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exam 2 > Anaesthesia > Flashcards

Anaesthesia Flashcards

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
Q

Lumbosacral epidural provides analgesia to structures…

A

…caudal to
thoracolumbar junction

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26
Q

Epidural injected between which spinal vertebrae

A

space between L7-S1

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27
Q

Patients who are at particular risk during Epidural anaesthesia

A

Patients Shock (Hypovolaemic)

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28
Q

When Would an Epidural Injection be
Contraindicated?

A

Patient suffering septicaemia
skin over lumbosacral junction is infected
Patient with coagulation disorder

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29
Q

When are Intravenous regional anaesthesia, or Bier block used

A

surgical procedures in body’s extremities e.g. removal of a toe

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30
Q

What is an Esmarch bandage

A

Drain blood from a limb

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31
Q

Dissociative Anaesthesia effects

A

analgesia and amnesia
minimal effect on respiratory function
can be used with brief surgery
Swallowing and eyes remain open

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32
Q

Dissociative anaesthesia hyperexcitation signs

A
  • Hypersalivation
  • Hyperventilation
  • Tachycardia
  • Muscle twitches
  • Paddling of the legs
  • Curling of the tongue
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33
Q

General Anaesthesia disadvantages

A

Effects major organs in the body
* Cardiovascular
* Respiratory
* Neurological
* Renal
* Hepatic

34
Q

Peri-neural Anaesthesia disadvantages

A
  • Pneumothorax
  • Bleeding
  • Nerve damage
35
Q

Disadvantages of epidural

A
  • Introduction of infection
  • Paralysis
  • Artificial ventilation required if
    cranial nerve involvement
  • Can cause hypotension
  • Possible urinary retention
36
Q

Dissociative anaesthesia disadvantages

A
  • CV stimulation
  • CNS stimulation (seizures)
  • Muscle hypertonicity
37
Q

what parts in the brain does anaesthetics effect

A
  • Receptors in CNS
  • Cell membrane of neuronal cells
38
Q

Function of the blood brain barrier

A

This barrier restricts movement of molecules into brain

39
Q

What molecules cross easily over the blood brain barrier

A

Oxygen, carbon dioxide and water

40
Q

The easier anaesthetic agents can cross the blood brain barrier are…

A

the more potent they are

41
Q

cardiovascular depression.
the three side effects

A

1.Reduction in cardiac output
2. reduction in blood flow
3. Potential tissue hypoxia

42
Q

Define Hypercapnia

A

Higher blood CO₂ than normal

43
Q

Define Hypocapnia

A

Lower blood CO₂ than normal

44
Q

What minimum percentage of Oxygen should be delivered to patient via breathing circuit

A

> 30% oxygen

45
Q

How does blood reach the liver?

A
  • Hepatic artery
  • Portal vein
46
Q

Inhalant anaesthetic agents reduce liver blood flow due to

A

Reduction in cardiac output

47
Q

Due to reduction in cardiac out put to the kidneys general anaesthesia also decreases

A
  • Glomerular filtration rate
  • Urine output
  • Electrolyte excretion
48
Q

What is (MAC)

A

Minimum Alveolar Concentration

49
Q

Definition of MAC

A

The measurement of potency
(The amount of inhalation agent required to suppress movement to noxious stimulant in 50% of patients)

50
Q

Isoflurane MAC

A

1.15%

51
Q

At what part of the body is the MAC potency measured at?

A

Spinal cord

52
Q

Halothane MAC

A

0.75%

53
Q

Sevoflurane MAC

A

2.05%

54
Q

Desflurane MAC

A

5-10%

55
Q

What is Blood – Gas Solubility Coefficient

A

The proportion of agent that
will dissolve in blood
compared to portion that
remains in gaseous state

56
Q

What does the Blood gas solubility coefficient determine

A

the speed of induction and recovery

57
Q

(Halothane) solubility

A

Slow induction
Slow recovery

58
Q

Very insoluble volatile anaesthetic agent=

A

Rapid induction
Rapid recovery

59
Q

Halothane Blood gas solubility

A

2-3

60
Q

Isoflurane Blood gas solubility

A

1.4

61
Q

sevoflurane Blood gas solubility

A

0.6

62
Q

Desflurane Blood gas solubility

A

0.42

63
Q

What is Critical Tension?

A

The necessary drug concentration needed in the brain to induce unconsciousness

64
Q

rate of onset and recovery of inhalation
anaesthesia depends on what 5 factors

A
  • Anaesthetic agent concentration
  • Alveolar ventilation
  • Blood/gas solubility
  • Cardiac output
  • Blood/tissue solubility
65
Q

Define Pain

A

“A sensory or emotional experience associated with actual or potential tissue
damage”

66
Q

The 3 classification of pain

A
  1. Physiological
  2. Inflammatory
  3. Neuropathic
67
Q

Physiological Pain properties?

A

proportional to stimulation
Pain experienced is localised
Normal pain pathway activation

68
Q

Inflammatory Pain properties

A

Pain associated with changes to pain pathway

69
Q

Neuropathic Pain

A

Pain caused by nervous system damage

70
Q

Allodynia define

A

Pain from stimuli which are not normally painful

71
Q

Primary hyperalgesia define

A

increased responsiveness to stimulation in the area of injury.

72
Q

Pre-emptive Analgesia prevents

A

“sensitisation” or “wind-up”

73
Q

Multimodal Analgesia

A

Using multiple analgesics to control pain pathway at different levels and sites

74
Q

Synergism define

A

An interaction between two or more drugs that causes the total effect of the drugs to be greater

75
Q

Spinal Response to Pain?

A

receives the pain message from nociceptors which is
then sent to the brain

76
Q

Medullary response to Pain?

A

Processed pain message and responds

77
Q

Hypothalamic response to Pain

A

Releases hormones
e.g. cortisol releasing hormone (CRH)

78
Q

Cortical response to Pain

A

Adrenal cortex release (Cortisol) under the
influence of ACTH

79
Q

Fentanyl and buprenorphine bioavailability % for cats and dogs?

A
  • Cats – 34%
  • Dogs – 64%
80
Q

Analgesia used in Rabbits and Rodents

A

Opioids
NSAIDS
Alpha 2 agonists
Ketamine

exam 2 (11 decks)

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