Malignant hyperthermia (MH) can develop after receiving general anesthesia. Triggering agents include, but are NOT limited to:
Malignant hyperthermia (MH) is a hereditary, life-threatening, hypermetabolic acute disorder, developing during or after receiving general anesthesia. The clinical incidence of MH is about 1:12,000 in children and 1:40,000 in adults. A genetic predisposition and one or more triggering agents are necessary to evoke MH. Triggering agents include all volatile anesthetics ( eg, halothane, enflurane, isoflurane, sevoflurane, and desflurane) and the depolarizing muscle relaxant succinylcholine. Volatile anesthetics and/or succinylcholine cause a rise in the myoplasmic calcium concentration in susceptible patients, resulting in persistent muscle contraction.
Postoperative nausea and vomiting (PONV) typically occurs in what percentage of surgical cases?
Postoperative nausea and vomiting (PONV) typically occurs in 20 to 30% of surgical cases, with considerable variation in frequency reported between studies (range, 8-92%). PONV is generally considered a transient, unpleasant event carrying little long-term morbidity; however, aspiration of emesis, gastric bleeding, and wound hematomas may occur with protracted or vigorous retching or vomiting. Troublesome PONV can prolong recovery room stay and hospitalization and is one of the most common causes of hospital admission following ambulatory surgery.
The intentional dilution of blood volume often is referred to as:
The intentional dilution of blood volume often is referred to as acute normovolemic hemodilution (ANH) anemia. ANH is a technique in which whole blood is removed from a patient, while the circulating blood volume is maintained with acellular fluid. Blood is collected via central lines with simultaneous infusion of crystalloid or colloid solutions. Collected blood is reinfused after major blood loss has ceased, or sooner, if indicated. Blood units are reinfused in the reverse order of collection. Under conditions of ANH, the increased plasma compartment becomes an important source of O2, which is delivered to the tissues.
Hydroxyethyl starch (HES), gelatin, and albumin are several types of:
Several types of colloids are available, but three are most commonly used-hydroxyethyl starch (HES), gelatin, and albumin. The HES preparations differ from one another according to their concentration, molecular weight, and extent of hydroxy- ethylation or substitution, with resultant varying physiochemical properties. HES solutions most often are described according to their weight -averaged mean molecular weight in kilodaltons (kDa): high molecular weight (450 kDa), middle molecular weight (200 kDa, 270 kDa), and low molecular weight (130 kDa, 70 kDa). HES 450 kDa solutions are available in a normal saline solution (HES 450/NS) and in a lactated, balanced salt solution (HES 450/BS). Although all of these colloids are used in Europe, gelatins are not available in the United States, and the only HES preparations approved by the U.S. Food and Drug Administration are the 6% high molecular weight ( 450 kDa) formulations.
Of the options below, which is a stage of a patient undergoing inhalation induction?
Patients undergoing inhalation induction progress through three stages: (a) awake, (b) excitement, and (c) surgical level of anesthesia. Adult patients are not good candidates for this type of induction, as the smell of the inhalation agent is unpleasant and the excitement stage can last for several minutes, which may cause hypertension, tachycardia, laryngospasm, vomiting, and aspiration. Children, however, progress through stage 2 quickly and are highly motivated for inhalation induction as an alternative to the intravenous (IV) route. The benefit of postinduction IV cannulation is the avoidance of many presurgical anxieties, and inhalation induction is the most common technique for pediatric surgery.
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