Anaesthetics Flashcards
Induction: propofol
Commonyl used
Decreased PONV
Drop in HR, BP
Induction: thiopentone
RSI
Drop in BP, increase in HR
Rash, bronchospasm
Induction: ketamine
Dissociative anaesthesia
Short procedures
N&V
Emergence phenomenon
Induction: etomidate
Rapid onset
Haemodynamic stability
PONV
Adrenocortico suppression
Maintenance: seroflurane
MAC 2%
Maintenance: desflurane
MAC 6%
rapid onset/offset
long ops
Maintenance: isoflurane
Least effect on organ perfusion
Analgesia: short acting opioids
fentanyl
Analgesia: long acting opioids
morphine
oxycodone
Analgesia: others
Paracetamol
NSAIDs - parecoxib, diclofenac
Weaker opioids - tramadol, dihydrocodeine
RSI
If full stomach (emergency) or risk of reflux
Preoxygenate
IV access
Opioid and thiopentone and muscle relaxant
Intubate
Muscle relaxants
Depolarising - suxamethonium (RSI) - muscle fasiculations, malignant hyperthermai, hyperkalaemia
Non-depolarising:
Short acting - atracurium, mivacurium
Intermediate - vecuronium, rocuvonium
Long acting - pancuronium
Antiemetics to prevent PONV
Ondansetron (5HT blocker) Cyclizine (antihistamine) Dexamethasone (steroid) Phenothiazine Metoclopramide (antidopaminergic)
Reversal of non-depolarising muscle relaxants
Neostigmine (anticholinesterase)
(with glycopyrrolate to prevent brady)
Causes PONV
Max dose bupivacaine
with/without adrenaline
2mg/kg