ANAESTHETICS Flashcards
ANAESTHESIA
what are the three main components of anaesthesia?
- hypnosis
- analgesia
- muscle relaxation
ANAESTHESIA
what are the three levels of hypnosis?
- awake
- sedated
- asleep
ANAESTHESIA
what are the different types of anaesthesia?
- local
- sedation
- general
ANAESTHESIA
what are the different types of local anaesthetic?
- local
- regional
- neuraxial
ANAESTHESIA
when is local anaesthetic used?
small surgery - laceration or wound repair
ANAESTHESIA
when is regional anaesthetic used?
- target specific nerves
- usually for post op pain relief
ANAESTHESIA
what are the different types of neuraxial anaesthetic?
spinal
epidural
ANAESTHESIA
what is a spinal also known as?
subarachnoid block
ANAESTHESIA
what happens during a spinal?
the needle goes into the CSF
it goes through the ligaments and the dura
local anaesthetic is injected as a bolus which lasts around 2 hours
ANAESTHESIA
what happens during an epidural?
the needle goes between the ligaments and the dura
a catheter is passed
local anaesthetic is given through the catheter an an infusion
ANAESTHESIA
what are the differences between spinals and epidurals?
SPINAL
- single bolus
- anaesthetic
- lumbar region
EPIDURAL
- continuous infusion
- anaesthesia or analgesia
- thoracic or lumbar
ANAESTHESIA
what dermatome level can you operate on when using a spinal or epidural?
allow you to operate below the highest nerve root affected by the block
normally is below T10 (umbilicus)
ANAESTHESIA
what are the different local anaesthetic agents?
lidocaine
bupivacaine
ANAESTHESIA
what is the onset and duration of lidocaine?
immediate onset
15 minute duration
ANAESTHESIA
what is the onset and duration of bupivacaine?
10 minute onset
lasts 2 hours for anaesthesia
lasts 12-24 hours for analgesia
ANAESTHESIA
what is lidocaine used for?
small procedures
laceration repair, chest drains, big cannulae
ANAESTHESIA
what is bupivacaine used for?
regional
spinal
epidural
ANAESTHESIA
what should you be aware of with epidurals?
usually have opioids running through them
do not prescribe additional opioids
ANAESTHESIA
what does induction mean?
sending to sleep
ANAESTHESIA
what does maintenance mean?
keeping asleep
ANAESTHESIA
what are the different forms of hypnotic drugs?
inhalational
intravenous
ANAESTHESIA
what are the reasons for providing sedation?
- reduce anxiety
- reduce consciousness
- reduce irritability (of the airway)
- induce amnesia
ANAESTHESIA
what medication is used for short term sedation?
IV midazolam
ANAESTHESIA
what situations may require short term sedation?
endoscopy
regional anaesthesia
ANAESTHESIA
what medication is used for long term sedation?
IV infusion of propofol +/- alfentanil
ANAESTHESIA
what situations may require long-term sedation?
intensive care
intubated patients for theatre/transfer
ANAESTHESIA
what are the different types of hypnotic gases?
isoflurane
desflurane
sevoflurane
ANAESTHESIA
what is isoflurane used for?
cheapest gas
used to maintain sedation
ANAESTHESIA
what is desflurane used for?
used to maintain sedation
wears off quickly
ANAESTHESIA
what is sevoflurane used for?
used to induce and/or maintain anaesthesia
ANAESTHESIA
what are the different types of intravenous hypnotic drugs?
propofol - quick, commonest
thiopenthal - quick, mostly emergency
ketamine - used in CVS emergency, also analgesic
