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SL22044 Neuroscience > General anaesthetics > Flashcards

General anaesthetics Flashcards

1
Q

Objective of anaesthesia?

A

Inducing a lack of feeling (lack of sensation and pain)

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2
Q

Who was the father of surgical anaesthesia?

A

Hua Tuo

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3
Q

Who was the first surgeon who used NO2 as a GA?

A

Crawford Long

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4
Q

Triad of general anaesthetics?

A

Unconsciousness, analgesia, muscle relaxation

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5
Q

How many stages of anaesthesia are there?

A

4

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6
Q

What is stage 1 of anaesthesia?

A

Analgesia

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7
Q

Conditions of stage 1 of anaesthesia?

A

conscious, drowsy, anticonception, amnesia

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8
Q

What is stage 2 of anaesthesia?

A

Excitement

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9
Q

Conditions of stage 2 of anaesthesia?

A

loss of consciousness, delirium, irregular cardiorespiration, apnea, spasticity, gagging, vomiting

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10
Q

What is stage 3 of anaesthesia?

A

Anaesthesia

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11
Q

Conditions of stage 3 of anaesthesia?

A

regular respiration, loss of reflex and muscle tone

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12
Q

What is stage 4 of anaesthesia?

A

medullary paralysis

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13
Q

Conditions of stage 4 of anaesthesia?

A

Depression of cardiorespiration, death

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14
Q

Why is stage 1 of GA used for childbirth?

A

Want some lack of sensation but still need to be awake

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15
Q

How do you go from one stage of GA to a higher stage?

A

Increase the dose or potency of the GA

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16
Q

Which compound is used to induce stage 1 GA?

A

NO2

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17
Q

Which stage of GA causes erratic breathing?

A

2

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18
Q

What is a warning sign to an anaesthetist that a patient is too deeply anaesthetised?

A

Action of intercostal muscles decreasing

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19
Q

What are the four stages of stage 3 of GA?

A

Planes 1,2,3, and 4

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20
Q

When is the pupilary light reflex visible?

A

S3, planes 2-end of 3

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21
Q

When during GA does the corneal reflex stop?

A

S3P2

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22
Q

Precise aim of GA?

A

S3, P1 OR 2

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23
Q

When in GA is the respiratory response to skin inscision lost?

A

Midway through S3P2

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24
Q

When during GA are the muscles tense and struggling?

A

S2

25
Q

Super ideal GA?

A

Stable, potent, non toxic, controllable, rapid on off, adjustable, minimal cardio and respiratory depressant

26
Q

Why does the ideal GA need to be rapid on?

A

Through S2 quickly

27
Q

Why does the ideal GA need to be rapid off?

A

Able to titrate dose depending on their reaction, to keep them in S3

28
Q

Why is xenon not used as a GA?

A

V expensive

29
Q

2 main types of administering GAs?

A

Inhalation and intravenous

30
Q

Best aspect of inhaled GAs?

A

V controllable as the dose in the air is v quickly transferred

31
Q

Main inhaled GAs?

A

Halogenated ethers, halogenated hydrocarbons

32
Q

Halogenated hydrocarbon example?

A

Halothane, isofluorane

33
Q

Advantages of halothane and isoflurane?

A

V potent and stable

34
Q

Main pro of intravenous GAs?

A

V rapid

35
Q

Which type of general anaesthetic is used for induction of GA?

A

Intravenous

36
Q

Which type of anaesthetic is used for maintenance of GA?

A

Inhaled

37
Q

Major surgery general anaesthetic order?

A

Benzazepine, then intravenous (thiopental), then inhaled (halothane)

38
Q

Rapid unconsciousness anaesthetic?

A

thiopental (short acting)

39
Q

General anaesthetic to maintain GA?

A

N2O, halothane, sevofluorane

40
Q

When are analgesic drugs used?

A

post operative care

41
Q

What is fentanyl used for?

A

analgesic effect after surgery when the general anaesthetic has worn off

42
Q

Which compounds are used for paralysis of skeletal muscle?

A

Suxamethonium

43
Q

How does Suxamethonium work?

A

It is a nicotinic ACh receptor antagonist

44
Q

What drugs are people given pre-op?

A

Benzodiazepines, midazolam

45
Q

Examples of inhaled anaesthetics?

A

N2O, halothane, enflurane, isoflurane, desflurane, sevoflurane

46
Q

Side effect of halothane?

A

Toxic to liver

47
Q

Which inhaled GA is used more in veterinary than human surgery?

A

Halothane

48
Q

Why is sevoflurane used the least?

A

Has the least side effects

49
Q

Types of intravenous GAs?

A

Thiopental, etomidate, propofol, ketamine, benzodiazepines

50
Q

Most widely used intravenous GA?

A

propofol

51
Q

Mechanism of local anaesthetics?

A

Voltage-gated sodium channel block

52
Q

Two main theories of how GAs work?

A

lipid theory, and protein theory

53
Q

Lipid theory of GAs?

A

good GAs are more lipophilic (can soak into lipids) and so soak into the lipid bilayer and block membrane spanning proteins (Na+ channels in neurons etc)

54
Q

Protein theory of GAs?

A

More potent a GA is, less of it is needed to inhibit luciferase proteina action, so GAs might generally inhibit protein action

55
Q

What type of proteins do GAs target?

A

Transmitter receptors, ion channels, transporters and release

56
Q

What do GAs do regarding inhibitory receptors?

A

Potentiate them, meaning they are stronger (more hyperpolarisation)

57
Q

What do GAs to to excitatory receptors?

A

Block them

58
Q

How do GAs affect ion channels?

A

They reduce the frequency of them opening

SL22044 Neuroscience (9 decks)

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