Anaesthesia

Question 1

Local anesthetics:

Answer 1

• esters: Procaine, Chloroprocaine,
  Oxybuprocain, Tetracaine, Benzocaine, /Cocaine/
• amides: Lidocaine (lignocaine), Prilocaine,
  Mepivacaine, Bupivacaine, Ropivacaine etc

Question 2

Disappearance of nervous function:

Answer 2

Pain –> Warmth —> Touch —> Deep pressure —> Motor function

Question 3

Order of clearance of amides (most > less rapid):

Answer 3

Prilocaine>Lidocaine>Mepi-/Ropivacaine>Bupivacaine

Question 4

Which are the most potent of the local anaesthetics (from low to high potency:
- their onset

Answer 4

PROCAINE (slow) 
LIDOCAINE (rapid)
MEPIVACAINE (medium)
BUPIVACAINE (medium) 
TETRACAINE (slow)

Question 5

Toxicity in increased order:

Answer 5

Mepivacaine < Procaine ≤ Lidocaine < Tetracaine, Bupivacaine

Question 6

INJECTABLE ANAESTHETICS

Answer 6

 BARBITURATES
 PROPOFOL
 IMIDAZOLE ANAESTHETICS
 STEROID ANAESTHETICS
 NMDAr ANTAGONISTS
(DISSOCIATIVE ANESTHETICS)

Question 7

INHALATIONAL ANAESTHETICS

Answer 7

 HALOTHANE
 ISOFLURANE
 SEVOFLURANE
 DINITROGEN MOOXIDE
 DESFLURANE
 METHOXYFLURANE

Question 8

BARBITURATE examples:

- Pharmacological effects:

Answer 8

Pentobarbital, Methohexital, Hexobarbital,
Thiopental, Thiamylal, Venobarbital

– CNS, circulation, respiration

Question 9

STEROID ANAESTHETICS

Answer 9

Alfadolone & Alfaxolone

Question 10

IMIDAZOLES

Answer 10

Etomidate, Medomidate

Question 11

DISSOCIATIVE ANAESTHETICS

Answer 11

Ketamine, Tiletamine

Question 12

OTHER anaesthetics example:

Answer 12

Propofol
PROPANIDID
MgSO4, CHLORAL HYDRATE

Question 13

Barbiturates:

1. Classification according to:
2. Application
3. indications

Answer 13

1. the duration of action: (short acting, ultra-short acting)
2. Application: only IV, effective and harmless
3. Indications:
   – Induction, general anaesthesia (combination), analgesia Ø!
   – Convulsive state, epilepsy (pentobarbital i.v.)
   – Euthanasia

Question 14

Side effects barbiturates:

Answer 14

• respiratory depression (pronounced) —> neonates
• cardiovascular depression (hypotension, tachycardia)
• tissue irritation (paravenous, IM etc. inj.)
• prae/postnarcotic excitations (frequently)

Question 15

ETOMIDATE

Side effect:

Answer 15

 Broad therapeutic index
* severe tissue irritation (acidic pH) - only IV
* respiratory depression (mild)
* cardiovascular depression Ø
 cardiovascular insufficiency
* adrenocortical suppression (2-3h)
 bolus (continuous infusion Ø)
* prae/postnarcotic excitation (frequent)

Question 16

NMDA-r. antagonists

Answer 16

Ketamine, Tiletamine

Question 17

Ketamine

1. Contra indications:
2. Side effects

Answer 17

1. Sole use in horses and dogs, hepatic
   and/or liver impairment, late pregnancy
2. Side-effects:
   - Catalepsy-like condition
   - Increased sympathetic nervous system tone
   - Increased cardiac output, heart rate, blood pressure, arrhithmias
   - Mild respiratory depression, tidal volume slightly increased
   - Salivation,
   - Prae/Postanaesthetic excitations, convulsion
   - Increased ICP/eye pressure
   - Hallucinations – „bed dream”  Misuse – dependency

Question 18

Ataranalgesia=

Answer 18

benzodiazepine + ketamine

Question 19

Balanced anaesthesia

Answer 19

combination of antimuscarinics, sedatives, opioids, anaesthetics and muscle relaxants

Question 20

(TIVA)=

- examples

Answer 20

=Total intravenous anaesthesia.
- Combination of agents given exclusively by the intravenous route without the use of inhalation agents

(eg. propofol + fentanyl, fentanyl + lidocaine + ketamine „FLK”)

Question 21

COMBINATIONS USED FOR NEUROLEPTANALGESIA

Answer 21

Etorphine - Acepromazine
Butorphanol- Acepromazine
Fentanyl - Fluanisone
Fentanyl - Droperidol

Question 22

The most efficacious inhalation anaesthetic:

- contraindications

Answer 22

HALOTHANE (baned in EU)

- Teratogenic, carcinogenic, hepatotoxic, arrhythmogenic, Sensitivity to cathecolamines increased, ADH-level increase