Day 1: Overview Flashcards
what is an anaesthetist
Anaesthetists are perioperative physicians who care for patients before, during, and after their journey through surgery
what does peri mean
around
division of perioperative care
preoperative care
intraoperative care
postoperative care
anaesthesiology
also extends to pain managment (both acute and chronic)
requires meticulous applied knowledge of both basic and clinical science
types of anaesthesia
general anaesthesia
regional/ local anaesthesia
general anaesthesia
-unconscious patient induced, reversible coma
-may be achieved with intravenous or inhalational drugs
-depending on the surgery and/or drugs used, patients may breathe spontaneously or be ventilated artificially
-analgesia usually need to be administered separately
local or regional anesthesia
- a part of the body is rendered insensitive to pain, sensation (and possibly movement) by blocking nerves with a local anaesthetic
- patient is still fully conscious (although sedation may be given)
-specific nerves may be blocked, or whole sections
-includes the neuraxial blocks (spinal and epidural) which block the spinal cord
the triad of general anaesthesia
hypnosis
analgesia
immobility
what does hypnosis mean
loss of consciousness
how is hypnosis achieved
it is achieved with general anaesthetic agents (intravenous and/or inhalations)
typically anaesthesia is induced with IV agents and maintained with inhalations
most of these agents ONLY CAUSE HYPNOSIS and are not analgesic
Anaesthesia
what does anaesthesia mean
without sensation
are general anesthetic agents primarily analgesic
Most general anaesthetic agents primarily induce hypnosis and do not provide analgesia.
How is anaesthesia typically induced?
Anaesthesia is usually induced with intravenous agents.
In what situations is hypnosis increasingly used in anesthesia?
-Siting of invasive lines, particularly central lines.
-Siting of regional nerve blocks, especially brachial plexus blocks.
-Transthoracic echocardiography (TTE) can be conducted as a side room test to evaluate cardiac function.
-Invasive transoesophageal echocardiography (TOE) can be used intraoperatively to monitor cardiac function.
Why is analgesia essential during general anesthesia?
-The body still experiences pain under general anesthesia as most agents only interrupt consciousness.
-Pain activates the sympathetic nervous system, leading to deleterious effects.
-Additional analgesic agents are administered intravenously to ensure patient comfort.
-Strong opioids such as fentanyl and morphine are typically used.
-Regional anesthesia techniques like nerve blocks may also be employed for enhanced pain relief.
What is meant by “immobility” in anesthesia?
“Muscle relaxation” is often synonymous with “immobility.”
Why is immobility crucial for surgical procedures?
Immobility ensures an optimal surgical field for surgical access.
What are paralytic agents, and when are they used in anesthesia?
Paralytic agents, or neuromuscular blockers, are used for surgery in large body cavities like the chest and abdomen.
How do patients receiving paralytic agents typically manage their airways?
Patients receiving paralytic agents are typically intubated and require assisted ventilation.
In what types of surgeries might immobility be particularly important?
Immobility may also be necessary for delicate microsurgery, such as on the retina or brain.
Does deep general anesthesia alone guarantee immobility?
Deep general anesthesia induces muscle relaxation but may not completely halt respiration.
What happens to pain perception under general anesthesia?
Pain perception persists under general anesthesia due to interruption of consciousness only.
Why is adequate analgesia crucial during surgery?
Adequate analgesia is vital for patient comfort and to prevent sympathetic nervous system activation.
How does pain affect the sympathetic nervous system?
Pain activates the sympathetic nervous system, leading to detrimental effects like increased heart rate and blood pressure.
What additional measures are taken to provide analgesia during anesthesia?
Additional analgesic agents, typically strong opioids such as fentanyl and morphine, are administered intravenously.
Which types of analgesic agents are commonly administered intravenously?
Intravenous opioids, such as fentanyl and morphine, are commonly administered for systemic analgesia during anesthesia.
Besides systemic analgesia, what other technique can be used to enhance pain control?
Regional anesthesia techniques, such as nerve blocks, can be used in addition to systemic analgesia to enhance pain control.
What does hypnosis refer to in the context of anesthesia?
In anesthesia, hypnosis refers to the loss of consciousness induced by anesthetic agents.
How is loss of consciousness achieved during anesthesia?
Loss of consciousness is achieved with a combination of intravenous and/or inhalational anesthetic agents.