ANESTHESIA

DRUGS RELEVANT TO PRACTICE OF ANESTHESIA

Jul 4, 2016 by in ANESTHESIA Comments Off on DRUGS RELEVANT TO PRACTICE OF ANESTHESIA

Dolasetron (Anzemet): See 5HT3 Antagonists. Droperidol (Inapsine) Indication: (1) Prevention/treatment of postoperative nausea and vomiting. Also used for (2) sedation, GA adjunct, treatment of delirium although alternate drugs are preferred…

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FOR VASCULAR SURGERY

Jul 4, 2016 by in ANESTHESIA Comments Off on FOR VASCULAR SURGERY

(lower should remain OFF until after reperfusion & stabilization) • Foley catheter: Goal urine output >0.5 mL/kg/hr • PRBC in the OR; may also need FFP •  Management before clamping…

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IN ANESTHESIA

Jul 4, 2016 by in ANESTHESIA Comments Off on IN ANESTHESIA

•  In pediatric patients a 20–24 gauge needle may be used for the first cannulation and then exchanged with a larger gauge over a guidewire •  Proceed as described in…

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INTRAOPERATIVE PROBLEMS

Jul 4, 2016 by in ANESTHESIA Comments Off on INTRAOPERATIVE PROBLEMS

•  Consider bronchoscopy •  Consider bag ventilation •  Treat underlying problem BRONCHOSPASM Causes •  Preexisting reactive airway disease (asthma) •  Manipulation of upper airway (oral endoscopy) •  ETT with inadequate…

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ANESTHETICS

Jul 4, 2016 by in ANESTHESIA Comments Off on ANESTHETICS

PHARMACODYNAMICS •  Ionization best correlates with onset of action. LAs exist in free equilibrium in both charged (ionized) and neutral (non-ionized) forms: • The ionized form binds to the receptor…

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INHALED ANESTHETICS

Jul 4, 2016 by in ANESTHESIA Comments Off on INHALED ANESTHETICS

MAJOR FACTORS AFFECTING UPTAKE Solubility •  Partition coefficients express relative solubility of anesthetic gas at equilibrium •  Lower partition coefficients imply ↓ solubility, faster equilibration of partial pressure (alveolus ↔…

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AUTONOMIC, AND CARDIOVASCULAR DRUGS

Jul 4, 2016 by in ANESTHESIA Comments Off on AUTONOMIC, AND CARDIOVASCULAR DRUGS

ADRENERGIC AGONISTS General comments: Act on α, β, or dopaminergic receptors (see the table below). May cause tachycardia, hypertension, arrhythmias, myocardial ischemia, and tissue necrosis with extravasation (administer centrally, treat…

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BLOCKING DRUGS

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•  Clinical Considerations •  Indications: Bolus dosing used for rapid sequence induction when aspiration is a risk (i.e., full stomach, trauma, diabetes mellitus, hiatal hernia, obesity, pregnancy); infusion useful in…

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ANESTHETICS

Jul 4, 2016 by in ANESTHESIA Comments Off on ANESTHETICS

GENERAL PRINCIPLES •  Lipophilic drugs produce rapid induction of general anesthesia •  Most IV anesthetics exert effect through activation or augmentation of postsynaptic GABAA receptors (↑ chloride influx → hyperpolarization…

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limb blocks

Jul 4, 2016 by in ANESTHESIA Comments Off on limb blocks

CHAPTER 8 Upper limb blocks Interscalene block Use this block for anaesthesia/analgesia of the shoulder joint (dislocation reduction), arm, elbow, and proximal forearm injuries or amputations (Fig. 8.1). Fig. 8.1…

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