DAANCE - Module 3-Anesthetic Drugs & Techniques Latest Updates

DAANCE - Module 3-Anesthetic Drugs & Techniques Latest Updates Diazapam-valiumis used in out patient oral and maxillofacial surgery for what? - Sedate the patient Barbituates are detoxified in what? - Liver Rapid administration of anesthetic doses of methohexital-brevital can result in what? - Hiccups, tachycardia, and respiratory depression Why is methohexital-brevital considered to be ultra short acting? - It is not highly bound to fat as thiopental is Oxygen is opproximately what percentage of room air? - 21% Naloxone is used for what? - A narcotic antagonist Recovery from ketamine-ketalar anesthetics is associated with what? - Bad dreams Local anesthetics containing epinephrine should be used cautiously in patients who have what? - Cardiac dysrhythmias What is the major advantage for using propofol-diprivan over methohexital-brevital ? - Lower incidence of nausea and a shorter duration What is the advantage of using a local anesthetic alone? - A preoperative history is not necessary and a driver is not necessary Ester Drugs - Metabolized by enzymes in the bloodstream. Cocaine, procaine/novocaine- first local anesthetic. High potential for allergic reactions. Amide Drugs - Metabolized in the liver. Lidocaine /xylocaine with epi. 7-11 carpules / 170-190 minutes Lidocaine / xylocaine without epi. 4-8 carpules / 45-60 minutes Carbocaine/Mepivivaine with neocobefrin 6-11 carpules/130-185 minutes Carbocaine/ Mepivicaine without neocobefrin 6-7 carpules/90-165 min. Citnest/Prilocaine 8 carpules/ 105-220 minutes Marcaine/Bupivacaine 10 carpules adult only/ 340-440 Sepocaine/ Articaine 7 carpules/ 60-70 Duranest 6-14 carpules/ 280-470 The maximum dose of epinephrine in a healthy patient is? - 0.2 mg The maximum dose of epinephrine in a patient with cardiovascular disease? - .04 mg Basic requirements of an anesthetic - Lack of toxicity Non-flammable Preferably non-addictive Minimal allergenicity The components of balanced anesthesia (4) - Analgesia Amnesia Relaxation Loss of consciousness (hypnosis) Hypnosis - Feeling of being asleep. Agents which are most effective in providing loss of consciousness and hypnosis are proposal and barbiturates such as methohexital (brevital.) Relaxation and immobility - SX is often performed adjacent to important anatomical structures such as nerves of the face and neck so it is essential that the pt. Be relaxed and immobile during the procedure. Benzodiazepines used: versed, propofol, brevital, ketamine. Amnesia - Failure to remember events related to surgery. The agents that provide the most effective amnesia are benzodiazepines like versed (midazolam) and valum (diazepam) Analgesia - inability to feel pain Drugs used to achieve: ketamine, fentanyl. Additional desirable attributes of an anesthetic - Maintenance of the body's homeostatic mechanisms. (BP, HR.) Rapid, smooth comfortable induction Freedom of post operative nausea and vomiting Retention of sufficient pharyngeal and laryngeal reflexes to prevent aspiration but predispose pt to laryngospasm. Post of euphoria Rapid recovery and readiness for discharge Easily adapted and used for children and seniors Capable of easy administration with familiar equipment and supplies A technique well documented in the anesthesia literature and consistent with techniques currently used by anesthesiologists Cost effective 5 primary areas within the CNS where anesthetics work - 1. The centers of emotion 2. The centers of wakefulness