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Questions and Answers
What is the primary effect of anesthetics on the body?
What is the primary effect of anesthetics on the body?
What is moderate sedation also known as?
What is moderate sedation also known as?
What is the primary difference between general anesthesia and moderate sedation?
What is the primary difference between general anesthesia and moderate sedation?
What is the purpose of combining multiple drugs in general anesthesia?
What is the purpose of combining multiple drugs in general anesthesia?
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What is the primary route of administration for parenteral anesthetics?
What is the primary route of administration for parenteral anesthetics?
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What is the primary effect of inhalational anesthetics?
What is the primary effect of inhalational anesthetics?
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What is the purpose of using a synergistic combination of drugs in general anesthesia?
What is the purpose of using a synergistic combination of drugs in general anesthesia?
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What is the primary characteristic of local anesthesia?
What is the primary characteristic of local anesthesia?
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What is the purpose of injecting anesthesia into the subarachnoid space?
What is the purpose of injecting anesthesia into the subarachnoid space?
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What is the primary mechanism of action of local anesthetics?
What is the primary mechanism of action of local anesthetics?
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What is the main difference between spinal and epidural anesthesia?
What is the main difference between spinal and epidural anesthesia?
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What is the purpose of using epinephrine with local anesthetics?
What is the purpose of using epinephrine with local anesthetics?
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What is the primary advantage of topical anesthesia?
What is the primary advantage of topical anesthesia?
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What is a potential systemic effect of local anesthetics?
What is a potential systemic effect of local anesthetics?
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What is a common use of lidocaine?
What is a common use of lidocaine?
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What is a unique property of lidocaine?
What is a unique property of lidocaine?
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What is the primary purpose of using adjunct anesthetics?
What is the primary purpose of using adjunct anesthetics?
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Which of the following is NOT a type of adjunct anesthetic?
Which of the following is NOT a type of adjunct anesthetic?
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What is the characteristic of fat-soluble drugs compared to water-soluble drugs?
What is the characteristic of fat-soluble drugs compared to water-soluble drugs?
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What is the sequence of sensory loss during general anesthesia?
What is the sequence of sensory loss during general anesthesia?
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What is the most common cardiovascular effect of general anesthetics?
What is the most common cardiovascular effect of general anesthetics?
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What is the treatment for malignant hyperthermia?
What is the treatment for malignant hyperthermia?
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What is a factor that determines the dose of an anesthetic?
What is a factor that determines the dose of an anesthetic?
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What is the term used to describe the simultaneous use of general anesthetics and adjunct drugs?
What is the term used to describe the simultaneous use of general anesthetics and adjunct drugs?
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What is the main purpose of using Vancuronium in anesthesia?
What is the main purpose of using Vancuronium in anesthesia?
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What is essential during the preoperative phase of anesthesia?
What is essential during the preoperative phase of anesthesia?
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What is a potential complication of long-term use of Vancuronium in the ICU setting?
What is a potential complication of long-term use of Vancuronium in the ICU setting?
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What is the result of neuromuscular blocking drugs on skeletal and smooth muscles?
What is the result of neuromuscular blocking drugs on skeletal and smooth muscles?
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Why is mechanical ventilation required when using neuromuscular blocking drugs?
Why is mechanical ventilation required when using neuromuscular blocking drugs?
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What is an important aspect of nursing care during the postoperative phase?
What is an important aspect of nursing care during the postoperative phase?
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What should be monitored during the recovery phase of anesthesia?
What should be monitored during the recovery phase of anesthesia?
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What type of agonists are depolarizing neuromuscular blocking drugs?
What type of agonists are depolarizing neuromuscular blocking drugs?
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Why is it essential to reorient the patient to their surroundings during the postoperative phase?
Why is it essential to reorient the patient to their surroundings during the postoperative phase?
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Which of the following is a short-acting nondepolarizing neuromuscular blocking drug?
Which of the following is a short-acting nondepolarizing neuromuscular blocking drug?
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What is the primary use of neuromuscular blocking drugs during surgical procedures?
What is the primary use of neuromuscular blocking drugs during surgical procedures?
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What is a common adverse effect of neuromuscular blocking drugs?
What is a common adverse effect of neuromuscular blocking drugs?
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Why is succinylcholine used to facilitate endotracheal intubation?
Why is succinylcholine used to facilitate endotracheal intubation?
