Conduct + Principles of Anaesthesia Flashcards Preview

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Flashcards in Conduct + Principles of Anaesthesia Deck (87)
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1

What is the triad of anaesthesia and what types can you get

- General
- Regional - epidural / spinal
- Local

Analgesia
Relaxation
Hypnosis

Balanced anaesthesia has contribution from all 3 but doesn't require all 3
Allows flexibility
Can titrate doses so more accurate
Avoid overdosage

2

What provides analgesia

LA
Regional block
Opiates

3

What provides relaxation

LA
Muscle relaxants
General anaesthetics

4

Why is relaxation needed

Provide immobility for procedures and allow ventilation

5

What provides hypnosis / unconsciousness

GA
Opiates - small affect (lessen pain so less GA needeD)

6

What is always needed with a GA

Hyponosis

7

What is a GA

Central acting drugs which cause whole body unconsciousness except ketamine

8

What is regional anaesthesia

Insensbility in an area or region
Applied to nerves supplying area
Nerve and plexus block including spinal and epidural

9

What is a LA

Insensibility in relevant part of body
Applied directly to tissues

10

How can GA be given

Inhaled or IV

11

What does GA lead too

Hypnosis
Small degree of relaxation
Neglible analgesia except for ketamine

12

What does GA require

Airway management

13

How does GA work

Hyperpolarise neuronal ion channels
Less likely to fire
More complex processes lost first e.g. cerebral function and reflexes relatively spared

14

What is halothane and what are SE

Inhaled GA
Hepatotoxity - NO LONGER USED DUE TO THIS
Myocardial depression
Malignant hyperthermia

15

What is thiopental and what are SE

IV GA
Cause laryngospasm
Rapid onset
Quickly affects brain
Use if short procedure or risk of ICP
Reduces CO so not in truama/. hypovolaemia

16

What is propofol used for

Rapid onset
Rapid loss of reflexes
No obvious planes of GA
Widely used to maintain sedation / total IV anaesthesia and day case
Radidly metabolised
Anti-emetic

17

SE

Pain on IV injection so use with LA
Moderate myocardial and resp depression

18

What is agent of choice for rapid induction

Sodium thiopentone

19

SE / disadvantages

Metaoblites build up quick
Little analgesia
Marked myocardial depression

20

What is used in young children and why

Sevoflurane gas
Slow
More obvious planes of anaesthesia

21

When is ketamine useful for

Can be used for induction
Little myocardial depression and does not cause hypo so better if haemodynaimcally unstable / polytrauma
Also has mod-strong analgesic properties
Can increase BP so avoid in HTN or ICP

22

What has most favourable cardiac safety

Etomidate

23

What is it unsuitable for

Maintaining sedation as risk of adrenal suppression
Also high post-op vomiting

24

What is the sequence of GA

Pre-op
- Premeds
- Pre-oxygen
Preparation
Induction
Maintenance
Emergencies
Recovery
Post op care and pain management

25

What is IV induction

Rapid onset with rapid recovery

26

What is inhalation induction

WHAT IS MAC

Slow and prolonged duration
Minimum alveolar conc = minimum drug to produce anaesthesia
Low MAC = very potent

27

What is most common

IV induction with inhalation maintenance

28

What are planes of anaesthesia

Analgesia
Excitation
Anaesthesia - light then deep
Overdose

29

What is needed during GA

Careful monitoring of conscious
- Loss of verbral
- Movement
- RR
- EEG
- Planes
Airway maintenance

30

What is minimum monitoring with GA

SpO2, FiO2, ETCO2
NIBP - non-invasive BP
ECG
Temp / UO / NMG
Invasive venous / arterial