NSAIDs and Alpha-2 Adrenergic Agonists
Fig. 15.1 Mechanism of action of NSAIDs Clinical Uses In the perioperative period, NSAIDs are primarily used for their analgesic effect. They may be used alone for mild to moderate…
Opioids and Benzodiazepines
Fig. 12.1 Chemical structures of select opioid agonists and antagonist (naloxone) Pharmacokinetics Pharmacokinetics includes the processes of absorption, distribution, metabolism, and excretion. With respect to opioids, these processes characterize the…
Inhalational Anesthetics
Agent Blood–gas partition coefficient Desflurane 0.42 Nitrous oxide 0.47 Sevoflurane 0.65 Isoflurane 1.46 Halothane 2.5 Cardiac output: The uptake of the anesthetic gas into the blood is determined by the…
Intravenous Induction Agents
Fig. 11.1 Drug distribution in various tissues over time after an intravenous bolus dose This rapid metabolism of propofol minimizes any residual effects after wakening. This lack of “hangover” effect…
Antiemetics
Drug category Mechanism of action Specific drugs Typical dose Serotonin (5HT3) antagonists Antagonism of serotonin 5HT3 receptors in the CTZ, the medullary vomiting center, and in the periphery Ondansetron 4–16…
Preoperative Evaluation
Fig. 2.1 Goals of preoperative evaluation Table 2.1 Basic preoperative evaluation Patient particulars Age Sex Height Weight Allergies Drug and type of allergy: rash/anaphylaxis Medications List of medications and those…
Approach to Anesthesia
Problem Cause Treatment Difficulty/failure to ventilate Circuit disconnection Check circuit attachments Obstruction—mucus plug, biting ETT Suction of ETT, if biting ETT—insert oral airway, deepen anesthesia Pneumothorax (no breath sounds) Auscultate…
Neuromuscular Blocking and Reversal Agents
Fig. 13.1 Physiology of neuromuscular transmission. (a) At the neuromuscular junction, where calcium influx causes release of Ach. Ach then binds to the postsynaptic nicotinic Ach receptors at the motor…
High-Definition and Three-Dimensional Volumetric Ultrasound Imaging of the Sciatic Nerve
Fig. 18.1 Anatomical illustration showing the formation of the lumbosacral plexus by the union of the anterior primary rami of the L4, L5, S1, S2, S3, and S4 spinal nerves…
