CNS Anaesthesia Flashcards

1
Q

What is anaesthesia ? Types ?

A

Loss of sensation with out without loss of consciousness.
TYPES :
1)GENERAL ANAESTHESIA
2) LOCAL ANAESTHESIA
Spinal anaesthesia
Surface anaesthesia
Regiona anaesthesia
Nerve block anaesthesia
Infiltration anaesthesia

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2
Q

Principles of general anaesthesia

A

Reversible consciousness
Analgesia
Amnesia
Loss of external stimuli / loss of all reflexes
Adequate muscle relaxation

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3
Q

S/N pre anaesthetic medication

A

Pre- anaesthetic medication means using of drugs within last 24 hours of induction of anaesthesia for proper and safe anaesthesia.

Obj/ Purpose/ Role/ Pain
1) For analgesia = Morphine , fentanyl , Pethidine

2) To control vomitting = Inj . Ondansetrone , Inj Prochlorperazine

3)To reduce anxiety = Diazepam , Clonazepam , Midazolam

4) To reduce bronchial and salivary secretion = Inj. Atropine

5) To reduce gastric acid secretion = Inj PPI ( omeprazole , Pantoprazole)

6) To prevent infection = Inj cephalosporin ( Cefuroxime , Ceftriaxone)

7) For gut sterilization = glycerine sipp , enema , oral uria

8)To reduce allergic reaction = Inj antihistamine ( Dexamethasone , Chlorpheniramine )

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4
Q

Balanced anaesthesia

A

It is defined as the achievement of surgical anaesthetic state including unconsciousness with adequate analgesia and muscle relaxation with the help of various drugs and techniques .
Drugs = propofol , Pethidine , atracurium

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5
Q

Classify GA

A

I/V OR PARENTERAL GA

Barbiturate = Thiopental sodium
Ketamine
Propofol
Benzodiazepam = diazepam , Midazolam
Etomidate
Opoidal analgesic = morphine , Pethidine , fentanyl

INHALER GA
NO
Ether
Haloethane
Isoflurane
Enflurane
Desflurane
Sevoflurane
Methoxyflurane

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6
Q

Drugs used for induction of anaesthesia

A

Thiopental Na
Diazepam
Midazolam
Morphine
Pethidine
Fentanyl
Ketamine
Propofol

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7
Q

Drugs for maintainence of anaesthesia

A

NO
Haloethane
Isoflurane
Enflurane
Desflurane
Suxxamethonium
Pethidine/ morphine
Atropine

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8
Q

Properties of ideal anaesthesia

A

FOR THE PATIENTS
Should be pleasant , non irritating , induction and recovery should be fast , less emetic

FOR THE SURGEON
Adequate analgesia, immobility , muscle relaxant
Non inflammable
Non explosive

FOR THE ANAESTHESIST
Safe and effective
Easily available
Cost effective
Controllable and versatile
Less adverse effects

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9
Q

S/N thiopental Na

A

It is ultra short acting barbiturate
An injectable general anaesthetic drug
It is an ANAESTHETIC INDUCER
Highly lipid soluble
Produce unconsiousness within minutes ( less than 30secs)
Rapid recovery (5-10mins)
Quick muscle relaxant
Large and repeated dose needed

Necrosis and gangrene may occur due to extravastion.

A/E= laryngospasm , Hypotension , Apnoea , Shivering , Bronchospasm , Cough

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10
Q

S/N ketamine

A

I/V anaesthetic drug
Dissociative anaesthetic
ANASTHETIC INDUCER
It has analgesic action
Highly lipid soluble
May cause hallucination , illusion , increased CBF ,OP, HR,CO, BP

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11
Q

M/A of ketamine

A

Ketamine==> block membrane effect of glutamate ==> generalized CNS depression==> Anaesthetic action

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12
Q

A/E of ketamine

A

CVS = raised BP , HR, CO

CNS= 1)emergence delirium characterised by hallucination, vivid dreams, illusion
2) Markedly increases cerebral blood flow, oxygen consumption and ICP
3) Raised intraocular pressure

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13
Q

Indication of ketamine

A

GA in high risk patient
Children with cyanotic heart disease, minor surgery (circumcision)
Patient with shock , asthma
Cardiac catherization, opthalmic examination , radiotherapy
During large wound dressing
Sedation of asthmatic patient in ICU
Used as truth serum

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14
Q

Defn : local anaesthesia

A

Loss of pain sensation , loss of muscle reflexes and muscle relaxation in a localized area without amnesia and loss of consciousness.

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15
Q

What are the local anaesthetic drugs

A

Acc to chemical structure
ESTERS= procaine , Tetracaine , Cocaine , benzocaine //contains 1 i

AMIDES = Mepivacaine, Lidocaine , Bupivicaine, Ropivacaine

ACC TO duration of action

SHORT ACTING = Procaine , chloroprocaine

INTERMEDIATE ACTING = Lidocaine, Mepivacaine , prilocaine

LONG ACTING = Bupivacaine, Ropivacine , Tetracaine

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16
Q

M/A of lidocaine

A

Lidocaine ==> Blocks voltage gated Na channel ==> Blocks depolarization ==>No action potential ==>No transmission of pain sensation ==>Local anaesthesia action

17
Q

Clinical uses of LA/ Lidocaine

A

N-G Tube intubation
Catheterisation
Boil and abscess drainage
Stitching of local cut injury
Circumcision
Dressing of burn and wound
Tooth extraction and Root Canal Treatment
Caesarean section (spinal)

18
Q

A/E of lidocaine

A

CVS = BLOCK CARDIAC NA+ CHANNEL WHICH CAUSES :
Decrease cardiac pacemaker activity
Decrease excitability
Decrease rate of conduction

CNS = sleepiness
Restlessness
Tongue numbness
Nystagmus
Muscular twitching

NEUROTOXICITY

HEMATOLOGICAL = patient become cyantoic and blood becomes chocolate colored

Allergic reaction

19
Q

A/E of lidocaine

A

CVS = BLOCK CARDIAC NA+ CHANNEL WHICH CAUSES :
Decrease cardiac pacemaker activity
Decrease excitability
Decrease rate of conduction

CNS = sleepiness
Restlessness
Tongue numbness
Nystagmus
Muscular twitching

NEUROTOXICITY

HEMATOLOGICAL = patient become cyantoic and blood becomes chocolate colored

Allergic reaction