Anaesthetics Tutorial

Question 1

How long to fast for?

Answer 1

6hours

clear fluids

Question 2

crico pressure for what?

Answer 2

may occlude oesphagus

Question 3

why paralyze and muscle relaxants?

Answer 3

ease of intubation

for delicate procedures like neurosurg

Question 4

Aiway assessment?

Answer 4

Dentition: crowding
Open mouth: 3 cm needed
Mandibular protrusion
Mallenpatti
thyromental junction

Question 5

desirables in Anaesthesia

Answer 5

asleep
amnesia
analgesia
wakeful (day of surgery,  neurosurg)
anxiolysis
muscle relaxation
less PONV
airway
aspiration risk
temperature mx

Question 6

advantage of plexus and nerve blocks to general?

Answer 6

post-operative analgesia

Question 7

to kinds of neuraxial blocks?

Answer 7

spinal

epidural

Question 8

where does a spinal block go?

Answer 8

sub-arachnoid space

Question 9

epidural get good coverage?

Answer 9

Nope: about 3-4 above and below

Question 10

how much fluid needed for spinal block?

Answer 10

only 2-3 mls because it circulates in the CSF

Question 11

how much fluid needed for epidural block?

Answer 11

10-15ml to get appropriate spread

Question 12

why epidural for labour?

Answer 12

duration is longer due to infusion

post-op analgesia

Question 13

what kind of block for caeserian section?

Answer 13

spinal usually

Question 14

3 things to achieve General Anaesthesia?

Answer 14

hypnosis
analgesia
muscle relaxation

Question 15

2 kinds of general anaesthesia?

Answer 15

1. spontaneous ventilation

2. muscle relaxation (absolute - including diaphragm)

Question 16

what kind of airway device for spontaneously ventilation?

Answer 16

laryngeal mask

Question 17

what kind of airway device for muscle relaxant GA?

Answer 17

intubation

Question 18

why a cuff for the intubation?

Answer 18

prevent aspiration

Question 19

who is at risk for aspiration in anaesthesia?

Answer 19

non-fasting
trauma/emerg
GORD
preg for >20 weeks to >6weeks post partum

Question 20

why preg increase GORD?

Answer 20

increased intrabdominal pressure

progesterone relaxes esophageal sphincter

Question 21

3 phases of anaesthesia:

Answer 21

Induction
maintenance
reversal/emergence

Question 22

drugs for induction?

Answer 22

propofol
benzos: midazolan
fentanyl

Question 23

drugs for maintenance?

Answer 23

sevofluorane

morphine for analgesia

Question 24

fentanyl for what in induction?

Answer 24

ablate the sympathetic response for intubation process

Question 25

sevoflurane, isofluorane, desfluorane is what?

Answer 25

inhaled gas

Question 26

green dream/green whistle is what analgesia?

Answer 26

penthane

Question 27

who gets propofol infusion for maintenance?

Answer 27

PONV strong history

neurosurg

Question 28

TIVA is what?

Answer 28

total intravenous analgesia

Question 29

paralyzing agents?

Answer 29

Rocuronium
veccuronium
atracurium
suxamathonium

Question 30

Non depolarizing muscle relaxants work how? how long do they work for?

Answer 30

competitive antagonist to the muscle side receptor

works for 3-45 mins

Question 31

what to use to reverse muscle paralysis?

Answer 31

acetyl choline esterase inhibitor

neostigmine

Question 32

neostigmine side effects?

Answer 32

bradycardia

Question 33

antimuscarinic for reversal?

Answer 33

glycopyrorate

Question 34

how to prevent bradycardia in reversal after neostigmine admin?

Answer 34

give antimuscarinic

Question 35

suxamethasone lasts how long?

Answer 35

1-3 minutes

rapid sequence induction (RSI)

Question 36

ketamine is what? when used? where used?

Answer 36

dissociative drug
preserves some airway reflexes
used in developing countries, low resource settings