POST-ANESTHESIA RECOVERY
QUESTIONS AND CORRECT
ANSWERS
What form of aspiration is the most severe? ✅✅ANSW-Aspiration of gastric contents.
May result in a chemical pneumonitis
Bronchospasm ✅✅ANSW-Results from an increase in bronchial smooth muscle tone, with
resultant closure of the airways.
Can be caused by irritation or underlying disease
Treatment of broncospasm ✅✅ANSW-B2 agonists most common. Occasionally anticholinergics.
Epi if emergent
Hypoventilation ✅✅ANSW-Common in PACU
PCO2 >45. Symptoms occur when PCO2 >60, pH 7.25
Some causes of hypoventilation ✅✅ANSW--Medications
-Inadequate reversal of neuromuscular blocking
agents
-Abdominal surgery
Classically, hypotension has been defined as a blood pressure of less than ________ of the baseline
or preoperative blood pressure ✅✅ANSW-20%
Hypotension in the PACU is most commonly caused by what? ✅✅ANSW-Hypovolemia secondary
to inadequate replacement of intraoperative fluid and blood loss.
Initial treatment- replace volume. Start with a 300-500 mL bolus.
Other causes of hypotension ✅✅ANSW--Main cause is hypovolemia
, -Less common: decreased SVR from sepsis or drugs
-Even less common: myocardial collapse
Hypertension defined ✅✅ANSW-20-30 percent increase relative to baseline blood pressure.
Common finding in the PACU. Frequently from pain somatosympathetic reflex or visceral distension-
esp bladder
Leading cause of hypertension and tachycardia in the PACU ✅✅ANSW-Pain
Dysrhythmias in the PACU & their causes ✅✅ANSW--Rarely related to myocardial issues
-Hypercarbia: increases chance of dysrhythmia
-Hypokalemia: fairly common. From loss of GI secretions, hyperventilation, insulin
-Hypothermia: Can also cause issues including bradycardia, afib, conduction delays
-Vagal responses
- Residual anesthesia: can sensitize the body to any of the above
-**Surgical stress increase plasma catecholamine which makes dysrhythmias more likely
Emergence delirium can be split into four categories: ✅✅ANSW-Withdrawal
Toxic
Circulatory/Respiratory
Functional
Some common causes of postop delirium ✅✅ANSW--Straight volatile inhalation agent anesthesia
-Sevo in particular has been associated with emergence delirium in children
-High doses of Ketamine
-Benzos, especially in the elderly
-Pain
-Higher incidence in veterans
Anticholinergic syndrome as a cause of postop delirium is associated with which two
anticholinergics? ✅✅ANSW-Scopalamine and atropine
(both cross the BB
QUESTIONS AND CORRECT
ANSWERS
What form of aspiration is the most severe? ✅✅ANSW-Aspiration of gastric contents.
May result in a chemical pneumonitis
Bronchospasm ✅✅ANSW-Results from an increase in bronchial smooth muscle tone, with
resultant closure of the airways.
Can be caused by irritation or underlying disease
Treatment of broncospasm ✅✅ANSW-B2 agonists most common. Occasionally anticholinergics.
Epi if emergent
Hypoventilation ✅✅ANSW-Common in PACU
PCO2 >45. Symptoms occur when PCO2 >60, pH 7.25
Some causes of hypoventilation ✅✅ANSW--Medications
-Inadequate reversal of neuromuscular blocking
agents
-Abdominal surgery
Classically, hypotension has been defined as a blood pressure of less than ________ of the baseline
or preoperative blood pressure ✅✅ANSW-20%
Hypotension in the PACU is most commonly caused by what? ✅✅ANSW-Hypovolemia secondary
to inadequate replacement of intraoperative fluid and blood loss.
Initial treatment- replace volume. Start with a 300-500 mL bolus.
Other causes of hypotension ✅✅ANSW--Main cause is hypovolemia
, -Less common: decreased SVR from sepsis or drugs
-Even less common: myocardial collapse
Hypertension defined ✅✅ANSW-20-30 percent increase relative to baseline blood pressure.
Common finding in the PACU. Frequently from pain somatosympathetic reflex or visceral distension-
esp bladder
Leading cause of hypertension and tachycardia in the PACU ✅✅ANSW-Pain
Dysrhythmias in the PACU & their causes ✅✅ANSW--Rarely related to myocardial issues
-Hypercarbia: increases chance of dysrhythmia
-Hypokalemia: fairly common. From loss of GI secretions, hyperventilation, insulin
-Hypothermia: Can also cause issues including bradycardia, afib, conduction delays
-Vagal responses
- Residual anesthesia: can sensitize the body to any of the above
-**Surgical stress increase plasma catecholamine which makes dysrhythmias more likely
Emergence delirium can be split into four categories: ✅✅ANSW-Withdrawal
Toxic
Circulatory/Respiratory
Functional
Some common causes of postop delirium ✅✅ANSW--Straight volatile inhalation agent anesthesia
-Sevo in particular has been associated with emergence delirium in children
-High doses of Ketamine
-Benzos, especially in the elderly
-Pain
-Higher incidence in veterans
Anticholinergic syndrome as a cause of postop delirium is associated with which two
anticholinergics? ✅✅ANSW-Scopalamine and atropine
(both cross the BB
