Anaesthetic

Question 1

Define anaesthesia

Answer 1

“loss of sensation”

Question 2

How do drugs causing anaesthesia work?

Answer 2

they block signals that pass along nerves to the brain

Question 3

what occurs when these anaesthetic drugs wear off?

Answer 3

• normal sensation regained (including pain)

Question 4

define conscious sedation

Answer 4

a drug depressing the CNS where VERBAL CONTACT with the patient is maintained throughout the period of sedation

Question 5

what make general anaesthetic particularly difficult in dentistry and MFS?

Answer 5

where we want to work is where the anaesthetist wants to place tubes that will maintain an open airway

Question 6

what route of drug delivery induces anaesthesia?

Answer 6

intravenous

Question 7

what are 3 IV drugs that can induce anaesthesia?

Answer 7

• propofol
• thiopental
• etomidate

Question 8

what form of drug delivery will maintain anaesthesia?

Answer 8

inhalation

Question 9

what 2 drugs are inhaled to maintain anaesthesia?

Answer 9

• oxygen and nitrous oxide

Question 10

what are often given as premedication to reduce the amount of other agents are required for anaesthesia?

Answer 10

benzodiazepines

Question 11

how many stages of anaesthesia are there?

Answer 11

4

Question 12

what is stage 1 of anaesthesia?

Answer 12

loss of consciousness

Question 13

what is stage 2 of anaesthesia? what may occur at this stage?

Answer 13

excitement or delirium

coughing, vomiting and struggling

Question 14

what occurs at stage 3 of anaesthesia?

Answer 14

• laryngeal reflex lost

- pupils dilate

Question 15

what stage of anaesthesia must you have before surgery?

Answer 15

stage 3

Question 16

what can occur to the respiratory systems during stage 3 anaesthesia?

Answer 16

from onset of autonomic respiration to respiratory paralysis

Question 17

what can occur at stage 4 anaesthesia?

Answer 17

cessation of respiratory system to death

Question 18

what are the 2 subdivisions to muscle relaxants?

Answer 18

short acting

long acting

Question 19

name a short acting muscle relaxant.

Answer 19

suxamethorium

Question 20

why would a muscle relaxant be useful?

Answer 20

• surgical access to body cavities (esp abdomen)

- allowing incubation (an aid for ventilation)

Question 21

name a long acting muscle relaxant and how long does it last?

Answer 21

atracurium (30 mins)

Question 22

before a GA what are the most significant aspects of the medical history?

Answer 22

• cardiac
• respiratory
• diabetes
• epilepsy
• bleeding disorders
• acid reflux
• past surgery
• allergies

Question 23

what is malignant hyperthermia?

Answer 23

• an inherited disorder of skeletal muscles ONLY TRIGGERED BY CERTAIN ANAESTHETIC DRUGS.
• an abnormal accumulation of calcium in muscle which leads to hyper metabolism

Question 24

what are the two consequences of muscle hypermetabolism?

Answer 24

• muscle rigidity

- muscle breakdown

Question 25

what is the mortality rate of malignant hyperthermia?

Answer 25

just under 2% - an anaesthetic emergency

Question 26

what are 4 ways to indicated malignant hyperthermia

Answer 26

• temperature increase
• unexplained CO2 levels during expiration
• unexplained tachycardia
• unexplained increased need for oxygen

Question 27

what is the only drug that will be effective in limiting MH process?

Answer 27

Dantrolene