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Anesthesiology
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© PATH 2019
Anesthesiology Board Preparation Wyatt Blackwell, M.D.

Index
Introduction to anesthesiology ................................................................ 5

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Anesthesiology Board Preparation Wyatt Blackwell, M.D.

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All information contained in this book is provided for entertainment
purposes only. This information should not be used for the diagnosis or
treatment of any health problem or disease. This information is not
intended to replace clinical judgement or guide individual patient care in
any matter. The contents of this book should never be used for real life.
Acting upon this material is your own doing.

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disclaimer and agree to its terms.

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Anesthesiology Board Preparation Wyatt Blackwell, M.D.

Credits
Solely written by tek_o with ❤ in the USA.

I do sincerely hope this book helps you ace your boards!

Best of luck studying.

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Wyatt Blackwell, M.D. (tek_o)

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Anesthesiology Board Preparation Wyatt Blackwell, M.D.

Introduction to anesthesiology
ASA physical status classification

CLASS PATIENT STATUS

Class 1 Healthy patient

Class 2 Patient with mild systemic disease

Class 3 Patient with severe systemic disease that limits

activity but is not incapacitating

Class 4 Patient with an incapacitating systemic disease

that is a constant threat to life

Class 5 Moribund patient not expected to survive 24

hours without an operation

Class 6 Brain dead patient for organ harvesting

→ Systemic - referring to the system as a whole

→ An “E” is assigned if the surgery is done under emergent conditions. An emergent operation done on a healthy
patient would be Class 1E.

Types of anesthesia
Surgery is carried out using a variety of methods

General anesthesia
Using inhaled agents

Using intravenous agents

Using combinations of both

Regional anesthesia
Using epidurally administered drugs (epidural)

Using spinally administered drugs (intrathecal)

Using nerve plexus blocks or blocking individual nerves

Local anesthesia
Injection of local anesthetic agents

Application of topical anesthesia to mucous membranes

EMLA cream application to regular skin

Regional anesthesia offers many advantages over traditional anesthesia, however,

regional anesthesia procedures have higher failure rates.

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Anesthesiology Board Preparation Wyatt Blackwell, M.D.

General anesthesia typically aims for 6 conditions despite powerful stimuli:

Loss of consciousness

Loss of pain (analgesia)

Loss of memory (amnesia)

Motionless

Obtundation (weakened gag reflexes (for example))

Homeostasis (normal)

Minimum alveolar concentration

Minimum alveolar concentration (MAC) is a concentration needed to prevent
movement in ~50% of patients going under the knife. Using 1.3 MAC or more to
ensure the patient is more protected against movement from painful stimuli.

Emergent stuff & airway

Suction, oxygen, laryngoscope, ETT, defibrillator, crash cart, and emergent drugs

Common general anesthetic drugs for

adults
DRUG USUAL USE DOSE / kg
CONCENTRATION

Thiopental 25 mg/ml Induction 3-5 mg

Propofol 10 mg/ml Induction 1.5-3 mg

Fentanyl 50 mcg/ml Analgesia 2-5 mcg

Morphine varies Analgesia 20-60 mcg

Midazolam 1 mg/ml Loss of consciousness 20 mcg

Succinylcholine 20 mg/ml Intubation 1-2 mg

Rocurnium 10 mg/ml Muscle relaxant 0.5-1 mg

Dolacetron 25 mg/ml Antiemetic 0.2-0.4 mg

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Anesthesiology Board Preparation Wyatt Blackwell, M.D.

Maximum doses of some local

anesthetics
Amides
Lidocaine with epi ............. 7 mg/kg

Lidocaine plain .................. 5 mg/kg

Bupivacaine with epi ......... 3 mg/kg

Bupivacaine plain .............. 2 mg/kg

Mepivacaine ...................... 7 mg/kg

Ropivacaine ....................... 3 mg/kg

Esters
Cocaine (topical) ..... 3 mg/kg

Procaine .................. 14 mg/kg

Chloroprocaine .........14 mg/kg