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Exam 2 > Anaesthesia > Flashcards

Anaesthesia Flashcards

(80 cards)

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1
Q

Define General Anaesthesia?

A

“The reversible immobile state that induces amnesia”

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2
Q

Define nociceptive

A

Nociceptive pain is a type of pain caused by damage to body tissue.

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3
Q

Local Anaesthetics – Mode of Action

A

Blocking the generation and conduction of nerve impulses, resulting in
patients feeling no pain

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4
Q

Are sensory or motor neurons more sensitive

A

Sensory Neurons

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5
Q

5 stages of nervous Function is Lost?

A
  1. Pain
  2. Heat and cold sensation
  3. Touch
  4. Deep pressure
  5. Motor function
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6
Q

Why can local anaesthetics cross blood brain barrier

A

Lipid soluble and low molecular weight

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7
Q

Therapeutic effects of local anaesthesia

A

Anticonvulsants, sedatives and analgesia

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8
Q

Negative effects of local anaesthesia in high doses

A

Seizures
CNS depression
Slows myocardium conduction

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9
Q

effects of myocardial conduction

A

Depressing contractility
weak pulses
hypotension
bradycardia
cardiac arrest

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10
Q

Species more sensitive to local anaesthetic

A

Cats
(and exotics)

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11
Q

List local anaesthetic drugs

A

Lidocaine
Proxymetacaine
Bupivacaine

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12
Q

Lidocaine benefits

A

Rapid onset of activity
Good tissue penetration
Short duration of activity
Good for regional blocks and
general surgery

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13
Q

Lidocaine activity duration

A
  • 45 minutes without adrenaline
  • 1-2 hours with adrenaline
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14
Q

Proxymetacaine benefits

A

Topical analgesia of eye
Rapid onset
(Duration:15 minutes)

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15
Q

Bupivacaine effects

A

Good epidural analgesia
post-op anaesthesia
Potency x4 lidocaine

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16
Q

Bupivacaine onset of activity and duration

A

Slow onset of activity (15 minutes)
Longer duration of action (6-8 hours)

