14 Questions
Why do pediatric patients exhibit increased sensitivity to anesthetic drugs?
Due to decreased ability to form glucuronide conjugates in neonates and infants up to three months of age
What effect does decreased ability to form glucuronide conjugates have on drug metabolism in pediatric patients?
Decreased drug metabolism of drugs like propofol and lorazepam
What is the impact of increased half-life and duration of action of anesthetic drugs in children?
Narrower therapeutic index for anesthetic drugs
Why are simulation studies considered an alternative to clinical trials for determining dosing regimens for anesthetic drugs in children?
To determine the most appropriate dosing regimens without conducting clinical trials
How does the context-sensitive half-time of certain drugs like remifentanil affect pediatric patients?
It increases in children, leading to potential drug accumulation with prolonged infusions
What is a key factor that can help alleviate anxiety in pediatric patients undergoing surgery?
Preoperative preparation and tours of the operating room
Why is age alone not a reliable predictor of adverse outcomes in elderly surgical patients?
The aging process affects individuals differently based on their health and function.
Which technique is essential during obstetric anesthesia to prevent aortocaval compression syndrome?
Left uterine displacement
What is recommended to reduce the risk of gastric contents aspiration during general anesthesia for pregnant patients?
Rapid sequence induction and intubation
Why is deferred surgery often considered the safest option for patients with cardiovascular diseases?
To allow time for further medication optimization or coronary revascularization
Which population constitutes a large proportion of the surgical population according to the text?
Elderly surgical patients
Why do older patients tend to use more healthcare resources according to the text?
Because of increased health needs from deteriorating organ systems
What is a key factor to ease the progression to a surgical delivery during obstetric anesthesia?
"Determining surgical intervention indications"
What approach should be taken during surgery to alleviate anxiety and ensure a safe experience for pediatric patients?
Hold the child in the lap until anesthesia is induced
Study Notes
Pediatric Anesthesia
- Anxiety in children can arise from understanding of the hospital, fear of the unknown, isolation from parents, and loss of control over events.
- Preoperative preparation, tours of the operating room, and the presence of a comforting parent can help alleviate anxiety.
- Separation from parents should be done quickly, and holding the child in the lap until anesthesia is induced is generally the best approach.
Geriatric Anesthesia
- Geriatric patients are a growing segment of the population, and their care is complex and challenging.
- Age alone is not a reliable predictor of adverse outcomes in the elderly surgical patient.
- The aging process involves numerous physiologic and pathologic changes, affecting their health.
- Elderly patients are heterogeneous, with vast differences in functional ability between patients.
- Older patients tend to use more healthcare resources due to increased health needs from deteriorating organ systems and intolerance to disabilities.
Obstetric Anesthesia
- General anesthesia is the only type of anesthesia that can be formally administered to provide pain relief and loss of consciousness during surgery.
- Rapid sequence induction and intubation are recommended to reduce the risk of gastric contents aspiration during pregnancy.
- Left uterine displacement is essential to prevent aortocaval compression syndrome, which can cause hypotension and decrease blood flow to the uterus, potentially compromising the fetus.
- Muscle relaxants should be decreased due to difficulties in intubation and muscle weakness.
Anesthesia for Patients with Cardiovascular Diseases
- Perioperative cardiovascular evaluation for non-cardiac surgery involves assessing the patient's functional capacity, understanding of the surgical procedure, and understanding their risks based on comorbidities.
- Consultation with the patient's cardiologist or surgeon may be necessary to determine the risks of proceeding with surgery against the consequences of delaying or canceling the procedure.
Special Considerations
- Pediatric patients exhibit increased sensitivity to anesthetic drugs due to a combination of pharmacokinetic and pharmacodynamic factors.
- Pediatric patients and those of advanced age are at increased risk for adverse outcomes with general anesthesia due to immature organ system function and the severity of comorbid diseases.
Learn about the special considerations for administering anesthetic drugs to pediatric patients, including factors affecting drug metabolism and dosing frequency.
Make Your Own Quizzes and Flashcards
Convert your notes into interactive study material.
Get started for free
