[11.12a] Overview of Anesthesia (Part 1) V2.pdf

Dioscorides

Which Greek philosopher in the 1st century AD first used the term anesthesia?

Mandragora

Which plant did Dioscorides use to describe narcotic-like effects?

block sensation

What was the original definition of anesthesia?

Olive Wendell Holmes

Who described anesthesia as a sleep-like state that makes painless surgery possible in 1846?

without sensation

What is the etymology of the Latin word an-esthesia?

without painful sensation

What is the modern specific definition of anesthesia?

opium poppa, coca leaves, mandrake root, alcohol, and phlebotomy

What were five methods used for pain relief in ancient civilizations?

phlebotomy

Which ancient practice involved the drainage of blood to make body parts numb?

chewed coca leaves

What did ancient surgeons spit on surgical sites to lessen pain?

nerve ischemia

Ancient compression of nerve trunks aimed to provide numbness through what mechanism?

cryoanalgesia

What is the term for the application of cold to provide anesthesia?

William Morton

Who brought ether to public attention during the first public surgery?

ether

What was the first gas used in public surgery to make a patient unconscious?

John Snow

Which English physician was a leader in the development of anesthesia and medical hygiene?

cholera

John Snow is one of the founders of modern epidemiology for tracing an outbreak of which disease in 1854?

ether and chloroform

John Snow was one of the first to study and calculate dosages for which two surgical anesthetics?

designed an apparatus

How did John Snow ensure the safe administration of ether to patients?

obstetric anesthesia

John Snow started which field of anesthesia related to childbirth?

Queen Victoria

Which royalty did John Snow give a painless delivery?

consultant and primary care provider

What are the two major roles of a modern anesthesiologist?

specialist

What is another term for the consultant role of an anesthesiologist?

noncutting aspects

The anesthesiologist manages which aspects of patient care in the immediate perioperative period?

history taking and physical examination

What two clinical actions must an anesthesiologist perform before surgery?

comorbidity, medical history, and allergies

What three types of information must be disclosed to the anesthesiologist by the patient?

anesthetic plan

What is formulated after interviewing the patient and reviewing diagnostics?

poor planning or preparation

What is the most common cause of anesthetic complications?

airways

A life-threatening complication can occur if anesthesia is provided without examining the patient's what?

optimal medical condition

Until what condition is met should elective surgery not proceed?

hypertensive crisis or asthmatic attacks

Optimization aims to prevent the patient from experiencing which two intraoperative incidents?

everyone works together

What modern principle has replaced the captain of the ship doctrine in the OR?

sedation for comfort

Why are anesthesiologists called to procedures like gastroscopy or dental work?

gastroscopy, colonoscopy, MRI, CT scan, and dental procedures

Name five procedures outside the OR that may require anesthesia services.

pain management

Which specialty of anesthesiology involves diagnosing and treating painful syndromes?

airway management

What is a primary clinical responsibility of the anesthesiologist, especially in the OR?

monitoring and restoring homeostasis

What is the role of an anesthesiologist for critically ill patients?

CPR

Anesthesiologists manage and teach which type of resuscitation?

clinical pharmacology

Which field is unique to anesthesia because it involves using multiple drugs that must interact safely?

applied physiology

Which field allows anesthesiologists to manipulate the patient's status immediately in the OR?

biomedical technology

Dealing with machines, gadgets, and monitoring devices is part of which field?

state of calm or reduced nervous activity

What is the definition of sedation?

IM, IV, and subcutaneous

What are three routes of administration for sedation?

intravenous

What is the usual route for anesthesia administration?

loss of consciousness, analgesia, amnesia, akinesia, and inhibition of reflexes

What are the five characteristics of general anesthesia?

akinesia

What is the term for skeletal muscle relaxation in general anesthesia?

amnesia

What is the term for transient memory loss during anesthesia?

midazolam and diazepam

Name two benzodiazepines with amnesic properties.

inhalational and intravenous

What are the two routes of administration for general anesthesia?

stages and planes

What identifies the progression of physical signs indicating the depth of anesthesia?

