CORRECTION: At 28:58 I state that hyperventilation increases the seizure threshold. This is incorrect, it DECREASES the seizure threshold.
Reference: Barash Clinical Anesthesia 8th edition: Chapter on Local Anesthetics Outline by Brian Park, MD
Local anesthetics block nerve conduction by? a. Closing calcium channels b. Decreasing intracellular sodium concentration c. Decreasing K conductance d. Causing extrusion of intracellular K e. Inhibiting cellular influx of sodium
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 176: Keywords Part 11: Barbiturates and Bier Blocks
In this 176th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA key words. This time we discuss Barbiturates and Bier Blocks. I also take a moment up front to share some thoughts on the horrible tragedy of George Floyd’s death at the hands of the police and the importance of acknowledging white privilege and fighting for the fact that Black Lives Matter.
Reference: Clinical Anesthesia. Publication Year: 2017. Edition: 8th Ed. Authors/Editor: Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K.; Cahalan, Michael K.; et al. Outline by Brian Park, MD
Awakening after a single dose of thiopental is caused by redistribution from the brain primarily to which of the following sites? (A) Fat (B) Heart (C) Liver (D) Lung
It is actually the case that follow up studies were done in the US on volunteer patients through University of Arizona and Medical College of Wisconsin in the later 1990’s.Ebert, T., Frink, E. and Kharasch, E. Absence of Biochemical Evidence for Renal and Hepatic Dysfunction after 8 Hours of 1.25 Minimum Alveolar Concentration Sevoflurane Anesthesia in Volunteers. Anesthesiology. 1998;88(3):601-610.
The key point of the final article concludes that humans are nearly devoid of renal beta lyase, the key enzyme in directing biodegradation of compound A to the toxic renal thiol. Essentially, this research was done in the late 90’s but the original possibility of renal toxicity in humans from just a few years prior has stuck in peoples’ minds (and therefore textbooks).
Wolf Hall: https://www.amazon.com/s?k=wolf+hall+by+hilary+mantel&i=stripbooks&crid=2F978D2O2UCW&sprefix=wolf+hall%2Cstripbooks%2C135&ref=nb_sb_ss_i_1_9
Bottle of Lies: https://www.amazon.com/Bottle-Lies-Inside-Story-Generic-ebook/dp/B07JG49BQW/ref=sr_1_1?keywords=bottle+of+lies&qid=1581089047&s=books&sr=1-1
Thanks to Brian Robinson for pointing out: reversal of rocuronium with Sugammadex can occasionally cause severe bronchospasm, especially in higher doses, and this was one of the reasons its release was delayed in the U.S.
Although most sugammadex hypersensitivity reactions cause mild symptoms such as sneezing, nausea, rash, and urticaria, there is a small but finite risk of anaphylaxis with potentially life-threatening symptoms such as airway edema, bronchospasm, and cardiovascular collapse. www.apsf.org › article › sugammadex-the-anaphylactic-risk