Anesthesia

Topical application of local anesthetic agent can be accomplished orally (as a swish and swallow) or by transtracheal deposition into the tracheal lumen. However, these techniques may blunt the glottic and cough reflex, increasing the patient’s susceptibility to aspiration. The gag reflex can be further controlled by supplementary nerve blocks to the lingual branch of […]

Patients who have had a laryngospasm may be susceptible to secondary pulmonary edema. This can be the result of negative alveolar pressure of an expanding diaphragm against a closed glottis, or due to barotrauma from positive pressure ventilation. Pulmonary trauma arising from laryngospasm may become clinically evident hours after the spasm. In this case, signs

Large doses of prilocaine, generally greater then 600 mg, can result in methemoglobinemia in selected patients. Intravenous doses of articaine have been reported to cause similar problems. This occurs as a result of one of the metabolites of the drug converting reduced hemoglobin to methemoglobin. The patient will experience cyanosis with dark blood. Pulse oximetry

An increase in heart rate is usually the earliest and most consistent sign to be detected. An increase in end-tidal CO2 is usually the most sensitive sign in detecting malignant hyperthermia. While increase temperature and muscle rigidity are hallmark signs of malignant hyperthermia, these manifestations are less sensitive and may not present as early as

Blood Pressure Cuff When considering the correct size of cuff, two pertinent points should be recalled: The inflatable bladder in the cuff should be able to completely encircle the arm with minimal overlap. The width of the bladder in the cuff should be approximately 20% greater than the diameter of the extremity used for the

5mL/kg required for significant injury (sock or cardiac arrest) Complication have been reports with 20 mL   Rapid entry of large volumes of air entering the systemic venous circulation puts a substantial strain on the right ventricle, causing rise in pulmonary artery pressure and increasing pulmonary (RV) outflow obstruction. In turn, decreases pulmonary venous return

Sniffing Position Physiologically aligns: oral axis pharyngeal axis laryngeal axis Malampati Classification Class 1: Soft palate, uvula, tonsillar pillars can be seen Class 2: As above except tonsillar pillars are not seen Class 3: Only base of uvula is seen Class 4: Only tongue and hard palate can be seen. Cormack-Lehane Views Grade 1: full glottic exposure Grade 2: only posterior

GERD Pregnancy Trauma Diabetes Mellitus Recent oral intake Bowel obstruction Intra-abdominal pathology Obesity   Aspiration prophylaxis: agents which decrease the volume and/or acidity of gastric secretions (ranitidine, sodium citrate) Metoclopramide: increase gastric emptying and increase esophageal sphincter tone Parkinson’s’ disease is a neurodegenerative disease characterized by a loss of dopaminergic neurons in the substantia nigra

100: awake 70: moderate sedation 40-60: adequate hypnotic effect for general anesthesia

Safe induction according to American Society of Anesthesiologists Guidelines 2h – clear liquids (water, soda pop, coffee without creamer, fruit juice without pulp) 4h – human milk 6h – light solids (non-meat and non-fat) and non-clear liquids (non-human milk products and formula) 8h – fat and meats   Gastric emptying influenced by volume (distention), osmolarity