Podcast
Questions and Answers
When performing a tonsillectomy, what laser type is typically used?
When performing a tonsillectomy, what laser type is typically used?
Which of the following is NOT a common patient problem that would necessitate an endoscopic ENT procedure?
Which of the following is NOT a common patient problem that would necessitate an endoscopic ENT procedure?
During an endoscopic procedure, the presence of a tumor is identified. What is the MOST important factor to assess preoperatively regarding the tumor?
During an endoscopic procedure, the presence of a tumor is identified. What is the MOST important factor to assess preoperatively regarding the tumor?
During a procedure involving electrocautery and an open oxygen delivery system, what is the MOST appropriate action to minimize fire risk?
During a procedure involving electrocautery and an open oxygen delivery system, what is the MOST appropriate action to minimize fire risk?
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Which of the following laser types is LEAST likely to be used in an ENT procedure due to its clinical application?
Which of the following laser types is LEAST likely to be used in an ENT procedure due to its clinical application?
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Which of the following is NOT considered a standard fire safety precaution during ENT procedures?
Which of the following is NOT considered a standard fire safety precaution during ENT procedures?
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What is the PRIMARY reason for using a laser resistant and well-sealed ETT during an ENT procedure?
What is the PRIMARY reason for using a laser resistant and well-sealed ETT during an ENT procedure?
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During an airway fire, what is the initial MOST critical action?
During an airway fire, what is the initial MOST critical action?
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Which of the following is a SIGN of an airway fire?
Which of the following is a SIGN of an airway fire?
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Which of the following laser types requires ORANGE eye protection during use?
Which of the following laser types requires ORANGE eye protection during use?
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What is the primary reason laser-resistant endotracheal tubes (ETTs) should be used during airway-laser procedures?
What is the primary reason laser-resistant endotracheal tubes (ETTs) should be used during airway-laser procedures?
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In the context of ventilation techniques, what is a significant disadvantage of using intermittent apnea?
In the context of ventilation techniques, what is a significant disadvantage of using intermittent apnea?
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Which type of tubing is recommended for procedures involving CO2 and KTP lasers?
Which type of tubing is recommended for procedures involving CO2 and KTP lasers?
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Why should saline mixed with methylene blue be used to fill the pilot balloon cuff of a laser tube?
Why should saline mixed with methylene blue be used to fill the pilot balloon cuff of a laser tube?
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What is a unique advantage of using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) during procedures?
What is a unique advantage of using Transnasal Humidified Rapid-Insufflation Ventilatory Exchange (THRIVE) during procedures?
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Which of the following is NOT a consideration when positioning a patient for surgery?
Which of the following is NOT a consideration when positioning a patient for surgery?
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What is the primary objective of controlled hypotension during surgery?
What is the primary objective of controlled hypotension during surgery?
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Which medication is NOT utilized in the induction of controlled hypotension?
Which medication is NOT utilized in the induction of controlled hypotension?
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How much should the mean arterial pressure (MAP) typically be reduced in controlled hypotension?
How much should the mean arterial pressure (MAP) typically be reduced in controlled hypotension?
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Which of the following patients might require a higher MAP during controlled hypotension?
Which of the following patients might require a higher MAP during controlled hypotension?
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PONV is known to be more common with which type of surgical procedure?
PONV is known to be more common with which type of surgical procedure?
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Which topical local anesthetic has the potential side effect of methemoglobinemia?
Which topical local anesthetic has the potential side effect of methemoglobinemia?
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Which of the following agents is specifically mentioned as a controlled hypotension method?
Which of the following agents is specifically mentioned as a controlled hypotension method?
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In the context of controlled hypotension, what does UO stand for and why is it monitored?
In the context of controlled hypotension, what does UO stand for and why is it monitored?
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Which inhalational agent is commonly used in controlled hypotension?
Which inhalational agent is commonly used in controlled hypotension?
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Which of the following is a common patient problem frequently encountered prior to undergoing a tonsillectomy and adenoidectomy?
Which of the following is a common patient problem frequently encountered prior to undergoing a tonsillectomy and adenoidectomy?
