Management and Monitoring Perianesthesia

MANAGEMENT AND MONITORING PERIANESTHESIA

By : Stevan Pagar 406 138 052 Medical Faculty of Tarumanagara University

Goal? Early detection Prediction for future emergencies  Evaluation 

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CV

monitorin g PULM O

what to observe?? Airway pressure

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Blood pressure

Oxygen saturation 

EKG

scope Depth of anesthesia

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CV system

Respiration ventilation 

Temperature

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Urine output

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Fluid therapy

Depth of anesthesia 1.

2.

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

Depth of anesthesia 3.

Surgery : begins with irregular respiration until spontaneous respiration is lost 1. Breathing regular, spontaneous, chest

abdomen balance, pupillary mydriasis, no light reflex, lacrimation increased,muscle tone begin to decrease 2. + belly-chest,moderate muscle relaxation 3. + intercostal muscle paralysis, breathing by the stomach, striated muscle relaxation perfectly 4. + breathing irregular e.c paralysis intercostal muscle and stomach, greatly decreased muscle tone

Depth of anesthesia 4.

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

CV system 

Observe HR

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ECG

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BP

Respiration 

Monitor :

› Airway pressure › Hypersecretion › Bronchospasm › 1ml/kg/h  hyperglycemia Determine : › Blood volume › Blood pressure › Renal function

Fluid therapy 

Children › W : first10kg : 4ml/kg/h

10-20kg: 2ml/kg/h >20 kg : 1ml/kg/h 

Adult › Fasting replacement : 2cc/kg/h › Maintenance : 2cc/kg/h › Operative stress – mild : 4 ml/kg/h

moderate : 6ml/kg/h severe : 8ml/kg/h

THANK YOU