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17
Q

list the Local anaesthesia blocks

A

Local
regional
Epidural
Intra-articular

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18
Q

Peri-neural (regional) block locations

A

Intercostal nerve block
Brachial plexus block
Maxillary/mandibular nerve blocks

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19
Q

Intravenous regional block AKA

A

Bier block

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20
Q

What is a Perineural (Regional) Block

A

Local anaesthetic injected directly around nerve

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21
Q

What can be used to assist with Perineural (Regional) Block

A

Ultrasound or Nerve stimulator

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22
Q

Location of Intercostal nerve block site

A

caudal to ribs

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23
Q

Location of Brachial Plexus block site

A

Distal to elbow

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24
Q

Needle used for Epidural

A

Tuohy needle
or 22G spinal needle

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25
Lumbosacral epidural provides analgesia to structures...
...caudal to thoracolumbar junction
26
Epidural injected between which spinal vertebrae
space between L7-S1
27
Patients who are at particular risk during Epidural anaesthesia
Patients Shock (Hypovolaemic)
28
When Would an Epidural Injection be Contraindicated?
Patient suffering septicaemia skin over lumbosacral junction is infected Patient with coagulation disorder
29
When are Intravenous regional anaesthesia, or Bier block used
surgical procedures in body’s extremities e.g. removal of a toe
30
What is an Esmarch bandage
Drain blood from a limb
31
Dissociative Anaesthesia effects
analgesia and amnesia minimal effect on respiratory function can be used with brief surgery Swallowing and eyes remain open
32
Dissociative anaesthesia hyperexcitation signs
* Hypersalivation * Hyperventilation * Tachycardia * Muscle twitches * Paddling of the legs * Curling of the tongue
33
General Anaesthesia disadvantages
Effects major organs in the body * Cardiovascular * Respiratory * Neurological * Renal * Hepatic
34
Peri-neural Anaesthesia disadvantages
* Pneumothorax * Bleeding * Nerve damage
35
Disadvantages of epidural
* Introduction of infection * Paralysis * Artificial ventilation required if cranial nerve involvement * Can cause hypotension * Possible urinary retention
36
Dissociative anaesthesia disadvantages
* CV stimulation * CNS stimulation (seizures) * Muscle hypertonicity
37
what parts in the brain does anaesthetics effect
* Receptors in CNS * Cell membrane of neuronal cells
38
Function of the blood brain barrier
This barrier restricts movement of molecules into brain
39
What molecules cross easily over the blood brain barrier
Oxygen, carbon dioxide and water
40
The easier anaesthetic agents can cross the blood brain barrier are...
the more potent they are
41
cardiovascular depression. the three side effects
1.Reduction in cardiac output 2. reduction in blood flow 3. Potential tissue hypoxia
42
Define Hypercapnia
Higher blood CO₂ than normal
43
Define Hypocapnia
Lower blood CO₂ than normal
44
What minimum percentage of Oxygen should be delivered to patient via breathing circuit
>30% oxygen
45
How does blood reach the liver?
* Hepatic artery * Portal vein
46
Inhalant anaesthetic agents reduce liver blood flow due to
Reduction in cardiac output
47
Due to reduction in cardiac out put to the kidneys general anaesthesia also decreases
* Glomerular filtration rate * Urine output * Electrolyte excretion
48
What is (MAC)
Minimum Alveolar Concentration
49
Definition of MAC
The measurement of potency (The amount of inhalation agent required to suppress movement to noxious stimulant in 50% of patients)
50
Isoflurane MAC
1.15%
51
At what part of the body is the MAC potency measured at?
Spinal cord
52
Halothane MAC
0.75%
53
Sevoflurane MAC
2.05%
54
Desflurane MAC
5-10%
55
What is Blood – Gas Solubility Coefficient
The proportion of agent that will dissolve in blood compared to portion that remains in gaseous state
56
What does the Blood gas solubility coefficient determine
the speed of induction and recovery
57
(Halothane) solubility
Slow induction Slow recovery
58
Very insoluble volatile anaesthetic agent=
Rapid induction Rapid recovery
59
Halothane Blood gas solubility
2-3
60
Isoflurane Blood gas solubility
1.4
61
sevoflurane Blood gas solubility
0.6
62
Desflurane Blood gas solubility
0.42
63
What is Critical Tension?
The necessary drug concentration needed in the brain to induce unconsciousness
64
rate of onset and recovery of inhalation anaesthesia depends on what 5 factors
* Anaesthetic agent concentration * Alveolar ventilation * Blood/gas solubility * Cardiac output * Blood/tissue solubility
65
Define Pain
“A sensory or emotional experience associated with actual or potential tissue damage”
66
The 3 classification of pain
1. Physiological 2. Inflammatory 3. Neuropathic
67
Physiological Pain properties?
proportional to stimulation Pain experienced is localised Normal pain pathway activation
68
Inflammatory Pain properties
Pain associated with changes to pain pathway
69
Neuropathic Pain
Pain caused by nervous system damage
70
Allodynia define
Pain from stimuli which are not normally painful
71
Primary hyperalgesia define
increased responsiveness to stimulation in the area of injury.
72
Pre-emptive Analgesia prevents
“sensitisation” or “wind-up”
73
Multimodal Analgesia
Using multiple analgesics to control pain pathway at different levels and sites
74
Synergism define
An interaction between two or more drugs that causes the total effect of the drugs to be greater
75
Spinal Response to Pain?
receives the pain message from nociceptors which is then sent to the brain
76
Medullary response to Pain?
Processed pain message and responds
77
Hypothalamic response to Pain
Releases hormones e.g. cortisol releasing hormone (CRH)
78
Cortical response to Pain
Adrenal cortex release (Cortisol) under the influence of ACTH
79
Fentanyl and buprenorphine bioavailability % for cats and dogs?
* Cats – 34% * Dogs – 64%
80
Analgesia used in Rabbits and Rodents
Opioids NSAIDS Alpha 2 agonists Ketamine

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