anesthesia effects on GI system
anesthesia effects on GI system
Adynamic Ileus
GI bleeding
Pancreatitis
100

opioids reduce GI motlity how

high density of peripheral mu receptors in the myenteric and submucosal plexuses

leading to delayed gastric emptying and slower transit through the intestines

100

when should N2O be avoided

length abdominal surgeries

bowel is already distended

100
what is an adynamic ileus

colonic ileus with massive dilation of the colon without mechanical obstruction

100

upper GI therapeutic procedure of choice

EGD

*endoscopic ulcer litigation, ligation of bleeding varices

mechanical balloon tamponade

100

hallmark signs of pancreatis

increased serum amylase and lipase

200

other adverse effects of opioids on the GI system

nausea, anorexia, delayed digestion, abdominal pain, excessive straining during BM, incomplete evacuation

200
gut distention correlates with what 3 things

pre-existing gas in the bowel

duration of N2O administration

concentration of N2O adminstered

200

what can cause an adynamic ileus

loss of peristalis = distention of colon

200
blood loss > __% leads to Hypotensino and tachycardia

orthostatic hypotension indicates a HCT < __%

25%

30%


200

symptoms and complications of acute pancreatitis

Epigastric pain that radiates to the back, N/V, abdominal distention, steatorrhea, ileus, fever, tachycardia, and hypotension

complications: shocks, ARDS, renal failure, necrotic pancreatic abscess 

300

sugammadex effects on GI motility

no effect

300

T/F volatile anesthetics increase the spontaenous, electrical, contractile, and propulsive activity in the stomach, small intestine, and colon

false, depress

*volatile agents + SNS hyperactivity = can inhibit GI function and motility

300

causes and treatment of adynamic ileus 

electrolyte disorders, immobility, excessive narcotics, anticholinergics

Treatment: restore electrolyte balance, hydrate, mobilize, NG suction, enemas

neostigmine (2-2.5 mg over 5 min) immediate results in 80-90%

300

melena indicates

bleed above the cecum

300

how is autodigestion normally prevented

proteases packaging in precursor form

protease inhibitors

low intra-pancreatic calcium, which decreases trypsin activity

400

neostigmine effect on bowel peristalsis

increases PSNS and increases the frequency and intensity of contractions

400

inhbition of GI activity is directly proportional to 

amount of NE secreted from SNS stimulation

high anxiety= high inhibition

400

if an adynamic ileus is left unntreated what can occur

ischemia or perforation

400

causes of lower GI bleed

diverticulosis, tumors, colitis

generally occurs in the elderly 

400

common causes of acute pancreatitis

gallstones and alcohol abuse

Gallstones obstruct the ampulla of Vater and prevent pancreatic excretion (pancreatic HTN)

also seen in immunodeficiency symptoms, hyperparathyroidism, and hypercalcemia

500

T/F the cholinergic activity is partially offset by concurrent administration of glycopyrrolate or atropine

true! 

500

recovery of the GI tract postop

the small intestine is the first part to recover

followed by stomach 24 ours

then colpon 30-40 hours postop

500

an adynamic ileus is though to be caused by a 

neural - input imbalance of excessive SNS stim and inadequate PSNS input to colon

500
sigmoidoscopy vs colonscopy
unprepped sigmoidoscopy when HD stable

A colonoscopy preformed if the patient can tolerate prep


persistent bleeding warrants angiography and embolic therapy

500

treatment of acute pancreatitis

aggressive IVF, NPO to reset pancreas, enteral feedings (over TPN), opioids

ERCP

-remove stone, stent placement, sphincterotomy, hemostasis