Spinals and Epidurals
Spinals and Epidurals ▪General Information Spinal Needles Quincke: Cutting needle; end injection. Whitacre: Pencil point rounded; side injxn; decr incidence of PDSH. Sprotte: Long opening at end; side injxn; increases…
ANESTHESIA
Local Anesthetics
Local Anesthetics ▪Ester Local Anesthetics Metabolized by pseudocholinesterase to PABA; have incr risk of allergy. Procaine (Novocaine) 0.5-1% Onset fast, SDOA 25-30 min, low potency. Spinal, PNB. Cloroprocaine (Nesacaine) 1%-3%…
Pediatric Anesthesiology
Pediatric Anesthesiology ▪General Guidelines for Pediatric Patients General Guidelines Preemie Birth 6 mo 1 yo 2 yo 3 yo 4 yo 5 yo 6 yo 7 yo 8 yo 10…
Obstetric Anesthesia
Obstetric Anesthesia ▪Obstetric Patient and Anesthesia Decr in overall anesthetic requirements; MAC decreased by 40%. Decr gastric motility w/incompetent gastroesophageal junction leads to regurgitation of gastric contents. All OB pts…
Pharmacology
Pharmacology ▪Minimal Alveolar Concentration (MAC) Effects of Common Anesthetics on MAC Halothane Isoflurane Enflurane Sevoflurane Desflurane Nitrous Oxide Odor − + − − ++ − MAC 0.75 1.17 1.63 1.80…
Anesthesia Information
Anesthesia Information ▪Anesthesia Gas Machine Check Verify that backup equipment is available and functioning. Ambu bag (with mask) Check flashlight (working?) Suction on and ready Transtracheal Jet Ventilator, and 14…
Intravenous Fluids
Intravenous Fluids ▪Fluid Maintenance Maintenance rate Maintenance requirements: (4-2-1 Rule) 1-10 kg = 4 cc/kg/hr 40 cc (110 cc for a 70 kg pt) 11-20 kg = 2 cc/kg/hr 20…
FOR OBSTETRIC AND GYNECOLOGIC SURGERY
ANESTHESIA FOR LABOR AND DELIVERY • Nonpharmacologic analgesia choices: Hypnotherapy, hydrotherapy, and transcutaneous electrical nerve stimulation (TENS) • Pharmacologic analgesia: Inhalation analgesia, parenteral opioid analgesia (fentanyl, nalbuphine), pudendal block, paracervical…
ELECTROLYTES, & TRANSFUSION THERAPY
(LR, NS, & hetastarch → shown to ↑ neutrophil activation; blood, 7.5% hypertonic saline, & albumin did not have this effect) Figure 9-1. Assessment of volume status. Colloid osmotic pressure (COP)…
