General Anaesthesia Case Files

Question 1

In which stage of anesthesia is the patient most vulnerable, and why?

Answer 1

Stage 2 The excitatory phase
Why: The patient is hyperexcitable to external stimulus and they have lost both their airway reflexes and autonomic stability

Question 2

State three phases of anaesthesia

Answer 2

Induction, maintenance and emergence

Question 3

Outline the stages of anaesthesia

Answer 3

1. Analgesia: Patient is awake and responsive
2. Hyper excitable: Delirium, loss of airway reflexes, movement, autonomic instability, significant risk of complication
3. Return of autonomic stability, preservation of vital functions. Stage III is separated into 4 planes.
   Planes 2 and 3 are surgical anesthesia
4. Overdose: Depression of vital functions, autonomic instability
5. Cardiac arrest

Question 5

Which plane of the surgical anaesthesia stage of anaesthesia is optimal for surgery?

Answer 5

Plane 3/4

Question 6

List 5 monitors that should be placed prior to surgery

Answer 6

Electrocardiogram
BP
Pulse oximeter
Capnography(ETCO2)
Oxygen analyser in the breathing circuit

Question 7

What is the role of the capnography?

Answer 7

Monitors end-tidal CO2, detecting any deficit in ventilation or metabolism or elimination of CO2

Question 8

What is the function of the oxygen analyser in the breathing circuit?

Answer 8

Confirms the continuous flow of oxygen

Question 9

Indications for tracheal intubation 5

Answer 9

• Airway access
• Airway protection
• Need for muscle relaxation (paralysis)
• Length of procedure (> 2 hours)
• Need for mechanical ventilation

Question 10

Is STAGE 2 of anaesthesia more likely to be observed during induction or emergence?

Answer 10

Emergence: Because at induction, patients receive an intravenous induction agent and pass rapidly (and almost imperceptibly) through Stage II.