MANAGEMENT AND MONITORING PERIANESTHESIA

By : Stevan Pagar406 138 052Medical Faculty of Tarumanagara UniversityMANAGEMENT AND MONITORING PERIANESTHESIA

Goal?Early detectionPrediction for future emergenciesEvaluation

what to observe??Airway pressure

Blood pressure

Oxygen saturation

EKG

scopeDepth of anesthesia

CV system

Respiration ventilation

Temperature

Urine output

Fluid therapy

Depth of anesthesiaanalgesia : starting from the current administration of an anesthetic agent to loss of consciousnessDelirium/excitation, hiperrefleksi : starting from the loss of consciousness and eyelash reflex untill regular breathing again

Surgery : begins with irregular respiration until spontaneous respiration is lostBreathing regular, spontaneous, chest abdomen balance, pupillary mydriasis, no light reflex, lacrimation increased,muscle tone begin to decrease+ belly-chest,moderate muscle relaxation+ intercostal muscle paralysis, breathing by the stomach, striated muscle relaxation perfectly+ breathing irregular e.c paralysis intercostal muscle and stomach, greatly decreased muscle tone

Depth of anesthesia

Paralysis of the medulla oblongata : begins with the weakening of the abdominal breathing rather than stage III plana 4

Depth of anesthesia

CV systemObserve HR

ECG

BP

Respiration Monitor :Airway pressureHypersecretionBronchospasm 1ml/kg/h hyperglycemiaDetermine :Blood volumeBlood pressureRenal function

Fluid therapyChildren W : first10kg: 4ml/kg/h10-20kg: 2ml/kg/h>20 kg: 1ml/kg/hAdult Fasting replacement: 2cc/kg/hMaintenance: 2cc/kg/hOperative stress mild: 4 ml/kg/hmoderate: 6ml/kg/hsevere: 8ml/kg/h

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