Chapter 17: Overview of a General Anesthetic – Vocabulary Flashcards

Vocabulary flashcards covering key concepts, agents, stages, and clinical workflows from the lecture notes on general anesthesia.

Anesthesia

A state produced for surgery involving lack of awareness, analgesia, amnesia, and immobility, with continuous monitoring to maintain safety and homeostasis.

Dioscorides

Pedanius Dioscorides coined the term anesthesia in 40 AD.

Nitrous oxide

An inhalational adjunct with rapid onset/offset; not sufficient alone for full anesthesia.

Ether

Early inhalational anesthetic popularized in the 1840s; pivotal in public demonstrations of anesthesia.

Chloroform

In Europe, a widely used inhalational agent popularized by Simpson and used for Queen Victoria.

Sevoflurane

Volatile inhalational agent; onset/offset dependent on blood/gas solubility; acts via GABA receptor modulation.

Desflurane

Volatile inhalational agent; onset/offset dependent on blood/gas solubility; used for maintenance.

Isoflurane

Volatile inhalational agent; acts via GABA modulation; onset/offset influenced by solubility.

GABA receptor modulation

Mechanism by which many volatile agents produce hypnosis by enhancing inhibitory neurotransmission.

Propofol

Most common induction agent in adults; rapid onset with potential hypotension and respiratory depression.

Etomidate

Induction agent with minimal cardiovascular effects but risk of adrenal suppression and higher nausea.

Midazolam

Benzodiazepine used for premedication; longer-lasting effects make maintenance less suitable.

Ketamine

Dissociative anesthetic providing analgesia and CV stability; can raise BP/HR and cause emergence reactions.

Fentanyl

Potent opioid analgesic used in anesthesia; risk of respiratory depression and hypotension.

Sufentanil

Highly potent opioid analgesic used intraoperatively; similar respiratory depression risks.

Morphine

Opioid analgesic with potent pain relief; may cause respiratory depression and hypotension.

Hydromorphone

Opioid analgesic used in anesthesia for pain control.

Dexmedetomidine

Non-opioid adjunct for sedation and analgesia; alpha-2 agonist with calming effects.

Non-depolarizing neuromuscular blockers

Muscle relaxants (e.g., curare, vecuronium, rocuronium, cisatracurium) used to facilitate intubation and surgical conditions; require reversal.

Succinylcholine

Depolarizing neuromuscular blocker for rapid sequence intubation; short-acting but with potential adverse effects.

Curare

Non-depolarizing neuromuscular blocker used historically as part of muscle relaxation strategy.

Vecuronium

Non-depolarizing neuromuscular blocker used to maintain relaxation during surgery.

Rocuronium

Non-depolarizing neuromuscular blocker favored for rapid onset; facilitates intubation.

Cisatracurium

Non-depolarizing neuromuscular blocker with organ-independent elimination; used for relaxation.

Guedel’s Stages

Historical stages describing ether anesthesia progression: Stage 1 to Stage 4.

Stage 1

Pre-anesthesia to loss of consciousness.

Stage 2

Excitement phase with irregular respiration; potential agitation and vomiting.

Stage 3

Surgical anesthesia with stable respiration and loss of movement/reflexes.

Stage 4

Overdose with life-threatening depression of vital functions.

Preoperative phase

History/physical, risk assessment, airway evaluation, fasting, ASA status, allergies, and preop medications.

Intraoperative: Induction

Patient positioning, monitors applied, preoxygenation, induction agents, neuromuscular blockers, airway secured.

Intraoperative: Maintenance

Continued anesthesia with depth titration, analgesics, and muscle relaxation; maintenance of homeostasis.

Emergence

Tapering of agents, regaining consciousness, safe extubation, and management of complications.

Postoperative phase

Phase 1 PACU monitoring followed by Phase 2 transition to ward or home; evaluated by consciousness, stability, and pain control.

PACU Phase 1

Immediate post-anesthesia care with full vital support and reversal agents as needed.

PACU Phase 2

Transition to ward or home with criteria including stable vitals, adequate pain control, and orientation.

Anesthesia Machine

Equipment with flow meters, vaporizers, breathing circuit, and ventilator to deliver precise gas mixtures.

Standard Monitors

ECG, blood pressure, pulse oximetry, capnography, and temperature monitoring.

Mallampati score

Airway assessment tool predicting intubation difficulty based on oral anatomy.

ASA Physical Status

Global assessment of a patient’s operative risk (I–V) used to guide protocol.

Fasting guidelines

Recommended fasting times before anesthesia: 2 hours clear liquids, 4 hours breast milk, 6 hours formula/light meal, 8 hours fatty/protein foods.

Balanced Anesthesia

Using combinations of smaller drug doses to optimize effects and minimize side effects.

BIS monitoring

EEG-based tool (bispectral index) to estimate anesthetic depth.