Anesthesia and Muscle Relaxants Overview
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Questions and Answers

What is the primary use of Skeletal Muscle Relaxants (SMRs) in the operating room?

  • To provide muscle relaxation during surgery (correct)
  • To speed up the recovery process post-surgery
  • To induce general anesthesia
  • To enhance patient wakefulness

    • Which of the following muscle relaxants is known for causing muscle fasciculations?

  • Rocuronium
  • Pavulon
  • Neostigmine
  • Succinylcholine (correct)

    • What is a significant risk associated with the use of Succinylcholine?

  • Causing muscle paralysis
  • Increased heart rate
  • Triggering malignant hyperthermia (MH) (correct)
  • Causing excessive sedation

    • Which muscle relaxant can be reversed using a specific agent?

    <p>Pavulon</p> Signup and view all the answers

    What role does Glycopyrolate play when administered with Neostigmine?

    <p>Counters severe bradycardia</p> Signup and view all the answers

    Which condition prevents the administration of Succinylcholine?

    <p>Cholinesterase deficiency</p> Signup and view all the answers

    What is the characteristic of Rocuronium compared to other muscle relaxants?

    <p>It can be used for both induction and maintenance</p> Signup and view all the answers

    Which agent is primarily used for induction and maintenance of anesthesia?

    <p>Isoflurane</p> Signup and view all the answers

    What is the primary purpose of anesthesia during surgical procedures?

    <p>To induce a state of controlled, temporary loss of sensation or awareness</p> Signup and view all the answers

    Which type of anesthesia involves the patient being intubated and requiring mechanical ventilation?

    <p>General Anesthesia</p> Signup and view all the answers

    What are the phases of General Anesthesia?

    <p>Induction, Maintenance, Emergence</p> Signup and view all the answers

    What is an essential component of the surgical safety checklist?

    <p>Time-Out before skin incision</p> Signup and view all the answers

    Which anesthetic-related emergency is characterized by a severe hypermetabolic response to anesthetic agents?

    <p>Malignant hyperthermia</p> Signup and view all the answers

    How is General Anesthesia commonly administered in pediatric patients?

    <p>Inhalation gases through a face mask followed by IV insertion</p> Signup and view all the answers

    What role does the RN play in the preoperative phase concerning anesthesia?

    <p>Transporting the patient and assisting with assessments</p> Signup and view all the answers

    What distinguishes monitored anesthetic care from general anesthesia?

    <p>Monitored care provides sedation while maintaining responsiveness</p> Signup and view all the answers

    What is the primary function of the carbon dioxide absorber in a Closed Circuit or Circle System?

    <p>To remove expired CO2 from the patient</p> Signup and view all the answers

    Which component of the carbon dioxide absorber changes color upon CO2 absorption?

    <p>Soda Lime</p> Signup and view all the answers

    Which pharmacological agent is classified as a hypnotic used for amnesia?

    <p>Diazepam</p> Signup and view all the answers

    What potential risk is associated with the use of the inhalation gas Desflurane?

    <p>Risk of malignant hyperthermia</p> Signup and view all the answers

    Which of the following gases is specifically used for preoxygenation before induction?

    <p>Oxygen</p> Signup and view all the answers

    What is a unique characteristic of Propofol as an anesthetic agent?

    <p>Very short acting and used for rapid induction</p> Signup and view all the answers

    Which inhalation gas is often given in combination with oxygen during induction?

    <p>Nitrous Oxide</p> Signup and view all the answers

    What is a common concern when using Inhalation Gases like Desflurane?

    <p>Airway irritation</p> Signup and view all the answers

    What is the primary use of a Laryngeal Mask Airway (LMA)?

    <p>To secure the airway during short surgeries in the supine position</p> Signup and view all the answers

    Which local anesthetic medication can also be combined with epinephrine?

    <p>Lidocaine</p> Signup and view all the answers

    What is the correct procedure for injecting spinal anesthesia?

    <p>Inject into the subarachnoid space at L2-L5</p> Signup and view all the answers

    What is an important step before instilling analgesic medications in epidural anesthesia?

    <p>Insert a catheter in the epidural space</p> Signup and view all the answers

    What is a key consideration when performing a Bier Block?

    <p>The tourniquet should not be deflated during the surgery</p> Signup and view all the answers

    For which type of procedures is regional anesthesia typically indicated?

    <p>Specific surgeries requiring localized anesthesia</p> Signup and view all the answers

    In the Bier Block procedure, what is the effect of elevating the arm before exsanguination?

    <p>It helps ensure proper venous drainage</p> Signup and view all the answers

    What is the primary feature of using regional anesthetics?

    <p>They target specific nerve pathways</p> Signup and view all the answers

    What is the primary method to prevent aspiration during intubation and extubation?

