General Anaesthetics Flashcards

1
Q

What are the aims of General Anaesthetics?

A

Analgesia (Pain relief), relaxation of skeletal muscles, amnesia (loss of memory)

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2
Q

The higher the solubility of inhalent GA in blood, the _____ (faster/slower) the onset

A

slower

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3
Q

What are the different type of inhalant GA?

A
  • Halothane
  • Enflurane
  • Desflurane
  • Isoflurane
  • Sevoflurane
  • Nitrous Oxide
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4
Q

What are the stages of anaesthesia?

A

1) analgesia
2) excitement
3) Surgical Anesthesia (loss of eye movement, eye reflexes, as dept of anesthesia increases)
4) Medullary depression

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5
Q

What is the significances of Minimum Alveolar Concentration (MAC)

A

low MAC = High potency
MAC is the minimum concentration of drug in the alveolar air that will produce immobility in 50% of patients exposed to a painful stimulus.

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6
Q

What must be noted when giving sevoflurane?

A

Unstable when exposed to cardon dioxide absorbents in anaesthetics machines, degrading to a compound that is potentially nephrotoxic.

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7
Q

What is a major and unique concern of Nitrous oxide?

A

Postoperative nausea and vomiting
rapid onset and recovery but MAC is very high, least potent –> need other anesthetic agents

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8
Q

What are the different types of intravenous GA?

A

Thiopentone
Etomidate
Propofol
Ketamine
Midazolam

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9
Q

What is unique about thiopentone? What is its Mechanism of Action?

A

-Barbiturate with extremely high lipid solubility ( can enter BBB easily)
- rapid onset of action

MOA: Cause CNS depression by potentiating the action of neurotransmitters GABA on the GABAa receptor gated chloride ion channels

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10
Q

Characteristic of Propofol (5)

A
  • Rapid onset
  • short duration of action as rapid redistribution from brain to other tissues
  • recovery is faster than thiopentone
  • reduced postoperative vomiting
  • significant cardiovascular effect during induction –> hypo tension (used with caution with pts w compromised cardiac function, hypovolemic patients)
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11
Q

Characteristic of ketamine (5)

A
  • Produces a state known as dissociative anaesthesia
  • rapid induction
  • metabolized in liver, excreted in urine
  • Large Vd, rapid clearance, suitable for continuous infusion without lengthening in duration of action
  • only IV anesthetic that possess analgesic property
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12
Q

What are some anesthetic adjuncts and what do they do?

A

Benzodiazepines (midazolam), alpha2 adrenergic agonists, analgesics (NSAIDs), neuromuscular blocking agent (succinylcholine)
They augment GA –> reduce doses of GA needed –> reduce GA side effects

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