Fundamentals of anaesthetics Flashcards
Are the following general, topical or regional?
a) Spinal anaesthesia?
b) EMLA skin cream?
c) brachial plexus block
a) regional
b) local
c) regional
What are the 3 elements to anaesthesia? (A’s)
Amnesia
Analgesia
Akinesis
What induction agent should be used for a patient requiring a burn dressing change?
Ketamine: useful for single short procedures.
Ketamine:
Dose.
Uses/advanatges
Unwanted affects
a) 1-1.5mg/kg
Use
- dissociative anaesthesia
- slow onset (90 secs)
- Cardiostable (rise in HR/BP
- Bronchodilation
- Good analgesic properties
Unwanted:
- emergence phenomenon (hallucinations)
Which induction agent is best used for a patient undergoing an GA operation with a laryngeal masked airway?
Propofol
What does of propofol should be used?
How often used?
Benefits?
Unwanted effects
1.5-2.5mg
Commonly used (95%)
-Excellent suppression of airway reflexes (putting in LMA)
- Drop in HR and BP
- Pain on injection
- Myoclonus
What induction agent can be used for a patient with a history of heart failure requires a general anaesthetic?
Etomidate (haemodynamically stable)
Etomidate:
Dose:
Use:
Unwanted effects
0.5mg/kg
- Haemodynamically stable use for heart conditions
- Rapid onset
- Low incidence of hypersensitivity
Unwanted:
- Pain on injection
- Adreno-corticol suppression > lower cortisol > lower BP > never use for septic shock. Cortisol low for 72 hours.
- High incidence of PONV
What induction agent do you use for a patient with intestinal obstruction requires an emergency laparotomy?
Thiopentone (used for rapid sequence induction)
Thiopentone
Dose
Use
Unwanted effects
Dose) 4-5mg/kg
Use)
- Rapid Sequence Induction (faster than propofol
- Anti-epileptic properties and protect brain
Unwanted) - Drops BP and rise in HR - No analgesic property - Rash/bronchospasm - Hangover effect CI in prophyria
All inhalation agents end in what?
-flurane
Which inhalation agent is used for long operations as rapid onset and offset.
Desflurane
Which inhalation agent is commonly used for paediatrics?
Sevoflurane
Which inhalation agent is best for organ retrieval from a donor?
Isoflurane
Which two inhalation agents have low potency and low solubiluity?
Sevoflurane and desflurane
Name a depolarising muscle relaxant.
Suxamethonium
What problems are associated with suxamethonium
Malignant hyperthermia Muscle pain Fasiculations Hyperkalaemia > arrythymias Rise ICP
When is it used?
Rapid Sequence induction.
What drugs are used to reverse anti-muscarinics?
Neostigmine & Glycopyrrolate
Which drug do you use if BP and HR are low?
How does it work
Ephedrine
Rises HR which increases BP
Which drug(s) do you use when BP is low but heart rate is high.
How do they work
Phenylepherine
Metaraminol
Vasoconstriction increases BP which decreases HR.
