Anesthesia Review

local infiltration

injection of nerve conduction blocking agent into superficial skin that serve only the tissue at the surgical site. small group of superficial nerves anesthetized.

peripheral nerve block

time out needs to be done. provides anesthesia to a specific area of the body supplied by a major nerve or nerve plexus

IV bier block

blood temporarily displaced from limp and replaced by local anesthetic drug (tourniquet)

Spinal anesthesia

injected into L3 & L4. involves injection of anesthetic agent into cerebrospinal fluid in the subarachnoid space

Epidural and Caudal anesthesia

In peds, injected below umbilical cords, adults injected into tailbone region

emergence

extubating, reversal drugs, regaining consciousness

balanced anesthesia

combination of drugs to provide homeostasis, keep comfortable, etc.

preinduction

pre-op meds given to reduce anxiety

induction

loss of consciousness, important to be quiet.

maintenance

intraoperative, anesthesia maintains balanced unconsciousness

recovery

PACU

controlled ventilation

diaphragm is paralyzed, requiring assisted ventilation

endotracheal tube

invasive, used to deliver gas or vapor directly into trachea. cuff prevents aspiration of fluid.

laryngeal mask

does not protect against aspiration

oropharyngeal airway

commonly used when patient is semiconscious

nasopharyngeal

used if gagging or mouth injury, less invasive.

dextran

plasma volume expander

complications of inhallant anesthesia

malignant hyperthermia, aspiration, oligeria (decreased urine)

bier block supplies

eshmarck, turniquet, local anesthetic

early induction

patient retains ability to hear, still feel pain, can shiver response

general inhalant agent

nitrous oxide

polypharmacy

many different meds from different providers

hypercapnia

CO2 in blood streem