General Anaesthesia

Question 1

Anaesthetic state

Answer 1

• Amnesia
• Immobility response to noxious
• Analgesia
• Unconsciousness

Question 2

Thiopental

Answer 2

-Acts on GABA-a receptor
-Barbiturate
-Dose: 3-7mg/kg
Effects: hypnosis, antiepileptic & painful
Side effects: CVS- Myo-cardiac depression, dec. CO
MV reduction, apnea
Problems- extremely painful and limb threatening
- Hypersensitivity reactions 1:15000
Contraindications: Porphyria

Question 3

Propofol

Answer 3

-Dose; 1-2.5 mg/kg
- Hypnosis
-Pain on induction
-Vomiting and Nausea less likely
-better LMA than thiopental
Myocardial & respiratory depression
Contraindications: Children under 3 years
Porphyria

Question 4

Etomidate

Answer 4

-Modulator of GABA-a receptors
-0,3mg/kg
effects: Hypnosis
Side effects; Very little effect on HR, CO, SVR
Minimal respiratory depression
Problems: pain on injection, adrenocortical suppression, nausea and vomiting. 1:75000 hypersensitivity

Question 5

Ketamine

Answer 5

• Inhibits NMDA receptors
  CV effects: increase in HR, BP, CO, O2 consumption
  RS: increase in RR, preserved laryngeal reflexes
  CNS: Dissociative anaesthesia
  used in analgesic emergencies

Question 6

Succinylcholine

Answer 6

DOA: 3-5 mins
Adverse effects: Bradycardia, Muscle pain (sux pain raised pressure in eye, stomach and cranium.
Hyperkalaemia- raised K levels

Question 7

Summary of muscle relaxants

Answer 7

Mechanism of action - Acetylcholine receptors
Used to facilitate; tracheal intubation, Mechanical ventilation and surgery
Depolarizing- Succinylcholine, lots of side effects
Non-Depolarization- minimal CV &RS effects
-Vecuronium and Atracurium