anaesthesia

Question 1

local anaesthetics examples

Answer 1

• lignocaine (shortest, short surgical procedures)
• bupivacaine (longest, nerve blocks)
• prilocaine (safest, IV regional anesthetic)

Question 2

inhaled agents examples

Answer 2

hypnosis/amnesia

• isoflurane (CV stability)
• sevoflurane (children)
• desflurane (long cases)

Question 3

IV agents

Answer 3

hypnosis/amnesia

• etomidate (CV stability)
• ketamine (CV stimulant = shock)
• propofol (standard IV anesthetic)
• thiopentone (crash C sections)

Question 4

depolarising neuromuscular blocking agents

Answer 4

depolarises motor end plate

• Succinylcholine (rapid)

Question 5

non-depolarising neuromuscular blocking agents

Answer 5

Attach to AChR but don’t depolarise motor end plate

• rocuronium (rapid)
• vecuronium (CV stability)
• pancuronium (long cardiac procedures - vagolytic effects)
• atracurium (independent of liver & kidney)
• mivacurium (shortest acting)

Question 6

mechanism of inhaled anaesthetics

Answer 6

probably through GABA modulation in the brain and glycerine in the spinal cord

Question 7

mechanism of IV anaesthetics

Answer 7

prolonged GABA release causes increased extracellular to intracellular Cl-. Hyperpolarises cell

Question 8

mechanism of local anaesthetics

Answer 8

block voltage-gated Na+ channels intracellularly therefore cell cant depolarise

Question 9

mechanism of depolarising NMB agents

Answer 9

similar to ACh (depolarises motor endplate)

biphasic effect - initial tone then relaxation

Question 10

mechanism of non-depolarising NMB agents

Answer 10

bind to ACh receptors
competitive antagonist with ACh
no ACh no muscle tone