The Medical Student’s Anesthesia Pocketbook

Jun 29th, 2015
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We the contributors would first and foremost like to thank the faculty at the University of Texas at Houston for their support, guidance, and teachings in helping us create this pocket book. We would also like to thank the residents.

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The Medical Students Anesthesia PocketbookUniversity of Texas Health Science Center HoustonTable of ContentsAnesthesia Overview4Introduction4Preoperative History and Physical4IVs and Premedication7Room Setup and Monitors7Induction and Intubation10Maintenance11Emergence12PACU concerns13Commonly Used Medications14Volatile Anesthetics14IV Anesthetics15Most sedative hypnotics work through the inhibitory gamma-aminobutyric acid (GABA) neurotransmitter system in which increased chloride conductance leads to neuronal inhibition. Most IV induction agents bind to a specific site called GABAA for this inhibitory effect, and they have a rapid onset due to lipophilic properties which allow them to quickly partition into the highly perfused lipophilic brain and spinal cord. They also have short duration of action, with their termination of effect due to redistribution into less perfused tissues such as muscle and fat.15Local Anesthetics16Opioids16Fentanyl/Alfentanil/Sufentanil/Remifentanil - More potent than morphine, with Sufentanil being the most potent (up to 1,000x as potent). In addition, all are shorter acting than morphine, with Remifentanil being the shortest. Often used to attenuate the stress response to surgical stimulation. Low doses produce brief effect, but larger doses are long acting, increased incidence of chest wall rigidity vs. other opiates, no active metabolites, usually safe in patients with morphine allergies.17

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