Conduct of Anaesthesia

Question 1

What steps are involved in the process of anaesthesia?

Answer 1

1 - Pre-op assessment

2 - Preparation

3 - Induction

4 - Maintenance

5 - Emergence

6 - Recovery

7 - Post-op care and pain management

Question 2

What is involved in induction of anaesthesia?

Answer 2

• Quiet
• Gas (sevoflurane) or IV agent (propofol, thiopentone etc.)
• Careful monitoring of conscious level (respiratory pattern, EEG, movement)
• Airway maintenance

Question 3

What are some of the complications that can be encountered during airway maintenance?

Answer 3

1 - Obstruction (poor triple airway manoeuvre, laryngospasm etc.)

2 - Aspiration due to loss of airway reflexes (gastric contents, blood, surgical debris)

Question 4

What is the definition of a maintained airway?

Answer 4

An airway is maintained if it is open and un-obstructed

Question 5

What is endotracheal intubation and why is it used?

Answer 5

Endotracheal intubation - Placement of a cuffed tube in the trachea

Why is it used?

• Protect airway from gastric contents
• When there is a need for muscle relaxants, e.g. laparotomy
• Risk of blood contamination
• When there is a need for tight control of blood gases

Question 6

What are the biggest risks faced by an unconscious patient before surgery begins?

Answer 6

1 - Loss of airway

2 - Temperature change

3 - Loss of protective reflexes

4 - Venousthromboembolism risk

Question 7

What is measured in the basic monitoring during anaesthesia?

Answer 7

• SpO2
• ECG
• FiO2 (fraction of inspired oxygen)
• NIBP (Non-invasive blood pressure)

Question 8

What are main complications encountered during anaesthesia?

Answer 8

Airway

Breathing

Circulation

Problems with techniques or position

Awareness

Question 9

What happens during emergence from anaesthesia?

Answer 9

1 - Muscle relaxation reversed

2 - Anesthetic agents removed

3 - Spontaneous respiration resumes

4 - Airway reflexes return