Understanding Anesthesiology - The Global Regional Anesthesia ...

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Sevoflurane Class Volatile inhaled anesthetic. Used for maintenance of anesthesia. Can be used for induction of anesthesia particularly in children. Rarely may be used as a treatment for status asthmaticus. Mechanism of Action Uncertain Dose Titrated to effect; MAC (age 40) = 2.1%. Onset Low solubility allows rapid uptake and equilibration. Onset of effect is hastened by using higher flows of carrier gases and by using higher concentrations of volatile agent. Duration Clinical recovery in less than 10 minutes (usually). If given for prolonged periods, wake-up will be slower as adipose stores have been saturated and are slow to off-load. Elimination Pulmonary (major); hepatic (2-5%); renal (metabolites excretion only) Effects CNS Sevoflurane produces an additive central nervous system (CNS)-depressant effect along with other sedative/hypnotics and analgesics. Has the potential to increase intracranial pressure which can be mitigated with hyperventilation. Delirium. CVS Dose-related hypotension (vasodilation). Respiratory Respiratory depression with a rapid, shallow respiratory pattern. Loss of intercostal muscle function creates a rocking boat appearance. Causes bronchodilation. Sevoflurane is sweetsmelling and not as irritating to the respiratory tract as desflurane. GI Nausea, vomiting. MSK Potentiates neuromuscular blockade. Malignant hyperthermia trigger. Misc. Potential nephrotoxicity due to Compound A which is produced through contact with sodalime. Compound A can be produced if sevoflurane is used with very low fresh gas flows or for long MAC-hours. Therefore, sevoflurane must be used with a minimum of 2 litres/ minute of fresh gas flow. Related Glossary Terms Balanced anesthesia, Desflurane, Four A’s of anesthesia, Inhaled agents, Isoflurane, MAC, Malignant hyperthermia, Vapourizer, Volatile Index Find Term Chapter 2 - Anesthetic Equipment and Monitoring Chapter 3 - General Anesthesia Chapter 6 - Drug Finder Chapter 6 - Inhaled Agents
Shock Shock occurs when perfusion of oxygenated blood to the tissues is inadequate to support vital organ function. Categories of shock are hypovolemic, cardiogenic, neurogenic and distributive. Hypovolemic shock is inadequate organ perfusion that results from decreased circulatory volume, which can result from dehydration or blood loss. Related Glossary Terms Autonomic nervous system, Blood products, Colloids, Crystalloid, Epinephrine, Etomidate, Euvolemia, Ketamine, Maintenance fluid requirements, Metabolic acidosis, Pre-operative fluid deficit, Pulmonary artery catheter, Pulse oximeter, Pulse pressure, Sympathetic nervous system, Third space loss, Venous air embolism Index Find Term Chapter 1 - Fluid Management Chapter 1 - Fluid Management Chapter 1 - Fluid Management Chapter 3 - General Anesthesia Chapter 6 - Opioid agonists and antagonists Chapter 6 - Opioid agonists and antagonists Chapter 6 - Opioid agonists and antagonists Chapter 6 - Opioid agonists and antagonists Chapter 6 - Induction Agents Chapter 6 - Induction Agents Chapter 6 - Vasoactive Agents Chapter 6 - Vasoactive Agents
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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
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GLYCOPYRROLATE Class Anticholinergi
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SECTION 4 Induction Agents Drugs 1.
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SODIUM THIOPENTAL Class Short-actin
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KETAMINE Class Phencyclidine deriva
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ETOMIDATE Class Short-acting hypnot
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DESFLURANE Class Volatile inhaled a
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ISOFLURANE Class Volatile inhaled a
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SECTION 6 Anxiolytics Drugs 1. Mida
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SECTION 7 Antiemetics Drugs 1. Onda
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DIMENHYDRINATE Class Antihistamine,
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SECTION 8 Vasoactive Agents Drugs 1
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EPHEDRINE SULFATE Class Sympathomim
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SECTION 9 Local Anesthetics Drugs 1
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LIDOCAINE Class Local anesthetic. U
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KETOROLAC TROMETHAMINE Class Non-st
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DANTROLENE Dantrolene is used in th
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Acetylcholine Acetylcholine (Ach) i
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Adjunct An adjunct is something add
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Airway assessment The purpose of th
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Aldrete score Phase 1 of recovery m
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Analgesia Pain relief Related Gloss
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Antecubital fossa The antecubital f
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Anticholinesterase Anticholinestera
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Antisialagogue An antisialogogue is
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Apneic threshold Apneic threshold i
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Asepsis Asepsis is another word for
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Atracurium Class Nondepolarizing sk
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Autonomic nervous system The autono
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Bacterial endocarditis The 2007 Ame
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Balanced anesthesia Balanced anesth
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Bier Block An intravenous regional
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Brachial plexus The brachial plexus
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Bupivacaine Class Local anesthetic.
