Anesthesia Adjuncts: Helper Drugs

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Questions and Answers

What is the primary purpose of adjunct anesthetics?

To replace general anesthetics
To complement the use of general anesthetics (correct)
To reduce the dosage of general anesthetics
To induce anesthesia

Which of the following is NOT a type of adjunct anesthetic?

Antibiotics (correct)
Neuromuscular blocking agents
Sedative hypnotics
Opioid analgesics

What is the primary effect of general anesthetics on the CNS?

Alteration of sensory and motor functions
No effect on sensory and motor functions
Stimulation of sensory and motor functions
Reduction of sensory and motor functions (correct)

What is the last system to be affected by general anesthesia?

Cardiac and pulmonary functions (C) Signup and view all the answers

What is a rare but potentially fatal complication of general anesthesia?

Malignant hyperthermia (C) Signup and view all the answers

What is the treatment for malignant hyperthermia?

Administration of dantrolene (C) Signup and view all the answers

What are two factors that influence the dose of an anesthetic?

Complexity of the surgical procedure and physical characteristics of the patient (A) Signup and view all the answers

What is a characteristic of all general anesthetics in terms of pharmacokinetics?

Rapid onset and rapid elimination (A) Signup and view all the answers

Which system is commonly affected by the adverse effects of general anesthetics?

All of the above (D) Signup and view all the answers

What is a benefit of Sevoflurane in outpatient surgery settings?

It has a rapid onset and rapid elimination (A) Signup and view all the answers

What is a characteristic of Ketamine?

It is highly lipid soluble (B) Signup and view all the answers

What is Propofol commonly used for?

General anesthesia and sedation for mechanical ventilation (C) Signup and view all the answers

What is the primary effect of local anesthetics?

Blocking nerve conduction in specific areas (B) Signup and view all the answers

When are local anesthetics commonly used?

In clinical settings where loss of consciousness is undesirable or unnecessary (B) Signup and view all the answers

What is an adverse effect of Ketamine?

Hallucinations (B) Signup and view all the answers

What is Isoflurane similar to?

Enflurane (C) Signup and view all the answers

What type of anesthesia involves injection of anesthetic into the subarachnoid space?

Intrathecal anesthesia (B) Signup and view all the answers

What is the main mechanism of action of local anesthetics?

Blocking the movement of certain ions (A) Signup and view all the answers

What is the name of the local anesthetic that is available in several strengths and is used for both infiltration and nerve block anesthesia?

Lidocaine (A) Signup and view all the answers

What is the main purpose of topical anesthesia?

To prevent pain from being sensed (A) Signup and view all the answers

What is the potential systemic effect of local anesthetics on the body?

Affecting circulatory and respiratory function (C) Signup and view all the answers

What is the term for the injection of anesthetic solution into the tissue that surrounds the operative site?

Infiltration (A) Signup and view all the answers

What is the other medical use of parenteral lidocaine besides anesthesia?

Treating cardiac dysrhythmias (A) Signup and view all the answers

What is the term for the injection of anesthetic solution at the site where the nerve innervates a specific area?

Nerve block (A) Signup and view all the answers

What is the main effect of Neuromuscular Blocking Drugs (NMBDs) on skeletal and smooth muscles?

Paralysis (B) Signup and view all the answers

Why is mechanical ventilation required when using NMBDs?

To prevent brain damage or death by suffocation (A) Signup and view all the answers

What is the mechanism of action of depolarizing NMBDs?

Competitive agonists of acetylcholine (C) Signup and view all the answers

What is the main use of NMBDs in surgical procedures?

Maintaining controlled ventilation during surgical procedures (B) Signup and view all the answers

Which of the following NMBDs is a short-acting nondepolarizing drug?

Mivacurium (C) Signup and view all the answers

What is a common adverse effect of NMBDs due to the release of histamine?

Hypotension (D) Signup and view all the answers

Why does succinylcholine cause flaccid muscle paralysis?

Because of its slow metabolism compared to acetylcholine (D) Signup and view all the answers

Which of the following NMBDs is most commonly used for long surgical procedures?

Pancuronium (D) Signup and view all the answers

What is the primary purpose of Vancuronium in surgical settings?

To facilitate tracheal intubation and provide skeletal muscle relaxation (B) Signup and view all the answers

What is a crucial aspect of nursing assessment during the preoperative phase?

Assessing past history of surgeries and response to anesthesia (A) Signup and view all the answers

What is a potential complication of prolonged use of Vancuronium in the ICU setting?

Prolonged paralysis and difficulty in weaning (B) Signup and view all the answers

What is an important aspect of patient care during the postoperative phase?

Reorienting patient to their surroundings (A) Signup and view all the answers

What is a vital sign that should be monitored during the preoperative, intraoperative, and postoperative phases?

Oxygen saturation (C) Signup and view all the answers

What is an important teaching point for patients during the postoperative phase?

Postoperative turning, coughing, and deep breathing (B) Signup and view all the answers

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Study Notes

Anesthesia and Adjuncts

Anesthesia is used to facilitate endotracheal intubation and provide skeletal muscle relaxation during surgery or mechanical ventilation.
Adjuncts are "helper drugs" that complement the use of general anesthetics for anesthesia induction, sedation, reduction of anxiety, and amnesia.

Neuromuscular Blocking Agents (NMBDs)

NMBDs prevent nerve transmission in skeletal and smooth muscles, leading to paralysis.
They are used as adjuncts with general anesthetics and require mechanical ventilation to prevent brain damage or death by suffocation.
NMBDs are classified into two groups based on mechanism of action: depolarizing and nondepolarizing.

Depolarizing NMBDs

Succinylcholine is a depolarizing NMBD that is metabolized slowly, causing flaccid muscle paralysis.
It is used to facilitate endotracheal intubation due to its quick onset of action (less than 1 minute).

Nondepolarizing NMBDs

Examples include atracurium, rocuronium, vecuronium, and pancuronium.
They are competitive antagonists of acetylcholine and are classified as short-acting, intermediate-acting, or long-acting based on their duration of action.

General Anesthetics

Isoflurane is a fluorinated ether with a rapid onset of action, minimal cardiovascular depression, and low toxicity.
Sevoflurane is the newest fluorinated ether, with rapid onset and elimination, making it useful for outpatient surgery.
Ketamine is used for general anesthesia and moderate sedation, with a rapid onset of action and low incidence of cardiovascular and respiratory depression.
Propofol is a parenteral general anesthetic used for induction and maintenance of general anesthesia, as well as sedation for mechanical ventilation in ICU settings.

Local Anesthesia (Regional Anesthetics)

Local anesthetics reduce pain sensations at the level of peripheral nerves, blocking nerve conduction in specific areas of the body.
They are used in clinical settings where loss of consciousness is undesirable or unnecessary, such as childbirth, dental procedures, and diagnostic procedures.

Types of Local Anesthesia

Central: spinal or intraspinal anesthesia, including intrathecal and epidural anesthesia.
Peripheral: infiltration, nerve block, and topical anesthesia.

Mechanism of Action and Adverse Effects of Local Anesthetics

Local anesthetics work by interfering with nerve transmission in a specific area, blocking the generation and conduction of impulses.
Systemic adverse effects depend on the administration site and dosage, and may affect circulatory and respiratory functions.

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