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Some Components of “Balanced General Anesthesia”
- 1. Unconsciousness (General anesthesia is a reversible drug-induced coma.)
- 2. Analgesia (pain relief)
- 3. Immobility (muscle relaxation)
- 4. Hemodynamic stability (Many general anesthetics, spinal anesthesia, and epidural anesthesia all tend to drop the BP.)
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Bad side effects of GA
- Resp. Depression
- Nausea and Vomitting
- Seizure
- Cardiovascular Instability
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Resp depression is common with...
- Propofol
- Inhaled anesthetics
- Fentanyl
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Nausea and vomitting common with...
- Fentanyl
- Nitrous oxide
- Volatile inhaled anesthetics (isoflurane, desflurane, sevoflurane)
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What can be given as anti-emetic
Ondansetron (ZofranR), a 5HT3-receptor antagonist, is often given IV to prevent or to treat nausea and vomiting.
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What 2 drugs are discouraged with use in those with seizure disorders?
etomidate and sevoflurane
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iEphedrine
- 1. Classification: Sympathomimetic amine
- Think of it as a “weak epinephrine”
- Indirect norepinephrine release
- Some direct action
- 2. Clinical Use: Increase BP and HR
- Rx. of hypotension
- 3. Clearance: Mostly renal
- 4. Correcting for SE: Titrate carefully ! Increases BP, HR, arrhythmias
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