Anesthesia 2.0 3 PDF

Anesthesia INSTRUMENTS SIZE OF LMA Child: 3 Female: 4 Male: 5 HAND: INSERT: Streamlined Liner PRESSURE: of the Pharynx Airway (SLIPA) MC injury: Low-pressure,...

Anesthesia INSTRUMENTS SIZE OF LMA Child: 3 Female: 4 Male: 5 HAND: INSERT: Streamlined Liner PRESSURE: of the Pharynx Airway (SLIPA) MC injury: Low-pressure, high-volume cuff Male: 8-9 Female:7-8 Child-3-4 DIFFICULT INTUBATION Plan A: Facemask ventilation and tracheal intubation Direct/ video Laryngoscopy (max 3+1 attempts) Plan B: 2nd generation SAD insertion Max-3 attempts Plan C: Facemask ventilation Plan D: Front-of-neck-access Scalpel Cricothyrodotomy Obese Bearded Edentulous Fibreoptic Snorer intubation Elderly Neck circumference >40cm Finger breadth:TMJ Thyromental distance N Sternomental distance N MC vein for central line: TPN MC vein for TPN: 20:30:50 Max risk of pneumothorax: >1kg/day weight gain: Max risk of infection: Weight gain after: Max risk of thrombosis: Refeeding syndrome: Zn, B12 deficiency MC metabolic complication: Mc nerve: 2nd mc nerve: Extubation TOF: MC stimulus: Tetanic stimulation: MC circuit in spontaneous: MC circuit in controlled: Max flow rate: 5l/min Max saturation: 40% Max flow rate: 10l/min Max flow rate: 15l/min Max saturation: 60% Max saturation: 60% Max flow rate: 15l/min Max flow rate: 60l/min Humidification, PEEP+ Max saturation: 85-90% Max saturation: 100% May delay intubation  Length of NG tube: NEX NEMU Colour Code Orange Green 14fr Gray Orange 16Fr White Red 18Fr Green Pink Yellow 20Fr Blue Purple 22Fr Yellow Violet Blue 24Fr PHARMACOLOGY MAC BLOOD GAS SOLUBILITY Methoxyflurane 0.2 12 Halothane 0.75 2.5 Isoflurane 1 1 Sevoflurane 2 0.65 Desflurane 6 0.45 Compound A Coronary steal? Min MAC Tec-6 vaporizer (Xenon min) Fruity odour AI hepatitis Maintenance agent N20 104 0.47 Asthma of choice Best for Renal Sx, Obese Concentration effect CO with dessicated Second gas effect soda lime Diffusion hypoxia ALL Inhalational agents: ALL IV agents: -Cerebral metabolic O2 -Cerebral metabolic O2 -CBF/ ICP -CBF/ ICP -CVS, HR -CVS,HR -Respiratory drive -Respiratory drive IV anesthetic agents: DOC (Induction) for day care/ liver/ kidney/ neuroSx/TIVA/malignant hyperthermia/porphyria Infusion syndrome, Painful injection-soyabean oil, egg lecithin NMDA antagonist, Dissociative anesthesia, DOC in asthma/COPD, Cyanotic HD, Shock CI in hypertension / epilepsy/ glaucoma DOC in cardiac surgery, S/E Adrenal suppressant (11B-hydroxylase) DOC in hyperthyroidism, seizures, narcoanalysis, cause Intra-arterial vasospasm LA: MOA- Causing Hypertension: Most cardiotoxic: Dose: Max dose of lignocaine: Proparacaine duration: DOC for LAST: MethHb: MR Depolarising, Hyperkalemia, Bradycardia, Best for RSI- Most cardiostable- Hoffman elimination(safe in RF/LF/pediatrics)- Byproduct- Shortest acting: Reversal- Sugammadex- OPIOIDS Full agonist: Morphine, Pethidine, Heroin, Meperidine, Methadone, Codeine, Fentanyl Partial agonist: Buprenorphine Mixed agonist/antagonist: Nalbuphine, Pentazocine, Butorphanol Antagonist: AVOID IN: Mydriasis: Pruritus: No tolerance to: Serotonin syndrome: Wooden chest syndrome: Prolonged QTc: Shortest acting (Day care): REGIONAL/ NERVE BLOCKS CAPNOGRAPHY Infrared spectroscopy Sch, Inhalational anesthetics Fever + tachycardia+ rigidity Earliest- Late- RYR/DHPR (Chr 19) DOC- MISCELLANEOUS Pre-op drug DOC to reduce anxiety: Pre-op drug DOC to reduce secretions: Pre-op Antibiotic time: MC nerve injured intra-op- MC intra-ophthalmic complication- PONV DOC: POVL MCC: MCC of intra-op anaphylaxis: Stop Clopidogrel: Warfarin: LMWH: UFH: Lithium: ACE/ARB/OHG/Insulin: Goldman Grading system Aldrete score: Activity/ BP/ Consciousness / Respiration/ o2 saturation Mendelson syndrome PIH, Heart disease in pregnancy: Epidural > GA NPO solid: Except coarctation of aorta/ Eisenmenger/ Uncorrected TOF -GA Liquids: Breastmilk: Dibucaine number