cardiac arrest during op

[Slink]

MercV8 said:

Propofol is why you had adrenaline, so no heart attack then.

Ive had profopol every other time Ive had an OP, (6) and never had adrenaline before, so dont really know how that was connected.

[MercV8]

Yamatrix850 said:

MercV8 said:

Propofol is why you had adrenaline, so no heart attack then.

Cardiac arrest isn't heart attack. A heart attack may lead to cardiac arrest but they're not the same thing - although people often think they are.

You get the jump-start pads stuck on you if you're having a severe attack, but they mostly don't need to use them. You'd know about it if they did, though.

Heart attack/cardiac arrest = laymans terms.

Propofol causes bradycardia and hypotension, adrenaline/epinephrine being used to counter this.

Adrenaline can stimulate the heart in cardiac arrest, but not restart it. The 'sticky pads' are only useful for a shockable rhythm.

[MercV8]

Yamatrix850 said:

MercV8 said:

Propofol is why you had adrenaline, so no heart attack then.

Cardiac arrest isn't heart attack. A heart attack may lead to cardiac arrest but they're not the same thing - although people often think they are.

You get the jump-start pads stuck on you if you're having a severe attack, but they mostly don't need to use them. You'd know about it if they did, though.

Heart attack/cardiac arrest = laymans terms.

Propofol causes bradycardia and hypotension, adrenaline/epinephrine being used to counter this.

Adrenaline can stimulate the heart in cardiac arrest, but not restart it. The 'sticky pads' are only useful for a shockable rhythm.

[MercV8]

Slink said:

MercV8 said:

Propofol is why you had adrenaline, so no heart attack then.

Ive had profopol every other time Ive had an OP, (6) and never had adrenaline before, so dont really know how that was connected.

You'll probably have had it before without knowing or realising. Its a very common drug and used as part of a spectrum of maintenance and emergency drugs by every anaesthetist. It also referred to as epinephrine by our colleagues accross the pond, and there are several similar derivatives with differeing names that have similar effects. It very much depends on what specific type of anaesthetic you received, the type of surgery and how long you were under.

[MercV8]

ucb said:

I dont know any anaesthetist that routinely uses adrenaline for BP and pulse maintanence intra-op for short daycase procedures.
It's far too potent and short acting to be useful.
You may well have had adrenaline into the joint at arthroscopy and the nurse may have simply been commenting that adrenaline is also used during a cardiac arrest.

Part of the benefit of using low concentrations of adrenaline is its short term effect during anaesthesia. You'll have observed it being diluted routinely. It doesn't last too long and doesn't need reversal. With BP fluctuations common during surgery, its a great drug to avoid short term brady and hypotension. "Other drugs are available!"

Adrenaline into the joint following arthroscopy will have been with a local anaesthetic, commonly bupivicaine. The adrenaline is there not for any cardiac influence, in fact the oposite. Its used in two ways. By causing vasoconstriction it reduces the systemic effects of the local anaesthetic and maximises its benefit and longevity. It also reduces post op bleeding.

[Yamatrix850]

MercV8 said:

Heart attack/cardiac arrest = laymans terms.

I think people need to know the difference - as the treatment the 'man in the street' can hand out for them both differs hugely.

Heart attack - try to get some aspirin into the victim.

Cardiac arrest - time to start the CPR.

I wonder how many lives could be saved if people actually knew the difference?

[Slink]

MercV8 said:

Part of the benefit of using low concentrations of adrenaline is its short term effect during anaesthesia. You'll have observed it being diluted routinely. It doesn't last too long and doesn't need reversal. With BP fluctuations common during surgery, its a great drug to avoid short term brady and hypotension. "Other drugs are available!"

