Ossicle/General

Anesthesia

 * Local Anesthesia
 * CNS Response usually biphasic - stimulation then depression.
 * Cardiovascular effects are usually depression.
 * Cocaine: (esther) 3mg/kg toxicity or 200mg. Causes htn, immediate onset with duration 45min
 * Lidocaine: (amide) 4mg/kg s epi, 7mg/kg with epi toxicity. CNS depression then arrhythmia
 * Epinephrine: max 10cc of 1:100,000 over 10mins with halothane
 * Most common complication of V3 block is cheek hematoma.

Halothane: sensitizes myocardium to catecholamines (epi). Caution.

Ecothiopates: (for glaucoma), are cholinesterase inhibitiors. Don't use succinylcholine.


 * Malignant Hyperthermia
 * Triggers: succinylcholine, halthone, ethrane, forane
 * 1:50k adults, 1:15k kid
 * Signs: increased CO2, HR, RR, temperature, muscle rigidity
 * Pathophysiology: incr Ca++ release from sarcoplasm w/ incr excitation-contraction coupling
 * Rx: dantrolene, procainamide, O2, insulin, glucose, lasix, bicarbonate