Anesthesia: Hospital And Specialty Cycle Quiz!

The correct answer is "All of Above" because it includes all the types of anesthesia mentioned in the given options. General anesthesia refers to the complete loss of consciousness during a medical procedure, local anesthesia involves numbing a specific area of the body, regional anesthesia blocks pain in a larger area of the body, and spinal or epidural anesthesia is used for procedures involving the lower part of the body. Therefore, "All of Above" encompasses all the different types of anesthesia listed.

The statement is true because when administering rocuronium bromide by continuous infusion, it is recommended to give a loading dose and then start administration by infusion. The infusion rate should be adjusted to maintain the desired level of neuromuscular block. The recommended infusion rates vary depending on the type of anesthesia used. Continuous monitoring of neuromuscular block is also recommended as the infusion rate requirements can vary between patients and with different anesthetic methods.

The given correct answer is "Oral Anesthesia." This is because oral anesthesia is not a recognized route of administering anesthesia. Anesthesia can be delivered intravenously, through inhalation, or via total intravenous anesthesia, but not orally.

Succinylcholine is classified as a depolarizing neuromuscular blocking agent. Depolarizing NMBA's work by initially causing depolarization of the motor end plate, which leads to muscle fasciculation. This is followed by a prolonged depolarization phase, during which the muscle remains in a state of paralysis. This medication is commonly used for rapid sequence intubation and short surgical procedures. It is important to note that succinylcholine has a relatively short duration of action compared to non-depolarizing NMBA's, making it a preferred choice in certain clinical situations.

The explanation for the given correct answer is that the recommended maintenance dose of Rocuronium is indeed 0.15 mg.kg-1 rocuronium bromide. However, in the case of long-term inhalational anesthesia, the dose should be reduced to 0.075-0.1 mg.kg-1 rocuronium bromide. It is also recommended to administer the maintenance doses when the twitch height has recovered to 25% of control twitch height or when 2 to 3 responses to a train of four stimulation are present. Therefore, the statement "The recommended maintenance dose is 0.15 mg.kg-1 rocuronium bromide" is true.

ASA-3 is assigned to patients with severe systemic disease that affects their daily life but is not life-threatening. This means that these patients have significant medical issues that impact their ability to carry out their daily activities, but their condition is not immediately life-threatening. In the given scenario, a brain dead person being taken for organ donation surgery would fall under this category as they have a severe systemic disease (brain death) that does not pose an immediate threat to their life.

The answer states that the experience with rocuronium bromide in rapid sequence induction in pediatric patients is limited, therefore it is not recommended for facilitating tracheal intubation conditions in pediatric patients. This suggests that there may be potential risks or complications associated with using rocuronium bromide in this specific situation, and it is advisable to explore other options.

PACU stands for Post Anesthesia Care Unit, which is a specialized area in a hospital where patients are closely monitored after undergoing anesthesia. In the PACU, patients are observed for any complications or side effects that may arise from the anesthesia, such as respiratory issues, pain management, and recovery from the effects of anesthesia. The PACU staff ensures that patients are stable and ready to be transferred to a regular hospital room or discharged home.

The Triad of Anesthesia consists of three components: analgesia (pain relief), sleep/hypnosis (inducing a state of unconsciousness), and muscle relaxation. Memory loss is not a part of the Triad of Anesthesia. This means that memory loss is not one of the essential components required for achieving a state of anesthesia.

Anesthesia refers to the reversible loss of feeling or sensation in all or part of the body. This means that the person who undergoes anesthesia will not feel pain or have any sensation in the areas where the anesthesia is administered. It is important to note that anesthesia can be administered either locally, affecting only a specific part of the body, or generally, affecting the entire body. Therefore, the correct answer is "Reversible Loss of Feeling or Sensation in All or Part of Body."

Rocuronium bromide has its effect on consciousness, pain threshold, thinking ability, and memory. This statement is incorrect because Rocuronium bromide is a neuromuscular blocking agent and its main effect is on skeletal muscle relaxation during surgery or mechanical ventilation. It does not have any direct effect on consciousness, pain threshold, thinking ability, or memory.

Cis-atracurium has several strengths, including organ-independent elimination, no significant histamine release, suitability for CV-unstable and atopic patients, and being ready to use. However, the one strength that it does not possess is a slow onset.

The explanation for the answer "True" is that in obese patients, doses of medication should be reduced based on their ideal body weight rather than their actual body weight. This is because the ideal body weight is a more accurate representation of the patient's size and metabolism, and using it to calculate the dosage can help prevent potential complications or adverse effects.

The correct answer is "Time (min) from end of injection till recovery of neuromuscular transmission (twitch height) to a level of 90% of control." This answer refers to the duration of time it takes for the neuromuscular transmission to recover to 90% of its original strength after the injection has been administered. This is an important measure in clinical settings as it helps determine the effectiveness and duration of the medication or treatment being used.

Acetylcholine is released from the presynaptic neuromuscular vesicles at the neuromuscular junction. This is where the nerve terminal and the muscle fiber meet, and acetylcholine is released into the synaptic cleft to bind to the post-synaptic nicotinic receptor sites on the muscle fiber. The inter-synaptic membrane refers to the membrane between two synapses and is not the site of release for acetylcholine. The answer "I don't know" is not correct. Therefore, the correct answer is Presynaptic Neuromuscular Vesicles.

