Anaesthesia 2 Flashcards by Abi Clark

TIDAL VOLUME

Volume of air breathed in or out in ONE respiratory cycle

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RESIDUAL VOLUME:

Air remaining in the lungs after maximum expiration

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MINUTE VOLUME

The air that’s moved in and out of the lungs in 1minute
Tidal volume x respiratory rate

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TOTAL LUNG CAPACITY

Total amount of air in the lungs in one breath

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EXPIRATORY RESERVE VOLUME (ERV):

Is the total volume of air that can be voluntarily expired in normal
breathing

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INSPIRATORY RESERVE VOLUME (IRV):

Is the volume of air that can be inspired above the tidal volume

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VITAL CAPACITY:

Is the maximum amount of air that a person can expel from the
lungs after first filling the lungs to their maximum extent

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FUNCTIONAL RESIDUE CAPACITY (FRC):

Air left in lungs after a quiet respiration (Normal out after a normal breath in!)

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Define Compliance in Anaesthesia

Measurement of pressure in breathing system
Affects the tidal volume of gas the patient receives
Increases in compliance can decrease tidal volume

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Narcotic

dulls the senses, relieves pain, and induces profound sleep

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Neuroleptanalgesia

tranquilising drug and an analgesic

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Anaesthetic sparing effect

Some medical agents have the ability to reduce the need for the full anaesthetic agent dose e.g. pre-meds, N2O

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Second gas effect

Occurs when a soluble first gas is delivered increases the alveolar concentrations of other gases present, accelerating their uptake.

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Triad of Balanced Anaesthesia

Loss of concentration
Muscle relaxation
Analgesia

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Antiepileptics

Phenobarbitone
Diazepam
Potassium Bromide

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Sedative and tranquillisers

Phenothiazines
A2 agonist
Ketamine
Benzodiazepines
Anticholinergics/Parasympatholytics

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Opioids (analgesics)

Morphine
Methadone
Pethidine
Fentanyl
Alfentanyl
Butorphanol
Buprenorphine
Naloxone

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Phenothiazines

Acepromazine

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A2 agonist

Medetomidine
Dexmedetomidine

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Benzodiazepines

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Diazepam
Midazolam

Anticholinergics/
Parasympatholytics

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Atropine
Glycopyrrolate

Common Sedative and an opiate
analgesic combinations for pre med

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Benzodiazepine and opiate
Phenothiazine and opiate
Alpha-2 agonist and opiate

Dissociative Anaesthetics

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Drugs in this group induce CNS depression characterised by
feeling dissociated from surroundings

TIVA

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“Total intravenous anaesthesia”

PIVA

“Partial intravenous anaesthesia”

Benefits of TIVA

good when inhalant agent hard to give, e.g. Bronchoscopy * Triad of balanced anaesthesia

Benefits of PIVA

Often need syringe driver, and more complex protocol * Anaesthetic machine needed

What drug groups are used for anaesthesia lasting long enough to perform a short procedure without the need for a maintenance agent

Alpha-2 agonist sedatives Opiates Ketamine

nitrous oxide is a gas that is

liquid at room temperature

How does anaesthesia effect the body to induce unconsciousness

1.Inhaled into the lungs 2.Cross the alveolar membrane and pulmonary capillary endothelium 3.Dissolve in the blood and taken via pulmonary circulation to LHS heart and to all body tissues 4.Cross the blood-brain barrier 5.Exert effect= unconsciousness

Oxygen should be administered at concentrations between

33-100%

how does N2O effect cardiovascular and respiratory function

Minimal effect on cardiovascular and respiratory system

Highest concentration of N20 that can be used

70%

Which circuits cannot be used with N20

Not suitable for circle or “to and fro” circuits

Contraindications of N20

pneumothorax, bowel obstruction, middle ear surgery retinal surgeries

What is Saturated Vapour Pressure

is the pressure of a vapour when it is in equilibrium with the liquid phase

How to Limit Pollution?

Vaporisers should be filled at the end of the day Scavenging Charcoal canisters do not absorb nitrous oxide Correct ET tube size/cuff inflated

Dorsal recumbency can impair ventilation by...

Pressure on diaphragm from abdominal contents

NEUROMUSCULAR BLOCKING AGENTS provides

1.full body relaxation 2.Less inhalent

When Would You Use A NMBA?

INTRAOCULAR SURGERY IPPV LAPAROTOMY THORACIC SURGERY CV UNSTABLE/HIGH RISK PATIENTS OESOPHAGEAL FB's

NMBA Mode of Action

Act on neuromuscular junction * Stopping transmission of motor nerve impulses to striated muscle

Depolarising NMBA's drug example

Suxamethonium

how does a Depolarising NMBA's work

depolarises a muscle without a further contraction -Can leave patients muscles sore.

Non-depolarising NMBA drug example

vecuronium and atricurium

how does Non-depolarising NMBA work

Do not open channels Do not contract the muscle

How to monitor patient given NMBA's

accelerometer observation Palpation of muscle twitch

how does an accelerometer work

electrically stimulating superficial peripheral nerve, and measuring responsive muscle contraction

How To Reverse NMBA

Non-depolarising agents are reversed by Antiacetylcholinesterase

Anaesthesia 2 Flashcards

(48 cards)