Stage 1

Which stage lasts from the induction of anesthesia to the loss of consciousness?

analgesia and amnesia

What two states characterize Stage 1?

loss of eyelid reflex

What is a key sign and monitoring tool for Stage 1?

Stage 2

In which stage does delirium or excitement sometimes occur?

Stage 3

Which stage is the optimal condition for surgery?

surgical anesthesia

What is the name for Stage 3?

apnea, regular respiratory depression, and muscle relaxation

Name three characteristics of Stage 3.

Stage 4

Which stage involves medullary depression and cardiovascular failure?

dangerous but reversible

Is Stage 4 permanent?

too much anesthesia or overdose

What causes a patient to enter Stage 4?

reverse or resuscitate

What must the anesthesiologist do if Stage 4 occurs?

regional anesthesia

What renders a specific area of the body insensitive to stimuli?

waist down, hands, or feet

Name three specific regions that can be targeted by regional anesthesia.

spinal, epidural, nerve blocks, topical, and local

Name five types of regional anesthesia.

nerve block

What type of regional anesthesia numbs only one arm or leg?

local anesthesia

Which type of regional anesthesia is used for minor procedures like cyst excision or circumcision?

ligand-gated ion channels

Anesthetic agents interact with protein binding sites in nerve endings to activate what?

GABA-agonist

What is the established mechanism of action for most general anesthetics?

chloride

GABA-receptor channels facilitate the increase of conductance for which ion?

hyperpolarize and inhibit

What is the effect of increased chloride conductance on the neuronal membrane?

synapse

Where in the nervous system do general anesthetics primarily work?

GABA

What is the major inhibitory neurotransmitter in the body?

potassium

Increased conductance of which ion can also hyperpolarize the membrane to inhibit activity?

halogenated volatile liquids

What is the physical nature of most inhalational anesthetics?

nitrous oxide

Which inhalational anesthetic is the exception to being a halogenated volatile liquid?

anesthesia machine

What is used to vaporize liquid anesthetics?

cardiovascular and respiratory depressants

What is the common effect of most anesthetics on heart rate and respiration?

non-flammable and non-explosive

What are two safety traits of modern inhalational anesthetics?

nitrous oxide, isoflurane, desflurane, and sevoflurane

Name the four most commonly used inhalational anesthetics.

sevoflurane

What is the most widely used inhalational anesthetic in the Philippines and abroad?

desflurane

Which anesthetic is no longer available in the Philippines?

laughing gas

What is the common name for nitrous oxide?

mask

Which delivery method is used for shorter, uncomplicated procedures, especially in children?

laryngeal mask airway

Which supraglottic device covers the laryngeal opening?

1 to 2 hours

Laryngeal mask airways are suitable for procedures of what duration?

i-Gel

What is a specific brand of supraglottic airway device mentioned in the source?

endotracheal tube

What is the most secure delivery method for long procedures to ensure ventilation?

intubation

What is the common name for the placement of an endotracheal tube?

Minimum Alveolar Concentration

What does the acronym MAC stand for?

MAC

What is the primary measure of potency for inhalational anesthetics?

50 percent

MAC is the concentration resulting in immobility in what percentage of patients?

surgical incision

What is an example of a noxious stimulus used to determine MAC?

more potent

What does a lower MAC value indicate about an agent?

age, pregnancy, hypothermia, and hypotension

Name four factors that decrease the MAC value.

gender and weight

MAC is independent of which two patient factors?

2

What is the approximate MAC of Sevoflurane?

6

What is the MAC of Desflurane?

Sevoflurane

Which is more potent: Sevoflurane or Desflurane?

dial

What does the anesthesiologist turn on the machine to set the anesthetic concentration?

solubility in blood

The rate at which partial pressure reaches equilibrium depends primarily on what?

blood-gas partition coefficient

What represents the relative solubility of an anesthetic in blood relative to air?

easy in, easy out

What phrase describes an ideal anesthetic with low solubility?