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Capnograph The capnograph is a moni
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Cholinesterase Cholinesterase is a
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Cis-Atracurium Class Non-depolarizi
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CO2 (carbon dioxide) absorber The C
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Competitive inhibitor Competitive i
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Cormack Lehane Cormack Cormack Leha
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Cricoid cartilage The cricoid is a
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Dantrolene Dantrolene is used in th
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Difficult airway The American Socie
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Diphenhydramine Class Antihistamine
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Dura The dura is the outermost (and
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Ephedrine Sulfate Class Sympathomim
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Epidural anesthesia In epidural ane
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Epiglottis The epiglottis is a cart
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Esophageal intubation Esophageal in
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Euvolemia Euvolemia indicates that
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Fentanyl Class Synthetic opioid ana
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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
Page 271 and 272: Neonatal opioid depression The resp
Page 273 and 274: Neuromuscular junction The neuromus
Page 275 and 276: Nicotinic Nicotinic receptors are t
Page 277 and 278: Non-depolarizing muscle relaxants T
Page 279 and 280: Ondansetron Class Seratonin ( 5-HT
Page 281 and 282: Oxygen saturation The oxygen satura
Page 283 and 284: Oxytocin Oxytocin is used in obstet
Page 285 and 286: Parturient The parturient is the pr
Page 287 and 288: Patient controlled analgesia Patien
Page 289 and 290: Peripheral nerve stimulator A perip
Page 291 and 292: Phrenic nerve The phrenic nerve, ar
Page 293 and 294: Positive pressure ventilation Posit
Page 295 and 296: Post-operative nausea and vomiting
Page 297 and 298: Pre-operative assessment Every pati
Page 299 and 300: Pre-oxygenation The purpose of pre-
Page 301 and 302: Prone In the prone position, the pa
Page 303 and 304: Pseudocholinesterase deficiency Pse
Page 305 and 306: Pulse oximeter The oxygen saturatio
Page 307 and 308: Radiculopathies Radiculopathy descr
Page 309 and 310: Re-narcotization A narcotized patie
Page 311 and 312: Recurrent laryngeal nerve The recur
Page 313 and 314: Remifentanil Class Synthetic opioid
Page 315 and 316: Reticular activating system The ret
Page 317 and 318: Rocuronium Class Non-depolarizing m
Page 319 and 320: Second stage of labour The second s
Page 321: Serotonin syndrome Serotonin syndro
Page 325 and 326: Sodium citrate Sodium citrate is a
Page 327 and 328: Spinal anesthesia Spinal anesthesia
Page 329 and 330: Subarachnoid space The subarachnoid
Page 331 and 332: Succinylcholine Class Depolarizing
Page 333 and 334: Superior laryngeal nerve The superi
Page 335 and 336: Sympathetic nervous system The symp
Page 337 and 338: Theophylline Theophylline is a medi
Page 339 and 340: Thrombocytopenia Low platelet count
Page 341 and 342: Tidal volume Tidal volume is the vo
Page 343 and 344: Transcutaneous electrical nerve sti
Page 345 and 346: Trendelenburg The trendelenburg pos
Page 347 and 348: Urticaria Hives. Urticaria is cause
Page 349 and 350: Vagolytic Drugs with a vagolytic ef
Page 351 and 352: Vallecula The vallecula is the spac
Page 353 and 354: Venous air embolism Venous air embo
Page 355 and 356: Videolaryngoscope The videolaryngos
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