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What is the characteristic of pancuronium?
What is the characteristic of pancuronium?
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Study Notes
Anesthesia
- Anesthesia is a state of reduced neurologic function, characterized by complete or partial loss of sensation.
Moderate Sedation
- Also known as conscious sedation or procedural sedation
- Does not necessarily cause complete loss of consciousness and does not normally cause respiratory arrest
- Uses a combination of several drugs from different groups
- Drugs may be given by IV, IM, spinal, or oral routes
- Allows the patient to relax yet maintain their own open airway and respond to verbal commands
- Used for diagnostic procedures and minor surgical procedures that do not require deep anesthesia
General Anesthesia
- Involves complete loss of consciousness, loss of body reflexes, elimination of pain and other sensations throughout the entire body, and skeletal and smooth muscle paralysis
- General anesthetics are drugs that induce general anesthesia, and are most commonly used to induce anesthesia during surgical procedures
- Often achieved by the use of one or more drugs, which allows for smaller doses of each drug and better control of the patient's anesthetized state
- Can be classified into inhalational anesthetics (volatile liquids or gases that are vaporized or mixed with oxygen) and parenteral anesthetics (given IV and used for induction and/or maintenance of general anesthesia, induction of amnesia, and as adjuncts to inhalation anesthetics)
Adjunct Anesthetics
- "Helper drugs" that complement the use of general anesthetics and are used simultaneously for anesthesia induction, sedation, reduction of anxiety, and amnesia
- Examples include neuromuscular blocking agents, sedative hypnotics or anxiolytics, propofol, benzodiazepines, barbiturates, hydroxyzine, promethazine, opioid analgesics, anticholinergics, and antiemetics
Mechanism of Action and Drug Effects
- The mechanism of action of general anesthetics varies widely and is not easily explained by a structure-receptor relationship
- Fat-soluble drugs are stronger anesthetics than water-soluble drugs
- The overall effect of general anesthetics is a progressive reduction of sensory and motor CNS functions
- The degree and speed of this process vary with the anesthetics and adjuncts used, along with their dosages and routes of administration
Adverse Effects of General Anesthesia
- Sites primarily affected include the heart, peripheral circulation, liver, kidneys, and respiratory tract
- Malignant hyperthermia is an uncommon but potentially fatal adverse effect, characterized by sudden elevation in body temperature, tachypnea, tachycardia, muscle rigidity, and can be treated with dantrolene
Local Anesthesia
- Types include central (spinal or intraspinal anesthesia), peripheral (infiltration, nerve block, and topical anesthesia)
- Mechanism of action involves blocking the generation and conduction of nerve impulses by blocking the movement of certain ions
- Adverse effects include systemic effects on circulatory and respiratory function, which depend on where and how the drug is administered
Lidocaine
- One of the most commonly used local anesthetics, available in several strengths and concentrations with epinephrine
- Used for both infiltration and nerve block anesthesia, and also available in topical form
- Parenteral lidocaine is also used to treat certain cardiac dysrhythmias
Neuromuscular Blocking Drugs (NMBDs)
- Prevent nerve transmission in skeletal and smooth muscles, leading to paralysis
- Often used as adjuncts with general anesthetics, and require mechanical ventilation to prevent brain damage or death by suffocation
- Can be classified into depolarizing (e.g., succinylcholine) and non-depolarizing (e.g., mivacurium, atracurium, rocuronium, vecuronium, dexacurium, pancuronium, and tubocurarine) types
- Indications include maintaining controlled ventilation during surgical procedures, endotracheal intubation, reducing muscle contraction in an area that needs surgery, and as diagnostic drugs for myasthenia gravis
Nursing Implications
- Always assess past history of surgeries and response to anesthesia
- Assessment is vital during preoperative, intraoperative, and postoperative phases
- Monitor vital signs, baseline lab work, ECG, oxygen saturation, and ABCs
- Watch for sudden elevations in body temperature during recovery, and monitor for cardiovascular depression, respiratory depression, and complications of anesthesia
- Implement safety measures during recovery, especially if motor or sensory loss occurs due to local anesthesia
- Reorient the patient to their surroundings and teach them about postoperative turning, coughing, and deep breathing
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Description
Learn the fundamentals of anesthesiology, including the definition of anesthesia, anesthetics, and moderate sedation techniques.
