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Anaesthetics > Conduct of Anaesthesia > Flashcards

Conduct of Anaesthesia Flashcards

1
Q

Describe the process of anaesthesia

A
  • Pre-op assessment
  • Preparation
  • Induction
  • Maintenance
  • Emergence
  • Recovery
  • Post-op care + pain management
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2
Q

2 drugs used in IV general anaesthesia

A
  • Propofol

- Thiopentone

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3
Q

Describe IV induction

A
  • Propofol or thiopentone used
  • Rapid (1 arm-brain circulation = ~ 20s)
  • No obvious planes
  • Easy to OD
  • Rapid loss of airway reflexes + apnoea is very common
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4
Q

Drug used in gas induction

A

-Sevoflurane

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5
Q

When is gas induction commonly used

A

Paediatric surgery

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6
Q

Describe gas induction

A
  • Slow

- Obvious planes of anaesthesia

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7
Q

4 planes of anaesthesia

A
  • Analgesia/sedation
  • Excitation
  • Anaesthesia: light => deep
  • Overdose

or
Sleepy/excited/Anaesthetised

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8
Q

How is conscious level monitored

A
  • Loss of verbal contact
  • Movement
  • Resp. pattern
  • Processed ECG
  • Planes of anaesthesia
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9
Q

Describe the triple airway manoeuvre

A
  • Head tilt
  • Chin lift
  • Jaw thrust
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10
Q

3 simple apparatuses used to maintain an airway

A
  • Face mask
  • Oropharyngeal (“Guedel”) airway
  • Nasopharyngeal airway
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11
Q

Describe the oropharyngeal (“Guedel”) airway

A
  • Rigid plastic
  • Only tolerated by unconscious patient
  • Insertion in a “light” patient may cause vomiting or laryngospasm
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12
Q

Describe the laryngeal mask airway

A
  • Cuffed tube with “mask” sitting over glottis
  • Maintains but does NOT protect airway
  • Sizes for adults and children
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13
Q

4 reasons for airway obstruction

A

-Ineffective triple airway manoeuvre
Airway device malposition or kinking
-Laryngospasm
-Foreign body

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14
Q

Describe a laryngospasm

A
  • Forced reflex adduction of the vocal cords
  • May result in complete airway obstruction
  • Caused by airway (or other) stimulation in light planes of anaesthesia
  • Often unrelieved by simple manoeuvres
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15
Q

Define maintaining and protecting an airway

A
  • Maintained = Open + unobstructed

- Protected = protected from aspiration, only a cuffed tube in the trachea protects the airway from contamination

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16
Q

Describe endotracheal intubation

A
  • Placement of a cuffed tube into trachea
  • Oral route most commonly used
  • Laryngeal reflexes must be abolished
  • Classic method uses laryngoscope, muscle relaxant and “sniffing the morning air” position
  • Possible in awake patient using local anaesthetic + fibre optic scope
17
Q

6 reasons to intubate

A
  • GCS < 8
  • Protect airway from aspiration (unfasted patient)
  • Need for muscle relaxation (laparotomy) therefore artificial ventilation
  • Shared airway w/ risk of blood contamination (tonsillectomy)
  • Restricted access to airway (max-fax)
  • Need for tight control of blood gases (esp. CO2 levels in neurosurgery)
18
Q

6 risks to unconscious patient

A
  • AIRWAY, AIRWAY, AIRWAY!
  • Temperature
  • Loss of protective reflexes (corneal, joint position)
  • VTE
  • Pressure areas
  • Consent + ID
19
Q

What is monitored in the anaesthetised patient

A
  • Basic “minimum” monitoring
  • Resp. parameters
  • Agent monitoring
  • Temp, urine output, NMJ
  • Invasive venous/arterial monitoring
20
Q

What does basic monitoring involve

A
  • SpO2
  • ECG
  • NIBP
  • FiO2
  • ETCO2
21
Q

5 common anaesthesia related complications

A
  • Airway
  • Breathing
  • Circulation
  • Related to techniques and position
  • Awareness
22
Q

Describe the process of emergence/awakening

A
  • Muscle relaxants reversed
  • Anaesthetic agents off
  • Resumption of spontaneous respiration
  • Return of airway reflexes/control
  • Extubation
  • Can be v quick or v slow
23
Q

4 types of local anaesthetic

A
  • Spinal
  • Epidural
  • Plexus block
  • Nerve block

Anaesthetics (5 decks)

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