1. Overview Of Anaesthesia Flashcards
Role of anaesthetists
Anaesthetists are responsible for the peri- operative care of a surgical patient m. This implies that they should be involved in the pre-, infra- and postoperative management of patients, in consultation with other clinicians e.g surgeon, physicians, intensivists, the primary care physician etc.
Define general anaesthesia
General anaesthesia can be defined as a reversible drug induced coma-like state that is characterised by loss of consciousness, loss of recall and variable loss of somatic and autonomic reflexes
What does “anaesthesia” in Greek mean
Without sensation
Division of anaesthetic into three distinct periods
Pre- operative
Anaesthetic
Post- operative
Pre- operative period
pre-operative visit or consultation where the anaesthetist meets the patient, examines them, and plans an anaesthetic appropriate for the specific procedure the patient is undergoing.
Sub-Division of the anaesthetic period
Induction phase
Maintenance phase
Emergence phase
Post- operative
postoperative or recovery period where the patient returns to full physiological functioning.
Anaesthetists as peri- operative physicians
They care for their patients during their operative journey
Anaesthetists are the patient’s guardian during this period and must endeavor to maintain normal physiological functioning whilst administering the anesthetic
things done in the pre- operative visit
- relevant history
- examination of the patient
- special investigations
- inform the patient about the attendant anaesthetic risks
- give outline of the journey through the surgical period
- premedication orders
division of the anesthetic period
- pre induction
- induction
pre induction
- machine, monitoring and equipment check
- identifying the presence of emergency equipment and drugs
- drawing up the drugs to be used
- patient is prepared for anaesthesia
how is the patient prepared for anaesthesia
by establishing venous access and administering pre- induction drugs
what does the administration of induction drugs depend on
on patient-, medical-, or surgical- factors ad well as the knowledge and technical skills of the anaesthetic team
risk of induction
the risks of induction come from:
it is a high risk period
the risks of induction come from:
*equipment and monitor malfunctions,
*failure to recognize airway problems
* untoward reactions to administered drugs
what does induction mean
the transition from an awake to an anaesthetized state
classification of anaesthesia
regional (local)
general
maintenance period
the anaesthesia must be administered adequately to the appropriate level and maintained until the surgery is complete
what must the anaesthetist monitor the patient on
- clinical grounds
- non invasive and invasive monitoring device
- “point of care” blood test
problems that may arise during the maintenance period
- peri operative fluid shifts
- blood loss
-aggravation of pre- existing medical or surgical conditions
how is the reversal period induced
removing maintenance drugs or administering antidotes
emergence or reversal
the patient is allowed to “lighten”, regain spontaneous ventilation and the ability to maintain their own airway and protective reflexes
examples of post- operative placement of the patient
- a recovery area or post anaesthesia care unit prior to returning to the ward (or home)
- a high care unit for more intensive monitoring or pain/fluid management
- the intensive care unit (ICU) for further invasive monitoring and organ support
post operative period
no anaesthetic is complete until the patient is fully recovered from the effects of the anesthetic drugs
patients must be monitored until able to cope will all basic physiological functions
pain management
it is crucial for relieving the patient from discomfort, both physical and psychological
