20 Questions
What is the primary mechanism by which abdominal insufflation and intraabdominal exploration induce a stress response?
Increased plasma concentrations of cortisol, renin, vasopressin, epinephrine, and norepinephrine
Which of the following anesthetic agents or techniques is recommended to attenuate the hemodynamic responses to laparoscopic surgery?
Opioids, alpha-2 agonists, dexmedetomidine, and beta-adrenergic receptor blockade
Why is nitrous oxide best avoided in laparoscopic surgery?
All of the above
What is the primary reason why neuraxial anesthesia is not commonly used as the sole anesthetic technique during bowel resection?
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
What is the primary advantage of combining epidural anesthesia with general anesthesia for laparoscopic bowel resection?
Decreased intraoperative medication requirements
What is the recommended anesthetic technique for laparoscopic surgery?
Volatile inhalation anesthetic agent with opioid and muscle relaxation
What is the primary disadvantage of using nitrous oxide in laparoscopic surgery?
Delayed resolution of a gaseous air embolism
What is the primary reason why laparoscopic surgery is associated with increased postoperative nausea and vomiting (PONV)?
Increased intraabdominal pressure
What is the primary benefit of combining epidural anesthesia with general anesthesia for laparoscopic bowel resection?
Decreased intraoperative medication requirements
Which of the following is NOT a recommended method to attenuate the hemodynamic responses to laparoscopic surgery?
Neuraxial anesthesia as the sole anesthetic technique
Which strategy may be employed to decrease postoperative pain after laparotomy as a primary modality or as a supplement to an epidural technique?
Patient-controlled analgesia (PCA)
What may be used to augment the effect of opioids in controlling postoperative pain after laparotomy?
Ketamine
Which technique anesthetizes sensory nerves of the anterior abdominal wall to provide analgesia after laparotomy?
Regional anesthesia using transverse abdominis plane block
What is used to decrease postoperative opioid requirements and is recommended as part of postoperative analgesia after laparotomy?
Dexmedetomidine
Which medication adminstered in low IV doses can be used to enhance the effects of opioids for postoperative pain management?
Ketamine
Which method can be initiated preoperatively and continued to provide an established level of analgesia for postoperative management?
Epidural infusion
Which intervention anesthetizes sensory nerves of the anterior abdominal wall to provide effective analgesic supplementation?
Regional anesthesia using transverse abdominis plane block
What may be combined with supplemental IV or oral medications to control postoperative pain effectively after laparotomy?
Epidural analgesia
What intervention anesthetizes sensory nerves of the anterior abdominal wall and may be utilized for postoperative pain management after laparotomy?
Regional anesthesia using transverse abdominis plane block
What can be used effectively as a single therapy or in combination with opiates for postoperative pain management after laparotomy?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
Explore the use of invasive intraoperative monitoring for bowel resection surgeries, including factors influencing the decision to employ such monitoring. Learn about the importance of arterial line and pressure monitoring during surgical procedures.
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