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Pain Management:Respiratory Physiology and Central Nervous Depression

Terms in this set (39)

Amount of gas inspired into the lungs greatly depends on the physical characteristics of the patient
Average is 500ml
tidal volume
breathing is
voluntary
Why is Minute Ventilation important?
It deals how much gas mixture should be given to a patient
Nitrous oxide is relatively ______________
insoluble
Nitrous helps other anesthetic gases work via the _______________________
second gas effect
Nitrous produces _______________ and changes pain perception
analgesia
Nitrous produces Central Nervous System (CNS) _____________
depression
Rapid movement of N2O and CO2 dilutes the amount of O2 in the alveoli (headache, lethargy, nausea)
diffusion hypoxia
Adverse effects can be prevented by ______ min. of _____ O2 at the end of the procedure
5, 100%
Nitrous Oxide is primarily eliminated through the _______
lungs
Physiological depression of the central nervous system that manifests itself with a decrease in breathing, heart rate, and can lead to a loss of consciousness
Can ultimately lead to death
Central Nervous System Depression
Feeling sleepy/uncoordinated
Staggering
Blurred vision
Impaired thinking
Slurred speech
Impaired perception of time and space
Slowed reflexes
Diminished sensitivity to pain
are symptoms of:
Central Nervous System Depression
State of being conscious
Fully alert, aware, oriented, and responsive to the environment
Alertness and being oriented to place and time are major characteristics of consciousness
Alertness means that you can respond appropriately to the people and things around you
You are oriented when you know who you are, where you are, where you live, and what time it is
Consciousness
State of impaired consciousness in which one shows no responsiveness to environmental stimuli but may respond to deep pain with involuntary movements
Unconsciousness occurs when a person is suddenly unable to respond to stimuli and appears to be asleep
People who become unconscious do not respond to loud sounds or shaking - they may even stop breathing or their pulse may become faint
unconsciousness
uanxiolysis - impaired coordination and cognitive function
minimal sedation
uanalgesia - drug induced depression of consciousness, responds purposefully to verbal commands
moderate sedation
uanalgesia - depression of consciousness, patient can't be easily aroused, responds purposefully after painful stimuli
deep sedation
uloss of consciousness, airway must be maintained
general anesthesia
Sedation is not always predictable, and each level seamlessly blends into the next
continuum sedation
______________ properties (pain control) - 20% N2O/80% O2 produces same potency as 15 mg of morphine
analgesic
___________________ effect - fear handled with a sense of well being; sedated, calm, relaxed with pain threshold increased
anxiolytic
_________________ effect - passage of time can become unclear, cannot recall the severity of pain or anxiety
amnesic
Nitrous has a ________ onset of action
quick
incremental amounts to a specific level that is customized to each patient
titration
Nitrous has a _________ recovery - 100% O2 for minimum of 5 minutes
fast
Nitrous has ____% Elimination within 5-10 minutes
99
Brain and spinal cord
central nervous system
Broken into autonomic and somatic
peripheral nervous system
Peripheral nerve fibers that send sensory information to the CNS
Motor nerve fibers that project to skeletal muscle
somatic nervous system
Controls involuntary muscles, such as smooth and cardiac muscle: sympathetic and parasympathetic
autonomic nervous system
controls activities that increase energy expenditures
sympathetic
controls activities that conserve energy expenditures
parasympathetic
dilation or constriction of the pupil
acceleration or deceleration of the heart
increased or decreased respirations are responses to __________
Nitrous Oxide sedation
Evidence of injury to the nervous system:
chronic exposure, _____________ in extremities
numbness
Effects on CNS:
sedation, depression of brain, senses altered, motor incoordination
Body warmth
Tingling hands, feet
Initial induction
Numb tongue, hands, feet
Numbness of soft tissues of oral cavity
Mild sleepiness
Euphoria (depends upon patient)
Feeling of heavy or light
Analgesia
Deeper to ideal levels
Dreaming, laughing, crying
Visual images confused
Increased sleepiness, tending toward unconsciousness
Sweating increases
Hearing of distant sounds becomes more acute
Nausea
Heavier sedation/slight over sedation
Detachment from environment
Dreaming, hallucinating, or fantasizing
Out of body experiences
Floating or flying
Inability to move or communicate, or keep mouth open
Droning sound
May experience increased sweating, fixed eyes, nausea, uncomfortable body warmth
Agitated or combative behavior
Sluggish delayed responses, slurred words - no verbal sense
May progress to vomiting and unconsciousness
oversedation
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