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Sedation Techniques
Clinical exam 4
| Question | Answer |
|---|---|
| Complete recovery of swallowing reflex takes ____ after return of consciousness after propofol anesthesia | 15 min |
| 15 mg of valium depresses the swallowing reflex up to _____ | 4 hrs |
| Versed depresses swallowing reflex up to ____ after return to normal state of consciousness | 2 hrs |
| In healthy adult males, administration of ____% nitrous oxide as a sedative caused marked depression of swallowing reflex | 50% |
| Opioids & benzos together have marked _____ reponse to the respiratory responsiveness | synergistic |
| Besides hypoxia, airway obstruction, & death, other possible disadvantages include (there are 6): | lack of control over the airway, technique failure, pt dissatisfaction, surgeon dissatisfaction, excitement, prolonged recovery |
| In a normal awake subject, upper airway collapse is prevented by __________ that holds open the pharynx, larynx, & trachea | upper airway dilator muscle tone |
| Upper airway dilator muscle tone is exquisitely sensitive to ______ drugs | sedative-hypnotic drugs |
| When airway tone decreases, the diameter of the airway is _____ & airway resistance is markedly _______. Which law is this? | diameter is reduced, resistance is increased. Poiseuille's Law |
| In the alveolar gas equation, if PACO2 increases from 40 to 80 d/t hypoventilation, PAO2 will decrease from 100 to _____ | 50 |
| What is the alveolar gas equation? | PAO2 = FiO2(Pb - Ph20)-(PaCO2/R) |
| What is the normal partial pressure of water (Ph20)? | 47 mmHg |
| What are the 5 causes of hypoxemia? | Low FiO2, hypoventilation, V/Q mismatch, diffusion abnormalities, pulmonary right-to-left shunt |
| What are the 2 causes of hypercarbia? | hypoventilation & V/Q mismatch |
| What is the mechanism of action of benzos? | benzos enhance the chloride gating function of GABA by fascilitating the binding of this inhibitory neurotransmitter to its receptor |
| GABA receptors are found throughout ____, with concentrations in ________ | CNS, cerebral cortex |
| Actions of GABA on CNS include (4 things): | alterations in sleep, anxiety, memory & (in larger doses) hypnosis |
| Enhancement of GABA causes ________ | disinhibitory behavior (pt may become less cooperative) |
| Which ion channel function is enhanced by benzos? | Chloride channel (benzos enhance Cl- gating fxn of GABA by facilitating the binding of this inhibitory NT to its receptor) |
| Sedation is defined as..... | a pharmacologically induced depression of consciousness consisting of varying degrees of amnesia, anxiolysis & analgesia tailored to the pt's needs for the procedure. Continuum is from minimal (light) sedation through deep sedation/GA |
| Minimal sedation is defined as..... | a drug-induced state during which pts respond normally to verbal commands. Although cognitive fxn & physical coordination may be impaired, airway reflexes, & ventilatory & CV fxns are usually unaffected |
| Moderate sedation is also called _______ _______ | conscious sedation |
| Moderate sedation is defined as..... | a drug-induced depression of consciousness; pts respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. No interventions are req'd to maintain a patent airway, & spont vent is usually adequate. CV fxn maintained |
| Reflex withdrawal from a painful stimulus (is / is not) considered a purposeful response | is not |
| Deep sedation/analgesia is defined as..... | a drug-induced depression of consciousness; pts cannot be easily aroused, but respond purposefully following repeated or painful stimulation. Spont vent may be inadequate. May have impaired ability to maintain airway. CV fxn usually maintained |
| General anesthesia is defined as ... | drug-induced LOC. Pts are not arousble, even to painful stimulation. Ability to maintain vent fxn is often impaired. Often req assistance to maintain patent airway & may need positive pressure ventilation. CV fxn may be impaired |
| 5 Goals of sedation from American Academy of Pediatrics are: | - to guard pt's safety & welfare. - minimize discomfort & pain. - minimize negative psychological responses to treatment by providing analgesia, & maximize amnesia potential - control behavior - return pt to state of safe discharge |
Created by:
Thommy413
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