Anaesthetics- Conduct of Anaesthesia Flashcards
What does General anaesthetic do?
period of controlled unconsciousness during which you will feel nothing and after which you will remember nothing
What are the 3 stages?
Perioperative
Preparation
Post-operative
When is the peri-operative stage
Months in advance of the surgery-depending on how major the surgery
What does the preparatory stage consist of?
Induction
Maintenance
Emergence
Recovery
What is induction?
Patient put to sleep
What is maintenance?
Keeping the patient asleep
What is emergence?
Process of waking up
What is recovery?
The period after the anaesthetic wears off
What do you need to monitor when someone is under anaesthesia?
- ECG
- Oxygen saturations
- Non-invasive blood pressure (NIBP)- Blood pressure often drops due to anaesthesia
- End Tidal C02 (ETC02)- Amount of C02 gas a patient is breathing out, indicates patency of airways and how much C02 in a patient’s blood
- Airway pressure
Why do you need to have an ECG?
Arrhythmias possible under anaesthesia
Why do you need to monitor blood pressure?
Blood pressure often drops due to anaesthesia
Why do you need to check End Tidal C02 (ETC02)?
Amount of C02 gas a patient is breathing out, indicates patency of airways and how much C02 in a patient’s blood
Why do you give supplementary oxygen when someone is under general anaesthesia?
Increases time to desaturation
Reduced Functional Residual Capacity under anaesthesia
What 3 things are given at the induction stage?
Analgesia
Hypnotic
Muscle relaxant
What type of analgesic would be given at the induction stage?
Short-acting opiate- Fentanyl, Alfentanil
What possible hypnotics could be given at the induction stage?
Propofol
Thiopentone
Ketamine
What are the stages between consciousness and unconsciousness called?
Guedel planes of anaesthesia
How many stages are there in Guedel planes of anaesthesia?
4 stages
What is stage 1 in Guedel planes of anaesthesia?
Analgesia and amnesia- feel floaty and relaxed
What is stage 2 in Guedel planes of anaesthesia?
Delirium and unconsciousness
What is stage 3 in Guedel planes of anaesthesia?
Surgical anaesthesaia
What is stage 4 in Guedel planes of anaesthesia?
Apnoea and death-want to avoid
Why do all patients anaesthetised require airway management?
- Anaesthesia will relax the upper airway and cause soft tissue collapse
- Leads to some degree of airway obstruction
What are possible reasons to intubate a patient under anaesthesia?
- Protection from aspiration
- Need for muscle relaxation
- Shared airway
- Need for tight C02 control
- Minimal access to patient
Why is airway management important?
Loss of airway reflexes lead to relaxation of tissues
What are possible risks of general anaesthesia?
- Anaphylaxis
- Regurgitation and aspiration
- Airway obstruction and hypoxia
- Laryngospasm
- Cardiovascular instability
- Rarely, cardiac arrest
What eye injury can occur under general anaesthesia?
Corneas dry out from a lack of blinking
What is used to prevent VTE from occurring?
TED stockings
What can hypothermia cause?
Low body temp increases the risk of surgical infection and post-operative pain
Which nerves are at risk of damage under general anaesthesia?
Peripheral
Especially Ulnar and perineal
What is does emergence involve?
- Reverse of neuromuscular blockade
- Return of spontaneous breathing
- Return of airway reflexes
- Suctioning and removal of airway device
- Transfer to recovery room