    <p>Strict adherence to NPO status</p> Signup and view all the answers

    Which complication is characterized by a lower airway obstruction due to spasm of the laryngeal cords?

    <p>Laryngospasm</p> Signup and view all the answers

    In the event of malignant hyperthermia, which medication is specifically administered?

    <p>Dantrolene</p> Signup and view all the answers

    What actions should be taken for a patient with a known latex allergy in the operating room?

    <p>Remove all latex supplies and schedule them first</p> Signup and view all the answers

    What is a sign indicating malignant hyperthermia?

    <p>Increased body temperature</p> Signup and view all the answers

    What is the core body temperature threshold that defines perioperative hypothermia?

    <p>36 °C</p> Signup and view all the answers

    What measures should perioperative nurses be familiar with concerning a code situation in an operating room?

    <p>Hospital protocol and crash cart equipment</p> Signup and view all the answers

    What is a potential consequence of blood rushing to the field during surgery?

    <p>Risk of cardiac arrest</p> Signup and view all the answers

    Study Notes

    Anesthesia Overview

    • Anesthesia is a controlled loss of sensation or awareness, essential for surgical procedures.
    • Three phases of general anesthesia: induction, maintenance, and emergence.

    Isoflurane

    • Increases heart rate and has an irritating odor.
    • Effective for providing muscle relaxation during induction and maintenance.

    Muscle Relaxants

    • Classified as skeletal muscle relaxants (SMR) with minimal impact on smooth or cardiac muscles.
    • Facilitates intubation by relaxing the patient’s jaw and vocal cords.
    • SMRs require concomitant use of sedative medications (e.g., propofol) to prevent patients from being awake but paralyzed.

    Types of Muscle Relaxants

    • Depolarizing Muscle Relaxant:

      • Example: Succinylcholine
      • Fast-acting and short half-life (2-3 minutes).
      • Triggers malignant hyperthermia (MH); no reversal agent available.
      • Contraindicated in patients with serum cholinesterase deficiency.

    • Non-Depolarizing Muscle Relaxants:

      • Examples: Rocuronium (long-acting, has a reversal agent), Pavulon (longest acting, used in extensive surgeries).

    Reversal Agents

    • Neostigmine is the primary reversal agent, used with Glycopyrolate to manage bradycardia.

    Surgical Safety Protocols

    • Briefing: Patient on the table pre-induction.
    • Time-Out: Surgical pause before incision begins.
    • Debriefing: Conducted after surgery completion to ensure all measures are addressed.

    Anesthesia Types

    • General Anesthesia (GA): Causes a reversible unconscious state; involves intubation and mechanical ventilation.
    • Regional Anesthesia: Targets specific nerve pathways, including spinal and epidural blocks.
    • Local Anesthesia: Administered for minor procedures with minimal system involvement.
    • Monitored Anesthetic Care: Combination of sedation and local analgesia.

    Inhalational Gases

    • Stored outside hospitals, specific pipelines deliver gases like oxygen, nitrous oxide, and others.
    • Each inhalation gas can trigger malignant hyperthermia; those ending in “ANE” are particularly noted.
    • Types:
      • Oxygen: Preoxygenation before induction.
      • Nitrous Oxide: Used during induction and maintenance.
      • Sevoflurane: Suitable for pediatric mask induction.
      • Desflurane: Generally used in outpatient (ambulatory) surgery.

    Laryngeal Mask Airway (LMA)

    • Supraglottic device for maintaining airway without needing laryngoscope or muscle relaxants.

    Regional Anesthesia Techniques

    • Spinal Anesthesia: Direct injection into the subarachnoid space.
    • Epidural Anesthesia: Catheter placement for continuous analgesia.
    • Bier Block: Extremity block using local anesthetic, involving a double tourniquet.

    Anesthesia Complications

    • Aspiration: Risk of regurgitation during intubation; prevention through NPO status is vital.
    • Laryngospasm: Spasm causing airway obstruction; quick response needed.
    • Malignant Hyperthermia: Rare but serious inherited syndrome; treated with Dantrolene and supportive measures.
    • Latex Allergy: Two types (Immediate and Delayed); necessitates removal of latex items from the OR.
    • Hypothermia: Core body temperature falls below 36 °C during procedures.

    Pharmacological Agents

    • Amnesia/Hypnotic Agents: Diazepam and Midazolam.
    • Analgesics (Opioids): Fentanyl and Morphine.
    • Sleep Inducing Agents: Propofol, Sodium Methohexital, and Thiopental.
    • Muscle Relaxants: Succinylcholine, Rocuronium, and Pavulon.

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    Description

    This quiz covers essential concepts related to isoflurane, its effects on heart rate, and its role in anesthesia induction and maintenance. Additionally, it explores muscle relaxants and their functionality in the operating room, particularly in relaxing skeletal muscles. Test your knowledge of these critical components of anesthesia practice.

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