Anesthesiology 2
Total intravenous anesthesia with fentanyl has been selected for a frail elderly woman about to undergo cardiac surgery.
Questions and tasks:
1. What are the mechanisms of action involved in effects of intravenous general anesthetics?
2. Which statement about the anesthesia protocol mentioned above will is accurate?
a) intravenous opioids will provide useful cardiostimulatory effects
b) opioids control the hypertensive response to surgical stimulation
c) marked relaxation of skeletal muscles is anticipated
d) patient awareness may occur during surgery, with recall after recovery
e) the patient is likely to experience pain during surgery
3. If ketamine is used as the sole anesthetic in the attempted reduction of a dislocated shoulder joint, its activation will include:
a) analgesia
b) bradycardia
c) hypotension
d) muscle rigidity
e) respiratory depression
4. An intravenous bolus dose of thiopental usually leads to loss of consciousness within 10-15 s. If no further drugs are administered, the patient will regain consciousness in just a few minutes. This is because thiopental is:
a) a good substrate for renal tubular secretion
b) exhaled rapidly
c) rapidly metabolized by hepatic enzymes
d) redistributed from brain to other body tissues
e) secreted in the bile
5. Respiratory depression after use of which of the following agents may be reversed by administration of flumazenil?
a) desflurane
b) fentanyl
c) ketamine
d) midazolam
e) propofol
6. For which of these drugs is the following true? Postoperative vomiting is uncommon with this intravenous agent, and patients are often able to ambulate sooner than those who receive other anesthetics.
a) enflurane
b) etomidate
c) morphine
d) propofol
e) remifentanil