Anaesthesia Flashcards
Q:
What happens during the induction stage of anesthesia?
A:
The patient transitions from awake to unconscious using agents like Propofol or inhalational agents. Airway management and vital signs monitoring are crucial.
Q:
What happens during the maintenance stage of anesthesia?
A:
Anesthesia is sustained using inhalational or intravenous agents. The depth of anesthesia, hemodynamics, and oxygenation are monitored.
Q:
What happens during the emergence stage of anesthesia?
A:
Anesthesia is discontinued, and the patient regains consciousness. Airway reflexes, pain management, and post-anesthesia care are prioritized.
Q:
What is the primary goal of analgesia in anesthesia?
A:
The primary goal of analgesia is to provide pain relief during and after surgery. It can be achieved through various agents such as opioids (e.g., morphine, fentanyl), non-opioid analgesics (e.g., NSAIDs), or regional techniques like nerve blocks.
Q:
What are muscle relaxants, and why are they used during anesthesia?
A:
Muscle relaxants are medications used to induce muscle paralysis, facilitating intubation and surgical procedures by preventing muscle movement. Examples include non-depolarizing agents (e.g., Rocuronium) and depolarizing agents (e.g., Succinylcholine).
Q:
How are muscle relaxants reversed after surgery?
A:
Reversal of non-depolarizing muscle relaxants can be achieved using agents like Neostigmine or Sugammadex. These drugs restore muscle function by either inhibiting acetylcholinesterase (Neostigmine) or directly binding to the muscle relaxant (Sugammadex). Monitoring neuromuscular function is essential during reversal.
Q:
What are the ASA classifications?
A:
ASA I: Healthy patient with no systemic disease.
ASA II: Mild systemic disease (e.g., well-controlled diabetes, hypertension).
ASA III: Severe systemic disease limiting activity (e.g., poorly controlled diabetes, COPD).
ASA IV: Severe systemic disease that is a constant threat to life (e.g., recent MI, CVA).
ASA V: Moribund patient unlikely to survive without surgery.
ASA VI: Brain-dead patient undergoing organ donation.
Q:
When should heparin be administered during a CABG procedure?
A:
Heparin is typically administered immediately before the cardiopulmonary bypass (CPB) to prevent blood clotting in the bypass circuit. The target activated clotting time (ACT) is usually greater than 400–480 seconds before initiating CPB. Monitoring ACT throughout the procedure ensures adequate anticoagulation.
Q:
What should be done if a patient has antithrombin deficiency during CABG?
A:
In patients with antithrombin deficiency, standard doses of heparin may not achieve adequate anticoagulation. In this case:
Antithrombin concentrates or fresh frozen plasma (FFP) can be administered to replenish antithrombin levels.
Monitoring activated clotting time (ACT) and adjusting heparin dosing is essential to achieve adequate anticoagulation before starting cardiopulmonary bypass.
Q:
What should be administered during cardiopulmonary bypass (CPB) if a patient tests positive for Heparin-Induced Thrombocytopenia (HIT)?
A:
In patients with HIT, heparin should be avoided. Instead, use direct thrombin inhibitors such as Argatroban or Bivalirudin for anticoagulation during CPB. These agents are effective in managing anticoagulation and minimizing the risk of thromboembolic events associated with HIT.
