Overview Post-operative Nausea and Vomiting is the leading cause of delayed discharge from PACU. Current recommendations is at least 2 prophylactic drugs for patients with at least 1 risk factor for PONV. Combinations should be with drugs that have different…
Overview Blood pressure represents the force exerted by the circulating blood on the walls of blood vessels. It is determined by cardiac output (CO) and systemic vascular resistance (SVR). (MAP – SVR) = HR X SVR CO = HR X…
Massive Transfusion Massive transfusion is defined as the administration of greater than 1 total blood volume (10 – 20 units of blood) in 24 hours or replacing 1/2 of the blood volume in < 1 hour *(*about 5 – 10…
Pre-Transfusion Testing Group and Screen (Type and Screen) Antigens that are not present in screened cells are unlikely to cause significant hemolytic reactions (0.2% risk of transfusion reaction if only type and screen is done). They can be safely transfused…
Overview Definition of terms Term Definition Osmosis Spontaneous movement of water across a semi-permeable membrane from a region of low solute concentration to one of high solute concentration which tends to equalize the solute concentration on either side of the…
Overview Shock is defined as a state of global cellular and tissue hypoxia due to either reduced oxygen delivery, increased oxygen consumption, inadequate oxygen utilization, or a combination of these processes. Shock is almost always caused by low blood pressure…
Overview NMBAs facilitate intubation, mechanical ventilation, and surgical relaxation. Categories of NMBAs Category Examples Depolarizing Succinylcholine Non-depolarizing Atracurium, Cisatracurium, Rocuronium, Vecuronium Agent ED 95 (mg/kg) Intubating Dose (mg/kg) Onset (min Duration to 25% recovery (min) Intra-op maintenance Metabolism and Excretion…
Local Anaesthetics Local anesthetics provide analgesia and anaesthesia by disrupting the conduction of impulses along nerve fibers. They block voltage-gated Na+, thus inhibiting the influx of sodium and preventing an action potential from being reached. They are weak bases in…
Overview IV induction agents target GABA receptors (most common), NMDA receptors, and alpha-2 receptors to cause anaesthesia. Propofol and Barbiturates decrease the rate of dissociation of GABA from its receptors increasing the duration of chloride channel opening. Benzodiazepines facilitate the…
Overview Historically there have been several accounts of the use of various forms of anesthesia from cannabis and other herbs to carotid compression. The earliest account of modern anesthesia was in the 1840s when ether was used to excise a…