Anaesthesia

Question 1

Definition

Answer 1

Loss of sensation
Evolved from pain relief and altered consciousness to allow surgery

Question 2

Types of Anaesthesia: General

Answer 2

Reversible state of consciousness

Question 3

General anaesthesia: Induction stage

Pre-meds, IV and gas anaesthetic agents, paralytic / muscle relaxant

Answer 3

Securing the airway and administering drugs
Pre-medication - opioids / benzodiazepines
Anaesthetic agents IV - propofol, ketamin, thiopental
Anaesthetic agents gas - sevoflurane, desflurane, nitric oxide
Paralytic / muscle relaxant - suxamethonium, rocuronium

Question 4

General anaesthesia: Maintenance stage

Volatile gas, IV anaesthesia

Answer 4

Pain-free, unconscious state throughout surgery
Inhalation of volatile gas - sevoflurane, isoflurane, desflurane + nitrous oxide
IV anaesthesia - propofol + remifentanil

Question 5

General anaesthesia components

Always included, standard IV induction, often given, intubation required

Answer 5

Always includes - hypnotic agent and muscle relaxant
Standard IV induction - propofol
Often given - opioid
If intubation is required - muscle relaxant

Question 6

Inhaled induction

Volatile agent, anaesthetic gas

Answer 6

Volatile agent - sevoflurane
Anaesthetic gas - nitrous oxide, xenon

Question 7

Rapid Sequence Induction

Answer 7

Used when rapid intubation of the trachea is required

Question 8

Muscle relaxation with Neuromuscular Blocking Agents (NMBAs)

Depolarizing and non-depolarizing muscle relaxants

Answer 8

Depolarizing muscle relaxants - suxamethonium, avoid in hyperkalaemia
Non-depolarizing muscle relaxant - atracurium / rocuronium

Question 9

Reversal of NMBAs at the end of surgery

achieved by and concurrent administration, other meds used

Answer 9

Achieved by - acetylcholinesterase inhibitor e.g. neostigmine
Concurrent administration of - antimuscarinic agents e.g. atropine / glycopyrrolate
Others - sugammadex