OMSB Anesthesia (OEA) key terms

A technique for inducing anesthesia in patients at risk of aspiration, using a fast-acting induction agent followed immediately by a neuromuscular blocker, with cricoid pressure and no bag-mask ventilation before intubation.

Pressure applied to the cricoid cartilage to compress the esophagus against the cervical spine, intended to reduce passive regurgitation and aspiration risk during induction before a definitive airway is secured.

Chemical injury to the lungs caused by inhalation of gastric contents that are acidic or particulate, producing bronchospasm, hypoxemia, and a chemical pneumonitis that may progress to acute respiratory distress syndrome.

Pharmacologic paralysis produced by agents that interrupt transmission at the neuromuscular junction, either by competing with acetylcholine at nicotinic receptors (non-depolarizing) or by persistent depolarization (succinylcholine).

Peripheral nerve stimulation delivering four supramaximal stimuli at 2 Hz to assess the depth of non-depolarizing neuromuscular blockade, with the number of evoked twitches indicating the degree of receptor occupancy.

A modified gamma-cyclodextrin that encapsulates rocuronium and vecuronium in the plasma, rapidly reversing even deep non-depolarizing neuromuscular blockade, but it does not bind succinylcholine or benzylisoquinolinium agents.

Persistent weakness after anesthesia due to incomplete reversal of neuromuscular blockade, detectable as a TOF ratio below 0.9 and associated with airway obstruction, hypoxemia, aspiration, and increased pulmonary complications.

A pharmacogenetic hypermetabolic crisis triggered by volatile anesthetics or succinylcholine, caused by uncontrolled calcium release from the sarcoplasmic reticulum, presenting with hypercarbia, rigidity, hyperthermia, and rhabdomyolysis.

The specific antidote for malignant hyperthermia, which inhibits calcium release from the sarcoplasmic reticulum of skeletal muscle; it must be reconstituted rapidly and given in repeated doses until hypercarbia and rigidity resolve.

The alveolar concentration of an inhaled anesthetic at which 50 percent of patients do not move in response to a standardized surgical stimulus, used to compare potency and to titrate volatile agents.

The phenomenon in which rapid uptake of a high-volume gas such as nitrous oxide concentrates the remaining alveolar anesthetic and accelerates the rise of the co-administered volatile agent's alveolar partial pressure.

An inorganic inhaled anesthetic and analgesic with low potency, rapid onset and offset, and a MAC of roughly 105 percent, which limits its use as a sole agent and expands gas-containing spaces.

A rare but potentially fatal complication of prolonged high-dose propofol infusion, characterized by metabolic acidosis, rhabdomyolysis, hyperkalemia, cardiac arrhythmias, and renal failure, requiring immediate cessation of the drug.

An intravenous alkylphenol anesthetic producing rapid hypnosis and amnesia, with dose-dependent hypotension and respiratory depression, commonly used for induction, maintenance, and sedation.

Anesthetic maintenance using only intravenous agents, typically propofol with an opioid, often delivered by target-controlled infusion and frequently combined with processed EEG monitoring to titrate depth.

A processed electroencephalographic monitor that converts frontal EEG activity into a dimensionless number from 0 to 100, where lower values indicate deeper hypnosis and 40 to 60 is a typical surgical range.

Explicit recall of events occurring during general anesthesia, ranging from vague auditory memories to full sensation of pain and paralysis, associated with psychological sequelae such as post-traumatic stress disorder.

A clinical situation in which trained personnel experience difficulty with face-mask ventilation, supraglottic device placement, laryngoscopy, tracheal intubation, or emergency invasive airway access, requiring a preformulated algorithm.

A four-grade classification of the view obtained during direct laryngoscopy, from full visualization of the vocal cords (grade 1) to inability to see any laryngeal structure (grade 4).

Tracheal intubation using a laryngoscope with a camera and screen that displays the glottis indirectly, often improving the view in patients with difficult direct laryngoscopy and reducing cervical spine movement.

An emergency front-of-neck airway created through the cricothyroid membrane to oxygenate a patient when intubation and supraglottic rescue have failed, serving as the final step in a cannot-intubate cannot-oxygenate algorithm.

A supraglottic airway device with an inflatable cuff that seals against the periglottis and delivers anesthesia or ventilation without entering the trachea, used for spontaneous ventilation and as a rescue device.

Central neuraxial blockade produced by injecting local anesthetic into the subarachnoid space, yielding rapid, dense sensory and motor block below the injection level, commonly used for lower abdominal and lower limb surgery.

Neuraxial blockade achieved by injecting local anesthetic into the epidural space, producing a segmental block with slower onset than spinal anesthesia and allowing catheter placement for continuous infusion and postoperative analgesia.

A postural headache, worse on standing and relieved by lying flat, caused by cerebrospinal fluid leakage through a dural puncture, often treated with caffeine, conservative measures, or an epidural blood patch.

A fall in blood pressure following spinal or epidural anesthesia due to sympathetic blockade, venodilation, and reduced venous return, managed with fluid, vasopressors, and left uterine displacement in obstetric patients.

A dose-related or inadvertent intravascular exposure to local anesthetics causing neurologic excitation followed by depression and cardiovascular collapse, treated with airway support, benzodiazepines, and intravenous lipid emulsion.

A rescue therapy for local anesthetic systemic toxicity consisting of a bolus and infusion of a lipid emulsion that sequesters lipophilic anesthetic from cardiac tissue and supports myocardial energetics.

A drug that reversibly blocks voltage-gated sodium channels in nerve membranes, preventing depolarization and impulse conduction; amide agents are metabolized hepatically and esters by plasma esterases.

A vasoconstrictor added to local anesthetic solutions to reduce systemic absorption, prolong block duration, and limit bleeding, while its systemic effects require caution in patients with ischemic heart disease.

Recommendations that limit oral intake before anesthesia to reduce aspiration risk, typically 2 hours for clear fluids, 4 hours for breast milk, and 6 hours for light meals in elective cases.

A multimodal perioperative pathway combining evidence-based interventions such as opioid-sparing analgesia, early feeding, and early mobilization to reduce surgical stress and shorten hospital stay.

The combined use of analgesics with different mechanisms, such as paracetamol, NSAIDs, opioids, and regional blocks, to improve pain relief while reducing opioid dose and related adverse effects.

An infusion pump system that allows a patient to self-administer small intravenous opioid doses within programmed limits, improving analgesia and satisfaction while requiring monitoring for respiratory depression.

Reduced respiratory rate and depth caused by opioid action on brainstem respiratory centers, presenting with sedation, hypoventilation, and hypercarbia, and reversed with naloxone when clinically significant.

A competitive opioid receptor antagonist used to reverse opioid-induced respiratory depression and overdose, with a short duration that may require repeat dosing or infusion because opioids can outlast it.

Nausea and vomiting occurring in the postoperative period, driven by patient, anesthetic, and surgical risk factors, and prevented with risk-based multimodal prophylaxis using antiemetics from different classes.

Reflex closure of the vocal cords caused by stimulation of the larynx during light anesthesia or airway irritation, which can obstruct ventilation and is managed with deepening anesthesia, positive pressure, or small-dose muscle relaxant.

Involuntary thermoregulatory muscle activity during recovery from anesthesia, increasing oxygen consumption and pain, treated with active warming and medications such as meperidine.

A core temperature below 36 degrees Celsius during surgery caused by anesthetic-induced vasodilation, heat loss, and impaired thermoregulation, associated with coagulopathy, infection, and delayed recovery.