Drugs with a vagolytic ef
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Vallecula The vallecula is the spac
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Venous air embolism Venous air embo
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Videolaryngoscope The videolaryngos
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