Action & Effects
T/F: Exact MOA within the PNS remains unknown?
False - CNS remains unknown
The Meyer Overton Rule correlates to what?
Oil/Gas Solubility (lipid solubility)
*Boards material
When we purposefully cause our patient's ETCO2 to read 30-35, what is this helping to decrease?
Decrease steal phenomenon (vasoconstriction = decreased ICP)
Which of the following TWO are not a risk factors of postoperative cognitive dysfunction (POCD)?
Elderly, Pediatric, Hx of stroke, cognitive decline at discharge, emergence delirium
Pediatrics & Emergence Delirium
In regard to changes in HR due to inhalation gas administration, which gas creates the most prominent increase in HR and MAP?
Desflurane
Which of the following is the incorrect paring:
(a) Amnesia - Abducens
(b) Unconsciousness - Thalamus
(c) Analgesia - Spinothalamic Tract
(a) Corrected: Amnesia - Amygdala
T/F: Volatile agents create an indirect relation between CMRO2 & CBF (uncoupled)?
True
Daily Double: Finish the Lyric
"..just a city boy, born and raised in South Detroit, he took the midnight train _______ ________"
"....Going Anywhere" (Journey)
What are the medications we could give to a pediatric when emerging after a tonsillectomy?
Fentanyl, Propofol, Ketamine, or Precedex
Of the volatile agents, which one will cause bradycardia the most often?
Sevoflurane
Which of the following is not a proposed site of action?
Ligand-Gated Ion Channels, NMDA receptors, Aquaporin, or Voltage-Gated Ion Channels
Aquaporin
There are a few factors that affect the amount of MAC given to the patient. Of the ones we discussed in lecture, which one cannot affect MAC value on its own?
NMB administration (do NOT only use a NMB, add analgesia and amnesia)
Which inhalation agent causes an increase in CBF around 1.3 MAC and is used most commonly in neuro cases today?
(physiochemical properties of volatiles graph)
Isoflurane
During a case, you administer both a volatile agent & N20. We know that this will alter the evoke potential monitoring. This situation is dose-dependent, and we would see and increase in ________ and decrease in _________.
Increase latency, Decrease amplitude
*Mimics ischemia
Of the inhalation agents that we have discussed in class, which one is not responsible for producing coronary steal?
N2O - volatile agents may produce coronary steal (reverse robin-hood effect)
Which of the following is not a neuroprotective effect of anesthetics?
Stimulation of GABA a receptors, antioxidant effect, increase apoptosis, preconditioning, or inhibition of glutamate release
Increase Apoptosis
Correct - Prevention of apoptosis
A patient of ours is going through Target Temperature Management (hypothermic protocol). Would N2O have a coupled or uncoupled impact on CMRO2 & CBF?
Coupled (both CMRO2 + CBF would decrease)
Hypercapnia leads to cerebral vascular vasodilation, in turn this would ______ ICP?
Increase
Hypercapnia = vasodilation = increased ICP
During a case, we are utilizing MEP monitoring. Would we want to use Roc or Succs to paralyze our patient?
Succs - We want to use a shorter acting paralytic so we can monitor the integrity of motor pathways during the procedure
Of the inhalation gases, which one will we avoid in patients with pulmonary HTN?
N20
Which gases result in the effect of decreased Pulmonary Vascular Resistance (PVR) and which ones result in increased PVR?
Decreased PVR - Volatile Agents
Increased PVR -N20
Inhalation agents influence the CNS by decreasing _______ _______ & increasing CBF.
Decreased cerebrovascular tone
When would we expect volatile agents to prevent an increase in CBF?
< 1.5 MAC + mild hyperventilation
During which stage of anesthesia will we see delirium, excitement, and unconsciousness?
Stage 2
Within the respiratory system, which factor has the greatest impact?
Tidal Volume (Vt)