Adrenaline into the joint following arthroscopy will have been with a local anaesthetic, commonly bupivicaine. The adrenaline is there not for any cardiac influence, in fact the oposite. Its used in two ways. By causing vasoconstriction it reduces the systemic effects of the local anaesthetic and maximises its benefit and longevity. It also reduces post op bleeding.

aaaah ok, i did have a local on the 'wound' so might have been something to do with that, but I did not get any feelings like when you have a local at the dentist when the local is wearing off and its tingly when feeling is coming back

[Du1point8]

Yamatrix850 said:

MercV8 said:

Heart attack/cardiac arrest = laymans terms.

I think people need to know the difference - as the treatment the 'man in the street' can hand out for them both differs hugely.

Heart attack - try to get some aspirin into the victim.

Cardiac arrest - time to start the CPR.

I wonder how many lives could be saved if people actually knew the difference?

Heart attack = blockage of the coronary artery when part of the muscle dies, if flow of blood returns in quick enough time the damage is minimised.

Cardiac arrest = the electrical signals to the heart are no longer working correctly and are random/chaotic... hence CPR is done to keep circulation going whilst something is found to get the electrical signals back into a uniform status.

usually die from CA than HA...

I think that is correct, I learn much from being around my family that are all in the medical profession.

[ucb]

MercV8 said:

ucb said:

I dont know any anaesthetist that routinely uses adrenaline for BP and pulse maintanence intra-op for short daycase procedures.
It's far too potent and short acting to be useful.
You may well have had adrenaline into the joint at arthroscopy and the nurse may have simply been commenting that adrenaline is also used during a cardiac arrest.

Part of the benefit of using low concentrations of adrenaline is its short term effect during anaesthesia. You'll have observed it being diluted routinely. It doesn't last too long and doesn't need reversal. With BP fluctuations common during surgery, its a great drug to avoid short term brady and hypotension. "Other drugs are available!"

Adrenaline into the joint following arthroscopy will have been with a local anaesthetic, commonly bupivicaine. The adrenaline is there not for any cardiac influence, in fact the oposite. Its used in two ways. By causing vasoconstriction it reduces the systemic effects of the local anaesthetic and maximises its benefit and longevity. It also reduces post op bleeding.

Thanks, my FRCA has permitted me to become familiar with the intra-operative period, drugs and their effects.
I still maintain that, in my 15 years of anaesthetic practise, I have yet to see an anaesthetist use adrenaline as cardiovascular support during the type of procedure being discussed. Its half-life is too short to be useful as a bolus drug in this context.

[turbolucie]

Slink said:

umm, dont know what your talking about regarding drapes?

before the op when i was taking to the anaesthetist and he was about to give me the knock out juice, my surgeon came out, said hello and shook my hand an said how am i sort of thing. next i know after going "whoooooo" when the profopol was kicking in and buzzing me out i came round in recovery. never actually saw the inside of the theatre

What he means regarding the drapes is that the surgeon is likely to not have a clue about what happened. Unless it was genuinely a cardiac arrest and they had to pause the surgery or whatever happened caused such a performance that everyone knew about it, most of the ins and outs of what the anaesthetist does remains unknown to the surgeon. He does his bit and the anaesthetist does his bit.

[Sevo]

ucb said:

Thanks, my FRCA has permitted me to become familiar with the intra-operative period, drugs and their effects.
I still maintain that, in my 15 years of anaesthetic practise, I have yet to see an anaesthetist use adrenaline as cardiovascular support during the type of procedure being discussed. Its half-life is too short to be useful as a bolus drug in this context.

Indeed, this thread is a good demonstration of the dangers of asking health advice on the net. People like to pretend they know what they're talking about. (For clarity that is not aimed at UCB!)

[The_Doc]

turbolucie said:

What he means regarding the drapes is that the surgeon is likely to not have a clue about what happened. Unless it was genuinely a cardiac arrest and they had to pause the surgery or whatever happened caused such a performance that everyone knew about it, most of the ins and outs of what the anaesthetist does remains unknown to the surgeon. He does his bit and the anaesthetist does his bit.

Note the drapes/curtain thingy