Anesthesia

Anesthesia 150 150 Tony Guo

Anesthesia

  • Anesthetic technique and agents are selected by the ACP that consider
    • Physical and mental status
    • Age
    • Allergy and pain history
    • Expertise of the ACP
    • Factors related to operative procedure
  • Classification of anesthesia
    • General anesthesia
      • Rarely use only one agent
        • Adjuncts
      • Dissociative anesthesia
        • Ketamine (Ketalar)
    • Adjuncts to general anesthesia
      • Opioids
        • Sedation and analgesia
        • Induction and maintenance intraoperatively
        • Pain management postoperatively
        • Respiratory depression
          • Assess respiratory rate and rhythm, monitor pulse oximetry, protect airway in anticipation of vomiting.
          • Use standing orders for antipruritics and antiemetics.
          • Reverse opioid-induced respiratory depression with naloxone (Narcan). If used, reversal of analgesic effects also occurs.
      • Benzodiazepines
        • Premedication for amnesia
        • Induction of anesthesia
        • Monitored anesthesia care
          • Monitor level of consciousness. Assess for respiratory depression, hypotension, and tachycardia.
          • Reverse severe benzodiazepine-induced respiratory depression with lumazenil (Romazicon).
      • Neuromuscular agents
        • Promote skeletal muscle relaxation (paralysis)
          • If intubated, monitor return of muscle strength, level of consciousness, and ventilation.
          • Maintain patent airway. Monitor respiratory rate and rhythm until patient able to cough and return to previous levels of muscle strength. Ensure availability of nondepolarizing reversal agents (e.g., neostigmine [Prostigmin]) and emergency respiratory support equipment.
          • Monitor temperature and levels of muscle strength with temperature changes.
      • Antiemetics
        • Prevent nausea and vomiting associated with anesthesia
          • Monitor heart rhythm, cardiopulmonary status, level of central nervous system excitation or sedation, ability to move limbs, presence of nausea or vomiting
    • Local anesthesia
      • Loss of sensation without loss of consciousness
      • Types
        • Topical
        • Ophthalmic
        • Nebulized
        • Injectable
    • Regional anesthesia
      • Loss of sensation in body region without loss of consciousness when specific nerve or group of nerves is blocked by administration of local anesthetic
      • Always injected

Leave a Reply

Your email address will not be published.