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In the context of bilateral myringotomy tube insertion, why are N2O and sevo preferred for mask induction and maintenance?
In the context of bilateral myringotomy tube insertion, why are N2O and sevo preferred for mask induction and maintenance?
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Which of the following scenarios would necessitate a comprehensive pre-operative evaluation using the STBUR questionnaire in a patient scheduled for tonsillectomy and adenoidectomy?
Which of the following scenarios would necessitate a comprehensive pre-operative evaluation using the STBUR questionnaire in a patient scheduled for tonsillectomy and adenoidectomy?
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What is an appropriate approach to administering anesthetics during bilateral myringotomy tube insertion?
What is an appropriate approach to administering anesthetics during bilateral myringotomy tube insertion?
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During a tonsillectomy and adenoidectomy, the anesthesia provider should prioritize which of the following?
During a tonsillectomy and adenoidectomy, the anesthesia provider should prioritize which of the following?
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What is the rationale for avoiding pre-operative sedatives in patients undergoing bilateral myringotomy tube insertion?
What is the rationale for avoiding pre-operative sedatives in patients undergoing bilateral myringotomy tube insertion?
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When planning for a tonsillectomy and adenoidectomy, which of the following aspects should be considered regarding the patient's history?
When planning for a tonsillectomy and adenoidectomy, which of the following aspects should be considered regarding the patient's history?
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What is a crucial consideration when managing a pediatric patient for a tonsillectomy?
What is a crucial consideration when managing a pediatric patient for a tonsillectomy?
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Why is meticulous oropharyngeal suctioning important after anesthesia in tonsillectomy?
Why is meticulous oropharyngeal suctioning important after anesthesia in tonsillectomy?
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Which factor is NOT a risk for post-tonsillectomy hemorrhage?
Which factor is NOT a risk for post-tonsillectomy hemorrhage?
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What is a correct statement about the anesthesia technique for adults?
What is a correct statement about the anesthesia technique for adults?
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What position is recommended when transferring a patient to the post-anesthesia care unit (PACU) after a tonsillectomy?
What position is recommended when transferring a patient to the post-anesthesia care unit (PACU) after a tonsillectomy?
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What is the 'Rule of 10' in the context of cleft lip and palate repair?
What is the 'Rule of 10' in the context of cleft lip and palate repair?
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Which condition requires extreme care during direct laryngoscopy (DL) after a tonsillectomy?
Which condition requires extreme care during direct laryngoscopy (DL) after a tonsillectomy?
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What airway management technique is not typically employed for children during anesthesia induction?
What airway management technique is not typically employed for children during anesthesia induction?
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What should be monitored after extubation to prevent post-operative complications?
What should be monitored after extubation to prevent post-operative complications?
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Study Notes
Patient Positioning
- Patients are often turned 90-180 degrees away from the anesthesia provider
- Precise attention to ETT placement and securement is critical
- Confirm ETT placement during every repositioning
- Vigilant monitoring is needed
Controlled Hypotension
- MAP is reduced to a predetermined acceptable level
- Aim: decrease bleeding and improve surgical visualization
- For certain patients, not appropriate
- Usually no more than 20% decrease from baseline
- Requires an arterial line (A-Line)
- Chronic hypertension patients may need higher MAP
- Monitor urine output, MAP, cerebral and cardiac perfusion pressures, and ABGs
- Methods include:
- Inhalational agents
- Vasodilating agents:
- Beta blockers (Labetalol, Esmolol)
- Alpha 2 adrenergic agonists (Dexmedetomidine)
- Calcium channel blockers -Ultra-short acting opioids (Remifentanil) -Magnesium sulfate
PONV
- ENT procedures can have a higher PONV incidence
- Middle ear procedures are associated with increased PONV risk
- Pediatric strabismus procedures also associated with increased risk
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Description
This quiz covers important aspects of patient positioning and controlled hypotension in anesthesia. It emphasizes the significance of ETT placement, monitoring during repositioning, and the controlled hypotension techniques used to enhance surgical outcomes. Additionally, it addresses PONV incidence in certain procedures.
