Intraoperative Monitoring for Bowel Resection
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Questions and Answers

What is the primary mechanism by which abdominal insufflation and intraabdominal exploration induce a stress response?

  • Decreased plasma levels of angiotensin
  • Decreased systemic vascular resistance and cardiac output
  • Decreased mean arterial pressure
  • Increased plasma concentrations of cortisol, renin, vasopressin, epinephrine, and norepinephrine (correct)

    • Which of the following anesthetic agents or techniques is recommended to attenuate the hemodynamic responses to laparoscopic surgery?

  • Volatile inhalation anesthetic agent alone
  • Nitrous oxide
  • Opioids, alpha-2 agonists, dexmedetomidine, and beta-adrenergic receptor blockade (correct)
  • Neuraxial anesthesia as the sole anesthetic technique

    • Why is nitrous oxide best avoided in laparoscopic surgery?

  • It can increase the incidence of postoperative nausea and vomiting (PONV)
  • It can cause bowel distention
  • It can delay resolution of a gaseous air embolism
  • All of the above (correct)

    • What is the primary reason why neuraxial anesthesia is not commonly used as the sole anesthetic technique during bowel resection?

    <p>Extensive intraabdominal procedures requiring significant visceral manipulation and retraction, particularly in the mid and upper abdomen, will dramatically increase the patient's work of breathing</p> Signup and view all the answers

    What is the primary advantage of combining epidural anesthesia with general anesthesia for laparoscopic bowel resection?

    <p>Decreased intraoperative medication requirements</p> Signup and view all the answers

    What is the recommended anesthetic technique for laparoscopic surgery?

    <p>Volatile inhalation anesthetic agent with opioid and muscle relaxation</p> Signup and view all the answers

    What is the primary disadvantage of using nitrous oxide in laparoscopic surgery?

    <p>Delayed resolution of a gaseous air embolism</p> Signup and view all the answers

    What is the primary reason why laparoscopic surgery is associated with increased postoperative nausea and vomiting (PONV)?

    <p>Increased intraabdominal pressure</p> Signup and view all the answers

    What is the primary benefit of combining epidural anesthesia with general anesthesia for laparoscopic bowel resection?

    <p>Decreased intraoperative medication requirements</p> Signup and view all the answers

    Which of the following is NOT a recommended method to attenuate the hemodynamic responses to laparoscopic surgery?

    <p>Neuraxial anesthesia as the sole anesthetic technique</p> Signup and view all the answers

    Which strategy may be employed to decrease postoperative pain after laparotomy as a primary modality or as a supplement to an epidural technique?

    <p>Patient-controlled analgesia (PCA)</p> Signup and view all the answers

    What may be used to augment the effect of opioids in controlling postoperative pain after laparotomy?

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

    Which technique anesthetizes sensory nerves of the anterior abdominal wall to provide analgesia after laparotomy?

    <p>Regional anesthesia using transverse abdominis plane block</p> Signup and view all the answers

    What is used to decrease postoperative opioid requirements and is recommended as part of postoperative analgesia after laparotomy?

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

    Which medication adminstered in low IV doses can be used to enhance the effects of opioids for postoperative pain management?

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

    Which method can be initiated preoperatively and continued to provide an established level of analgesia for postoperative management?

    <p>Epidural infusion</p> Signup and view all the answers

    Which intervention anesthetizes sensory nerves of the anterior abdominal wall to provide effective analgesic supplementation?

    <p>Regional anesthesia using transverse abdominis plane block</p> Signup and view all the answers

    What may be combined with supplemental IV or oral medications to control postoperative pain effectively after laparotomy?

    <p>Epidural analgesia</p> Signup and view all the answers

    What intervention anesthetizes sensory nerves of the anterior abdominal wall and may be utilized for postoperative pain management after laparotomy?

    <p>Regional anesthesia using transverse abdominis plane block</p> Signup and view all the answers

    What can be used effectively as a single therapy or in combination with opiates for postoperative pain management after laparotomy?

    <p>Nonsteroidal anti-inflammatory drugs (NSAIDs)</p> Signup and view all the answers

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