ch 5: sedation and general anesthetics

What are the 4 levels of sedation/anesthesia?

Minimal sedation → moderate sedation → deep sedation → general anesthesia.

What is minimal sedation also called?

Anxiolysis.

How does a patient respond during minimal sedation?

Responds normally to verbal commands.

Can a patient maintain their own airway during minimal sedation?

Yes; the patient independently and continuously maintains their airway.

How are coordination and cognitive function affected during minimal sedation?

Mildly impaired.

How is cardiovascular function affected during minimal sedation?

Remains normal.

What is moderate sedation also called?

Conscious sedation.

How does a patient respond during moderate sedation?

Responds to verbal and tactile stimuli.

Can a patient maintain their airway during moderate sedation?

Yes; spontaneous ventilation is maintained.

How is cardiovascular function affected during moderate sedation?

Usually remains normal.

How does a patient respond during deep sedation?

The patient cannot be easily aroused but responds after repeated or painful stimulation.

Can a patient maintain their airway during deep sedation?

Spontaneous respiration may occur, but airway assistance may be needed.

Where is deep sedation typically performed?

In a hospital or surgical center.

What is general anesthesia?

An induced state of unconsciousness with partial or complete loss of protective reflexes.

Can a patient respond to verbal or tactile commands during general anesthesia?

No.

Can a patient independently maintain their airway during general anesthesia?

No; the patient may be unable to maintain the airway independently.

What is balanced general anesthesia?

Using low doses of several drugs to minimize adverse events and speed recovery.

What is the purpose of the ASA physical-status classification?

To evaluate/classify a patient's medical status before treatment.

Which ASA classifications are considered ideal/medically stable for treatment according to the PowerPoint?

ASA I and ASA II.

Which ASA classifications may require medical consultation according to the PowerPoint?

ASA III and ASA IV.

What are Guedel's 4 stages of anesthesia?

Stage 1 = amnesia/analgesia; Stage 2 = excitement/delirium; Stage 3 = surgical anesthesia; Stage 4 = medullary paralysis/overdose.

What type of anesthetic is nitrous oxide?

A weak general anesthetic but a good analgesic and amnesic.

What is nitrous oxide administered with?

Oxygen (O2).

What color is the oxygen tank?

Green.

What color is the nitrous oxide tank according to the PowerPoint?

Blue.

What are important contraindications listed for nitrous oxide?

COPD, respiratory obstruction, and first-trimester pregnancy.

What is diffusion hypoxia?

After N2O ends, nitrous oxide rapidly leaves the blood and enters the lungs, occupying space normally available for oxygen and temporarily reducing oxygen availability.

When is diffusion hypoxia most likely to occur?

During the early recovery period after nitrous oxide is discontinued.

How is diffusion hypoxia prevented?

Administer 100% oxygen for at least 5 minutes at the end of treatment.

What are common adverse effects of nitrous oxide?

Nausea and vomiting.

What problems are associated with nitrous oxide abuse?

Megaloblastic anemia, neuropathy, vitamin B12 deficiency, and adverse reproductive effects.