In deze samenvatting zijn de volgende onderwerpen beschreven: algehele anesthesie, locoregionale anesthesie (spinaal, perifere zenuwblokkade, locoregionale verdoving), ASA classificatie en de ABCD methode.
Preoperatieve screening:
● Klinische evaluatie van co-morbiditieiten,
allergieën en eerdere complicaties bij anesthesie
o Invloed op de anesthesie
● ASA-classificatie
o I = patiënten zonder lichamelijke of
psychische aandoeningen
o II = patiënten met geringe systemische
aandoeningen zonder functionele beperkingen
o III = patiënten met ernstige invaliderende systemische aandoeningen
o IV = patiënten met ernstige systemische aandoeningen, die levensbedreigend zijn
o V = stervende patiënten, van wie verwacht kan worden binnen 24 uur zonder operatie
overlijden
● Optimaliseren van co-morbiditeiten en medicijn gebruik
● Risicoanalyse peroperatief
● Inschatting luchtweg
o Mallempati score
● Anesthesieplan en plan voor postoperatieve bewaking.
● Uitleg geven over anesthesie
● Informed consent
● Nuchterbeleid uitleggen
Klaarzetten benodigdheden voor algehele anesthesie:
● Toestel check
o Zuurstof
o Zuig
o Lekkagetest
● Anesthesieplan
● Klaarleggen volgens de ABCD-methodiek
o A = airway
▪ Tube / laryngoscoop
▪ Filter
▪ Kapje
o B = breathing
1
, ▪ Toestel instellen
o C = circulation
▪ Infuus
▪ Medicatie
o D = disability
o E = exposure / environment
▪ Operatie
> 30
minuten = temperatuursonde
Anatomie:
Luchtweg (A)
● Beoordelen
o Mallempati
▪ 4 klassen mondopening
o Cormack en lehane
1.Larynxmasker
● Geen gegarandeerde vrije luchtweg
● Maskerbeademing
2.Tubes
● Gegarandeerde vrije luchtweg
● Tube fixeren
● Cuffdruk meten = druk die je nodig hebt om de
trachea af te sluiten zodat geen lek ontstaat 🡪
20-30 mmHg
● Nasale tube 🡪 via de neus
● Dubbel-lumen tube
o Longen verschillend beademen
● Laryngoscoop
● Videolaryngoscoop
● Endotracheal tube stylets
2
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