Anaesthetics

Question 1

ASA scale

Answer 1

ASA I
A normal healthy patient
Healthy, non-smoking, no or minimal alcohol use

ASA II
A patient with mild systemic disease
Mild diseases only without substantive functional limitations. Examples include (but not limited to): current smoker, social alcohol drinker, pregnancy, obesity (30 < BMI < 40), well-controlled DM/HTN, mild lung disease

ASA III
A patient with severe systemic disease
Substantive functional limitations; One or more moderate to severe diseases. Examples include (but not limited to): poorly controlled DM or HTN, COPD, morbid obesity (BMI ≥40), active hepatitis, alcohol dependence or abuse, implanted pacemaker, moderate reduction of ejection fraction, ESRD undergoing regularly scheduled dialysis, premature infant PCA < 60 weeks, history (>3 months) of MI, CVA, TIA, or CAD/stents.

ASA IV
A patient with severe systemic disease that is a constant threat to life
Examples include (but not limited to): recent ( < 3 months) MI, CVA, TIA, or CAD/stents, ongoing cardiac ischemia or severe valve dysfunction, severe reduction of ejection fraction, sepsis, DIC, ARD or ESRD not undergoing regularly scheduled dialysis

ASA V
A moribund patient who is not expected to survive without the operation
Examples include (but not limited to): ruptured abdominal/thoracic aneurysm, massive trauma, intracranial bleed with mass effect, ischemic bowel in the face of significant cardiac pathology or multiple organ/system dysfunction

ASA VI
A declared brain-dead patient whose organs are being removed for donor purposes

Question 2

why is oxygen given before surgery

Answer 2

it replaces N2 in the lungs with O2

Question 3

can you inject adrenaline into the fingers and toes?

Answer 3

no

as they are supplied by end arteries injection of adrenaline would cause necrosis and ischaemia

Question 4

what is lignocaine

Answer 4

a local anaesthetic

Question 5

phases of anaesthesia

Answer 5

induction (Propofol)
maintenance (volatile, analgesia)
emergence (stop giving, reverse or antagonise - benzos and opiates)
recovery

Question 6

management of PONV

Answer 6

5HT3 receptor antagonists (ondansetron)
antihistamines (cyclizine)
butyrophenones (droperidol)
steroids (dexamethasone)
dopamine antagonists (metoclopramide, haloperidol)

Question 7

what is tranexamic acid used for?

Answer 7

to help stop bleeding - Tranexamic acid works by slowing the breakdown of blood clots, which helps to prevent prolonged bleeding. It belongs to a class of drugs known as antifibrinolytics.