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Surgery > Anaesthetics > Flashcards

Anaesthetics Flashcards

1
Q

What is the triad of anaesthesia?

A

Muscle relaxation
Analgesia
Hypnosis

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2
Q

Aside from the classic triad of anaesthesia, what else do anaesthetics monitor?

A

Temperature control
Fluid balance
Nausea

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3
Q

What are some major complications in anaesthetics?

A

Loss of airway
Malignant hyperthermia
Anaphylaxis
Catastrophic haemorrhage

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4
Q

What is an ASA score?

A

Score given to surgical pts to classify risk for anaesthetics

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5
Q

What is ASA 1?

A

A normal healthy pt

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6
Q

What is ASA 2?

A

A pt with mild systemic disease with no effect on daily life (i.e. well controlled disease)

Includes pt with BMI 30-40, smokers, and social drinkers

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7
Q

What is ASA 3?

A

A pt with severe systemic disease

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8
Q

What is ASA 4?

A

A pt with severe systemic disease that is a constant threat to life

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9
Q

What is ASA 5?

A

A pt who is not expected to survive without the operation

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10
Q

What is ASA 6?

A

Declared brain-dead pt whose organs are being removed for donor purposes

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11
Q

What analgesia do we give for short procedures?

A

Entonox
Fentanyl
Ketamine

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12
Q

What are the types of anaesthetic?

A

Local
General
Regional

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13
Q

What is the WHO checklist?

A

Safer surgery checklist performed outloud for all staff in theatre, done before, during, and after surgery

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14
Q

What does propofol do?

A

Induction agent so puts pt to sleep/hypnosis

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15
Q

What are the ADRs of propofol?

A

Respiratory depression (-> death if untreated)

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16
Q

What do we use for local anaesthetic?

A

Lidnocaine

17
Q

Which drugs can potentially cause malignant hyperthermia?

A

Some volatile anaesthetic gases e.g. halothane

Muscle relaxants e.g. Suxamethonium and decamethonium

18
Q

Post op, what is important to the pt that we need to manage?

A

PONV

19
Q

Apart from “because its nasty for the patient”, why is PONV important to get on top of?

A

It can cause wound dehiscence, esophageal rupture, aspiration, dehydration, increased intracranial pressure, and pneumothorax.

20
Q

What are the broad categories for causes of PONV?

A

Drugs
Central stimulation
Peripheral stimulation

21
Q

What drugs can cause PONV?

A

Opiods and anaesthetics

22
Q

What peripheral stimulation can cause PONV?

A

Direct gastric stimulation
Bowel surgery and blood in the gastrointestinal tract from oral or ear, nose, and throat surgery
Vagal nerve stimulation

23
Q

What central stimulation can cause PONV?

A

Fear, pain, anxiety, conditioned nausea related to environmental cues, and stimulation of the vestibular system

24
Q

How do we prevent PONV?

A

Treat according to risk of PONV with:

  • Adjusted anaesthetic technique
  • Anti-emetics at end of surgery
  • Post-op pain control
  • Adequate hydration
  • Rescue anti-emetics
25
Q

What are some of the risk factors for PONV?

A 
Female
Younger age
Hx of PONV/motion sickness
Opiod use in surgery
Non-smoker
Surgical and anaesthetic factors also
26
Q

What agent is given at induction to prevent PONV?

A

Dexamathasone

27
Q

How do we decide which anti-emetic to use?

A

According to what we think the cause of the N+V is

28
Q

When should a pro-kinetic antiemetic be used?

A

Impaired gastric emptying or gastric stasis (as long as no bowel obstruction)

29
Q

What prokinetic agent can we use?

A

Metoclopramide

30
Q

If a pt has bowel obstruction, which agent can we use for PONV prevention? What does it do?

A

Hyoscine - antimuscarinic that reduces secretions

31
Q

What do we use for opiod-induced N&V?

A

Ondansetron or cyclizine

32
Q

What is lignocaine?

A

AKA lidocaine

Local anaesthetic agent

33
Q

What is bupivicaine?

A

Na channel blocker anaesthetic agent used for topical wound infiltration

34
Q

Why is adrenaline given with local anaesthetics?

A

It prolongs the duration of action at the site of injection and allows higher doses to be used as it limits systemic absorption.

Surgery (11 decks)

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