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CPT > Intro To Anaesthetics > Flashcards

Intro To Anaesthetics Flashcards

1
Q

Types of anaesthesia

A
  • General: inhalational/volatile or IV
  • Local: regional
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2
Q

What is conscious sedation

A

Use of small amounts of anaesthetics or benzodiazepines to produce a sleepy like state

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3
Q

Routes of general anaesthesia

A

Inhalational/volatile
IV

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4
Q

Examples of IV general anaesthesia

A

Propofol
Barbiturates
Etomidate
Ketamine

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5
Q

What is anaesthesia a combination of?

A
  • Analgesia
  • Hypnosis (loss of consciousness)
  • Depression of spinal reflexes
  • Muscle relaxation
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6
Q

What drug is normally used as premedication anaesthesia?

A

Hypotonic-benzodiazepine

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7
Q

What class of drug is usually used as intra operative analgesia?

A

Opioid

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8
Q

Outline the polypharmacology of anaesthesia

A
  • premedication: benzodiazepine
  • induction: IV or inhalational
  • intraoperative analgesia: opioid
  • intubation: muscle relaxant
  • maintenance: IV or inhalational
  • reversal of muscle paralysis + recovery: opioid/NSAIDs/paracetaoml
  • provision for post op N+V: antiemetic?
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9
Q

What is volatile anaesthetic potency described by?

A

Minimum alveolar concentration

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10
Q

Stage 1 Guedel’s signs

A

Analgesia
Consciousness

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11
Q

Stage 2 guedel signs

A

Unconscious
Breathing erratic but delirium could occur > excitement phase

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12
Q

Stage 3 guedel’s signs

A

Surgical anaesthesia

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13
Q

Stage 4 guedel’s signs

A

Respiratory paralysis + death

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14
Q

What is the anatomical substrate for minimum alveolar concentration?

A

Spinal cord

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15
Q

What factors affect induction + recovery + potency?

A

Partition coefficients (solubility)
- blood:gas partition determines induction + recovery
- oil:gas partition determines potency

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16
Q

What does the blood:gas partition determine?

A

Induction + recovery

17
Q

What does the oil:gas partition determine?

A

Potency

18
Q

What increases minimum alveolar concentration?

A
  • hyperthermia
  • pregnancy
  • alcoholism
  • central stimulants
19
Q

What decreases minimum alveolar concentration?

A
  • increasing age
  • hypothermia
  • Other anaesthetics + sedatives
  • Opioids
20
Q

Why is nitrous oxide often added to other volatile agents?

A

To reduce the dosing needed + reduce side effects

21
Q

Relationship between lipid solubility + potency

A

High potency - high lipid solubility

22
Q

Relationship between potency + GABAA interaction

A

High interaction -

23
Q

Examples of volatile anaesthetics

A

Halothane
Isoflurane
Sevoflurane
Desflurane

24
Q

Describe GABAA

A
  • ligand gated ion channel
  • major inhibitory transmitter
  • potentiate GABA activity
  • sedation, anaesthesia + anxiolysis
25
Q

What receptors do anaesthetics work on?

A

GABAA
OR
NMDA glutamate receptor

26
Q

What anaesthesia act on NMDA receptors?

A

Xenon
Nitric oxide
Ketamine

27
Q

What affect do general anaesthetics have on parts of the CNS

A
  • reduces connectivity between reticular system
  • hippocampus depressed
  • brainstem depressed
  • spinal cord depress dorsal horn + motor neuronal activity
28
Q

What are the uses of IV general anaesthetics?

A

IV for induction
Total IV anaesthesia alone

29
Q

What is the mechanism of action of IV anaesthetics?

A
  • propofol + barbiturates: potentiate GABAA
  • ketamine: inhibits NMDA receptor
30
Q

Uses of local + regional anaesthesia

A
  • dentistry
  • obstetrics
  • regional surgery
  • post op for wound pain
  • chronic pain management
31
Q

Basic local anaesthetic structure

A

Aromatic ring + amine
Linked by ester or amide link

32
Q

Examples of local anaesthetics

A

Lidocaine
Bupivacaine
Ropivacaine
Procaine

33
Q

Target site for local anaesthetics

A

Voltage gated sodium channel

34
Q

What are the adverse drug reactions of general anaesthesia?

A

Post op N+V
Hypotension
Post operative cognitive dysfunction
Chest infection

35
Q

Mechanism of action of local anaesthetics

A

Block VGNCs
This prevents AP from being produced

36
Q

What are the adverse drug reactions of local anaesthetics?

A
  • Depends on agent used + usually result from systemic spread
  • Allergic reactions + anaphylaxis
  • Cardiovascular toxicity due to blockage of VGNC
37
Q

What is minimum alveolar concentration?

A

The concentration at which 50% of people fail to respond to surgical stimulus

38
Q

Relationship between minimum alveolar concentration and potency

A

High MAC = lower potency

CPT (28 decks)

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