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Anaesthetics and Genetics > Conduct of Anaesthesia > Flashcards

Conduct of Anaesthesia Flashcards

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1
Q

Stages of anaesthesia

A 
Preparation 
Induction 
Maintenance
Emergence
Recovery
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2
Q

Roles of an anaesthetist

A 
Pre-op assessment care
Critical care / intensive care
Pain management
Anaesthesia 
Post op care
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3
Q

What does the preparation stage of anaesthesia involve?

A 
Planning
Right patient, right operation 
Right or left side 
Pre medication 
Right equipment, right personnel 
Drugs drawn up 
IV access 
Monitoring
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4
Q

What does the induction stage of anaesthesia involve?

A

Quietness
Gas or IV agent
Careful monitoring of conscious level
Airway maintenance

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5
Q

Drugs used for IV induction

A

PROPOFOL
Thiopentone
Others

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6
Q

Features of IV drug induction

A 
Rapid - one arm brain circulation - approx. 20 secs 
Obvious planes 
Easy to overdose 
Generally rapid loss of airway reflexes 
Apnoea is common
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7
Q

Drugs used in gas induction

A

Sevoflurane (halothane)

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8
Q

Features of gas induction

A

Common in younger children
Slow
Considerably more obvious “planes” of anaesthesia

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9
Q

How to monitor conscious level

A 
Loss of verbal contact 
Movement
Resp pattern 
Processed ECG
stages and planes of anaesthesia
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10
Q

When is airway maintenance always required?

A

In general anaesthesia

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11
Q

What is the “triple airway manoeuvre”?

A

Head tilt
Chin lift
Jaw thrust

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12
Q

Simple apparatus used in airway maintenance

A 
Face mask 
Oropharyngeal ("Guedel") airway 
- unconscious patient 
Nasopharyngeal airway 
Laryngeal mask airway
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13
Q

Features of a laryngeal mask airway

A

Cuffed tube with mask that sits over glottis

maintains, but does not protect the airway

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14
Q

What is used for resuscitation?

A

I-gel

2nd generation LMA

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15
Q

What does I-gel used in resuscitation NOT protect you from?

A

Aspiration

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16
Q

Airway complications

A

Obstruction

Aspiration

17
Q

What causes obstruction of the airway in anaesthesia?

A

Ineffective triple airway manoeuvre
Airway device malposition or kinking
Laryngospasm = laryngeal spasm

18
Q

Features of laryngospasm

A

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

19
Q

When is the airway maintained?

A

When it is open and not obstructed

20
Q

Why intubate?

A

Protect the airway from gastric contents
Need for muscle relaxation -> artificial ventilation
Shared airway with risk of blood contamination
Need for tight control of blood gases
Restricted access to airway

21
Q

What route is most commonly used for endotracheal intubation?

A

Oral route

22
Q

What must be abolished in endotracheal intubation?

A

Laryngeal reflexes

23
Q

Risks faced by the unconscious patient before the surgery even begins

A 
AIRWAY
temperature
loss of protective reflexes e.g. corneal, joint position 
Venous thromboembolism risk 
Consent and identification 
Pressure areas
24
Q

What is the best monitor?

A

The anaesthetic

25
Q

How is monitoring done?

A 
Basic "minimum" monitoring
- SpO2, ECG, NIBP, FiO2, ETCO2
Respiratory parameters
Agent monitoring 
Temperature, urine output, NMJ
Invasive venous / arterial monitoring 
Processes ECG
VENTILATOR DISCONNECT 
anaesthetic best monitor
26
Q

Anaesthetic complications

A 
Airway 
Breathing 
Circulation 
Related to techniques or position 
Awareness
27
Q

Risk factors of anaesthesia awareness

A 
Paralysed and ventilated 
Previous episode of awareness 
Chronic CNS depressant use 
Cardiac surgery 
Major trauma 
GA C/section
28
Q

What happens during emergence/awakening?

A 
Muscle relaxation reversed
Anaesthetic agents off 
Resumption of spontaneous resection 
Return of airway reflexes/control 
Extubation 
Can be very quick or very very slow
29
Q

Issues surrounding recovery

A

Problems with A, B and C
Pain control
Post op nausea and vomiting

Anaesthetics and Genetics (15 decks)

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