The recommended dose of Rocuronium for geriatric patients and patients with hepatic and/or biliary tract disease and/or renal failure during routine anesthesia is 0.6 mg.kg-1. This dose should also be considered for rapid sequence induction of anesthesia in patients where a prolonged duration of action is expected. Regardless of the anesthetic technique used, the recommended maintenance dose for these patients is 0.075-0.1 mg.kg-1, and the recommended infusion rate is 0.3-0.4 mg.kg-1.h-1. This is because the dose of Rocuronium should be the same as that for a normal healthy adult, as it does not affect liver enzymes and renal function.

The correct answer states that the standard intubating dose during routine anesthesia is 0.6 mg.kg-1 rocuronium bromide, after which adequate intubation conditions are established within 60 seconds in nearly all patients. It also mentions that a dose of 1.0 mg.kg-1 of rocuronium bromide is recommended for facilitating tracheal intubation conditions during rapid sequence induction of anesthesia. Additionally, if a dose of 0.6 mg.kg-1 rocuronium bromide is used for rapid sequence induction of anesthesia, it is recommended to intubate the patient 90 seconds after administration of rocuronium bromide. This answer covers the correct information regarding the recommended doses and timing for intubation with rocuronium bromide.

The given answer states that the recommended intubation dose and maintenance dose of Rocuronium in infants, children, and adolescents are similar to those in adults. It also mentions that the infusion rates for continuous infusion in pediatrics, except for children, are the same as for adults. However, there is insufficient data to support dose recommendations for the use of Rocuronium in neonates. Additionally, the experience with Rocuronium in rapid sequence induction in pediatric patients is limited, so it is not recommended for facilitating tracheal intubation conditions during rapid sequence induction in pediatric patients.

Rocuronium bromide is a medication used for muscle relaxation during surgery. The given answer states that there is no clinical data available on the use of rocuronium in pregnant women, so caution should be exercised when prescribing it to them. However, it can be used during a Cesarean section if there are no anticipated difficulties with intubation and an adequate dose of anesthetic agent is given. Studies have shown that a dose of 0.6 mg.kg-1 of Esmeron (rocuronium) is safe for parturients undergoing a Cesarean section and does not affect the Apgar score, fetal muscle tone, or cardiorespiratory adaptation. Lactating women should only receive rocuronium if the attending physician determines that the benefits outweigh the risks.

Rocuronium is fully reversible from any depth of block with the use of Sugammadex. This means that Sugammadex can effectively reverse the effects of Rocuronium, regardless of the level of muscle relaxation.

Sugammadex is a modified cyclodextrin and not new to our human body. This indicates that Sugammadex is a known substance in the human body and has been modified to have specific properties for reversing neuromuscular blockade.

Sugammadex can be a life saver in Cannot Intubate, Cannot Ventilate (CICV) situations. This suggests that Sugammadex can be crucial in emergency situations where a patient cannot be intubated or ventilated, providing a potential life-saving solution.

Suxamethonium (Anectin) is a drug that has an ultra short duration of action, meaning it quickly wears off after administration. It also has a short recovery time, allowing patients to regain their muscle function relatively quickly. Additionally, it is a low-cost option, making it more accessible for medical professionals. It can be used for rapid sequence intubation even if a reversal agent is not available. It is suitable for short procedures and is commonly used in situations where there is a need for rapid muscle relaxation. However, it is important to note that it can increase intragastric, intracranial, and intraocular pressure, which may not be suitable for all patients. It belongs to the non-depolarizing neuromuscular blocking agents family and is particularly beneficial for patients with severe burns, muscular dystrophies, and hyperkalemia, as well as those with renal or hepatic failure.

Rocuronium Bromide is the only rapid onset non-depolarizing NMBA, meaning it quickly induces muscle relaxation for intubation. It has a low risk of causing pulmonary aspiration or regurgitation during intubation. It can be easily titrated with flexible dosing, allowing for precise control of muscle relaxation. It is fully reversible, meaning its effects can be quickly reversed if needed. It is stable in solution at temperatures up to 30 degrees Celsius for three months. It does not have any active metabolites. It is indicated for rapid sequence intubation (RSI). However, it is relatively expensive compared to Suxamethonium, another muscle relaxant.

Rocuronium, also known as Zemuron®, Eslax®, and rocuronium, is a fast onset, intermediate-acting aminosteroid NMBA. It binds to nicotinic receptors at the neuromuscular junction, similar to acetylcholine (ACh). It has good cardiovascular safety and is suitable for a wide variety of patient and clinical settings. It is indicated in the intensive care unit (ICU) to facilitate intubation and mechanical ventilation. It does not significantly increase plasma histamine levels. However, it may have a prolonged action in patients with clinically significant liver disease or renal failure. In obese patients, the dose should be based on estimated actual body weight. Overall, rocuronium is highly unpredictable.

Atracurium belongs to the Non-Depolarizing Neuromuscular blocker family, which means it works by blocking the action of acetylcholine at the neuromuscular junction, resulting in muscle relaxation. It has organ-independent elimination, meaning its effects are not significantly prolonged in elderly or patients with renal or hepatic impairment. Atracurium produces a byproduct called Laudanosine when used for a long time. It may cause an increased heart rate and a fall in blood pressure as side effects.