{"id":90,"date":"2013-10-20T19:40:51","date_gmt":"2013-10-20T19:40:51","guid":{"rendered":"http:\/\/www.modestosurgery.com\/surgeryblog\/?p=90"},"modified":"2013-10-20T19:44:15","modified_gmt":"2013-10-20T19:44:15","slug":"anesthesia-and-pain-management-for-the-surgeon-highlights-notes","status":"publish","type":"post","link":"http:\/\/www.modestosurgery.com\/surgeryblog\/anesthesia-and-pain-management-for-the-surgeon-highlights-notes\/","title":{"rendered":"Anesthesia and Pain Management for the Surgeon &#8211; Highlights &#8211; Notes"},"content":{"rendered":"<h2>Anesthesia and Pain Management<\/h2>\n<ul>\n<li>PRIS &#8211; Propofol Infusion Syndrome &#8211; can be fatal. \u00a0Cardiac failure, rhabdomyolysis, and a severe metabolic acidosis.<\/li>\n<li>Adrenal insufficiency secondary from Etomidate (induction agent) administration may be a cause of hypotension in the post op surgical patient.<\/li>\n<li><strong>Dexmedetomidine<\/strong>\u00a0\u00a0(<a title=\"precedex details\" href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/precedex-does-not-cause-respiratory-depression\/\">Precedex<\/a>)has \u00a0analgesic properties, sedation, stable respiratory rates, predictable cardiovascular responses.<\/li>\n<li>Ativan should not be discountinued abruptly after long term use in the ICU patient.<\/li>\n<li>Heterotopic calcification and myopathies are complications of long term chemical paralysis &#8211; thus chemical paralysis for ventilated patients are now not as popular.<\/li>\n<li>Pulse oximetry readings not as accurate in patients with smoke inhalation.<\/li>\n<li>Colorimetric CO2 indicator &#8211; stomach intubation can still change the color, initially.<\/li>\n<li>CNS and Cardiotoxity related to local anesthetic use &#8211; a concern when intercostal nerve blocks used for multiple rib fractures. \u00a0<a title=\"Lidocaine information and toxicity\" href=\"http:\/\/www.surgerytoday.com\/education\/lidocaine-info-important-for-my-surgical-practice\/\">Lidocaine info<\/a><\/li>\n<li>Place\/Pull epidural catheters, won&#8217;t do unless lovenox\/heparin sq held for 24 h.<\/li>\n<li>As doses and duration of Metaclopramide (Reglan &#8211; Dopaminergic blocker) increases &#8211; neurologic side effects (movement disorders) also increases.<\/li>\n<li>Oral to IV morphine is 3:1<\/li>\n<li>Main use for LMA is for short cases in operating room. \u00a0There are concerns for vomiting and aspiration.<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Anesthesia and Pain Management PRIS &#8211; Propofol Infusion Syndrome &#8211; can be fatal. \u00a0Cardiac failure, rhabdomyolysis, and a severe metabolic acidosis. Adrenal insufficiency secondary from Etomidate (induction agent) administration may be a cause of hypotension in the post op surgical patient. Dexmedetomidine\u00a0\u00a0(Precedex)has \u00a0analgesic properties, sedation, stable respiratory rates, predictable cardiovascular responses. Ativan should not be &hellip; <a href=\"http:\/\/www.modestosurgery.com\/surgeryblog\/anesthesia-and-pain-management-for-the-surgeon-highlights-notes\/\" class=\"more-link\">Continue reading <span class=\"screen-reader-text\">Anesthesia and Pain Management for the Surgeon &#8211; Highlights &#8211; Notes<\/span> <span class=\"meta-nav\">&rarr;<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[47,190,185,187],"tags":[194,217,197,205,206,211,261,202,195,198,215,216,208,210,193,201,213,214,200,196,191,192,203,212,209,204,207,199],"class_list":["post-90","post","type-post","status-publish","format-standard","hentry","category-adrenal","category-anesthesia","category-etomidate","category-precedex","tag-adrenal-insufficiency","tag-aspiration","tag-ativan","tag-colorimetric","tag-endotracheal-tube","tag-epidural-catheter","tag-etomidate","tag-heterotopic-ossification","tag-hypotension","tag-icu-2","tag-iv-morphine","tag-lma","tag-local-anesthesia","tag-lovenox","tag-metabolic-acidosis","tag-myopathy","tag-neurologic-side-effects","tag-oral-morphine","tag-paralysis","tag-precedex-2","tag-pris","tag-propfol","tag-pulse-oximetry","tag-reglan","tag-rib-fractures","tag-smoke-inhalation","tag-stomach-intubation","tag-ventilator"],"_links":{"self":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/90","targetHints":{"allow":["GET"]}}],"collection":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/comments?post=90"}],"version-history":[{"count":2,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/90\/revisions"}],"predecessor-version":[{"id":100,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/posts\/90\/revisions\/100"}],"wp:attachment":[{"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/media?parent=90"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/categories?post=90"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.modestosurgery.com\/surgeryblog\/wp-json\/wp\/v2\/tags?post=90"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}