GI - Co-existing

Question 1

ERCP:GI lab to treat conditions of the ______?

• technique?
• aspiration risk?

Answer 1

• bile ducts
• TIVA vs. GA
• GA with ETT

Question 2

Anesthesia Considerations for Chronic Peptic Esophagitis and Hiatal Hernia:

• preop? prevent?
• intubation/induction?
• meds/meds for gastric contents?/equip?

Answer 2

• aspir prophylaxis/aspiration, PNA
• RSI
• OG
• antibiotics, decrease gastric acidity, post pain, N/V

Question 3

Anesthetic Considerations for IBD:

• meds/concerns/management?
• AVOID?
• supplement?
• caution with?

Answer 3

• F/E management/ imbalance, low PB
• N2O
• suppl steroids
• anticholinesterase - increase intraluminal pressure

Question 4

Management of Anesthesia for Carcinoid Tumor:

• drug ideal for carcinoid tx?
• goal of treatment?
• avoid: drugs/release?
• HTN tx?
• hypotension/bronchospasm tx?

Answer 4

• octreotide (interferes with insulin release)
• minimize SNS stim and prevent crisis
• catecholamines (release serotonin), epi, histamine release, sympathomimetics
• labetolol
• octreotide (100-200mcg)

Question 5

Appendicitis:

• Concerns:
• induction:
• meds/avoid?

Answer 5

• Pain, N/V
• RSI
• abx, aspir prophylaxis, avoid N2O

Question 6

Anesthesia for Bowel Obstruction:

• meds to avoid?
• induction?
• fluids?
• equip?

Answer 6

• N2O/reglan
• RSI
• low albumin/ elyte status/ volume replacement
• OGT

Question 7

Anesthesia for Lap Chole (Colycystitis):

1. surgical considerations? 3. aspiration/equip?
2. positioning? 4. pain meds? drugs for SOO?

Answer 7

1. insuff with CO2 = increased intra-abd pressure and increase etCO2
   - interfere with vent
2. R Tberg = helps with vent
3. place OGT - increase abd pressure = reflux
4. avoid histamine release = SOO
   - NTG, glucagon, naloxone

Question 8

Anesthesia for Upper Endoscopy:

• technique?
• airway? considerations?

Answer 8

• TIVA - propofol
• jawlift/ O2/ NC
• Bite block before sedation
• Ambu

Question 9

Chronic Esophagitis: Surgery

1. Procedure?
2. Anesthesia technique?

Answer 9

1. nissen fundoplication - (open/laprascopic)

2. general (aspiration risk)

Question 10

PUD

1. med treatment?
2. surgery?
3. Anesthetic concerns? Intubation?

Answer 10

1. H2 antagonists and Anticholinergics
2. pyloroplasty, vagotomy
3. RSI, cimestidine inhibits CYP450