Hyperbolic Metabolic
Hyperthyroidism has this effect on MAC of inhaled agent.
What is no change?
Up to this level of Inhaled agents can be used when EP monitoring is being used.
What is 0.5 MAC?
*MEP more sensitive than SSEP
In a pt refusing an epidural this is a popular alternative that puts the pt in charge.
What is remifentanil PCA?
This is how CPP is calculated.
What is MAP-ICP (or CVP whichever is higher)?
Pt with heavy EtOH use are at risk for this potentially life threatening condition and should be treated with this.
What is DTs and Benzodiazepines (Ativan)?
Pt with hypothyroidism and infection develops bradycardia and lethargy is concerning for this condition and should be treated with this medication
What is Myxedema Coma and Thyroid hormone?
These changes are considered significant in SSEP monitoring and if the the pt is not hypotensive may be due to this, assuming not artifiact.
What is 50% decrease in amplitude and 10% increase in latency and Surgical manipulation/retraction?
Adding this to Lidocaine will increase the speed of onset and this will increase the duration.
What are bicarbonate and epinephrine?
Pt undergoing crani for tumor resection with high urine output and a sodium of 147 may have this diagnosis (also seen in kidney injury) treated with this.
What is DI and Fluids and Desmopressin (DDAVP)?
*Low ADH and urine concentration
This local anesthetic with vasoconstrictive properties often used off-label should in the acute intoxication setting will have this effect on MAC.
What is increased?
Pt with thyroid disease becomes hypertensive, tachycardic, and febrile may be experiences this and should be treated with these medications.
What is thyroid storm and Propranolol, PTU, and iodine?
Processed EEG monitoring may be helpful in cases using SSEP and/or MEP monitoring to help prevent this.
What is intraop awareness?
Shortly after spinal placement pt becomes unresponsive and hypotensive, doing this will likely improve the situation immediately by this physiologically.
What is raising the legs and increasing venous return (preload)?
The target intraop CPP in pts with head trauma.
What is 60-70?
Pt with EtOH withdrawal along with Benzos should be treated with this.
What is Thiamine (and Multivitamins)?
This can be confused with Thyroid Storm due to increased temperature and can be distinguished looking at these.
What is MH and CO2 levels and muscle rigidity?
While these medications ruin MEP monitoring they can be used and perhaps beneficial in SSEP monitoring/
What are NMBDs?
This technique for labor analgesia is often advocated for because of its quick onset and intense analgesia but also has some drawbacks, name 2.
What is CSE and greater sympathectomy and unproven catheter?
Following head injury a pt with low urine output and a sodium of 127 may have this diagnosis (also seen in small cell ca) treated with this.
What is SIADH and Fluid restriction and diuretics?
*High ADH and urine concentration
A pt with EtOH use taking medications for depression in PACU experiences tremor, fever, tachycardia and agitation after receiving several doses of this for nausea and may have this.
What is Zofran and Seritonin Syndrome?
This condition triggered by anti-psychotic medications can also be triggered by abruptly stopping medicatons to treat this condition and along with treating with Dantrolene can be treated with this.
What is NMS, Parkinson's disease, and Bromocriptine?
These two IV anesthetic agents increase SSEP signal.
What are Etomidate and Ketamine?
Pregnant pt with decrease in FHR 2 hours after a catheter was placed that had negative aspiration and test dose also has decreased blood pressure and paresthesia in her fingers may have the catheter placed here.
What is Subdural?
These are two causes outside of hemorrhage that a pt may abruptly have cardiac arrest upon opening the dura.
What is VAE nd abrupt release of ICP (accompanying decrease in BP)?
Pt with acute cocaine use in a shock state when given this medication hoping to maintain or improve hemodynamics may get the opposite effect.
What is Ketamine?