Anaesthetics Flashcards
When considering local V’s general anaesthetics what are four surgical factors that need to be considered?
- Duration of the procedure,
- Is the surgery above the umbilicus (if below can a spinal block be used?).
- Is the patient comfort insufficient using a local anaesthetic?
- Is the need for muscle relaxation significant?
When considering local V’s general anaesthetics what are four patient factors that need to be considered?
- Is the patient stable?
- Does the patient need their airway protected (if they are unable to maintain airway).
- Is the patient able to tolerate the anaesthetic type - note respiratory failure risk.
- Is the patient unable to cooperate or understand what is happening (think paed patient and PET scan) thus a general is required.
What are the three goals of General Anaesthetics?
- Loss of consciousness / amnesia,
- Analgesia, &
- Immobility.
What areas of the brain do we target with General anaesthetics to achieve:
1. Loss of consciousness & amnesia?
Loss of consciousness target:
- Thalamus
Amnesia target:
- Prefrontal cortex
- Amygdala
- Hippocampus
What areas of the brain do we target with General anaesthetics to achieve:
- Loss of consciousness,
- Amnesia?
Loss of consciousness target:
- Thalamus
Amnesia target:
- Prefrontal cortex
- Amygdala
- Hippocampus
What areas of the brain are targeted with GA to achieve:
- Immobility
Immobility target:
Spinal cord
There are four phases of GA what are these?
- Analgesia
- Excitation phase (delirium, combative, enhanced reflexes, uncontrolled movements, irregular breathing, risk of vomiting).
- Surgical Anaesthesia (LOC, gradual loss of reflexes, muscle relaxation, regular respiration followed by respiratory depression where ventilation takes over).
- Medullary depression (respiratory arrest, cardiac arrest - death).
Aim: move through stage 2 quickly and don’t go beyond stage 3.
