General anaesthetics

Question 1

Objective of anaesthesia?

Answer 1

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

Question 2

Who was the father of surgical anaesthesia?

Answer 2

Hua Tuo

Question 3

Who was the first surgeon who used N2O as a GA?

Answer 3

Crawford Long

Question 4

Triad of general anaesthetics?

Answer 4

Unconsciousness, analgesia, muscle relaxation

Question 5

How many stages of anaesthesia are there?

Answer 5

4

Question 6

What is stage 1 of anaesthesia?

Answer 6

Analgesia

Question 7

Conditions of stage 1 of anaesthesia?

Answer 7

conscious, drowsy, anticonception, amnesia

Question 8

What is stage 2 of anaesthesia?

Answer 8

Excitement

Question 9

Conditions of stage 2 of anaesthesia?

Answer 9

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

Question 10

What is stage 3 of anaesthesia?

Answer 10

Anaesthesia

Question 11

Conditions of stage 3 of anaesthesia?

Answer 11

regular respiration, loss of reflex and muscle tone

Question 12

What is stage 4 of anaesthesia?

Answer 12

medullary paralysis

Question 13

Conditions of stage 4 of anaesthesia?

Answer 13

Depression of cardiorespiration, death

Question 14

Why is stage 1 of GA used for childbirth?

Answer 14

Want some lack of sensation but still need to be awake

Question 15

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

Answer 15

Increase the dose or potency of the GA

Question 16

Which compound is used to induce stage 1 GA?

Answer 16

N2O

Question 17

Which stage of GA causes erratic breathing?

Answer 17

2

Question 18

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

Answer 18

Action of intercostal muscles decreasing

Question 19

What are the four stages of stage 3 of GA?

Answer 19

Planes 1,2,3, and 4

Question 20

When is the pupilary light reflex visible?

Answer 20

S3, planes 2-end of 3

Question 21

When during GA does the corneal reflex stop?

Answer 21

S3P2

Question 22

Precise aim of GA?

Answer 22

S3, P1 OR 2

Question 23

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

Answer 23

Midway through S3P2

Question 24

When during GA are the muscles tense and struggling?

Answer 24

S2

Question 25

Super ideal GA?

Answer 25

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

Question 26

Why does the ideal GA need to be rapid on?

Answer 26

Through S2 quickly

Question 27

Why does the ideal GA need to be rapid off?

Answer 27

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

Question 28

Why is xenon not used as a GA?

Answer 28

V expensive

Question 29

2 main types of administering GAs?

Answer 29

Inhalation and intravenous

Question 30

Best aspect of inhaled GAs?

Answer 30

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

Question 31

Main inhaled GAs?

Answer 31

Halogenated ethers, halogenated hydrocarbons

Question 32

Halogenated hydrocarbon example?

Answer 32

Halothane, isofluorane

Question 33

Advantages of halothane and isoflurane?

Answer 33

V potent and stable

Question 34

Main pro of intravenous GAs?

Answer 34

V rapid

Question 35

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

Answer 35

Intravenous

Question 36

Which type of anaesthetic is used for maintenance of GA?

Answer 36

Inhaled

Question 37

Major surgery general anaesthetic order?

Answer 37

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

Question 38

Rapid unconsciousness anaesthetic?

Answer 38

thiopental (short acting)

Question 39

General anaesthetic to maintain GA?

Answer 39

N2O, halothane, sevofluorane

Question 40

When are analgesic drugs used?

Answer 40

post operative care

Question 41

What is fentanyl used for?

Answer 41

analgesic effect after surgery when the general anaesthetic has worn off

Question 42

Which compounds are used for paralysis of skeletal muscle?

Answer 42

Suxamethonium

Question 43

How does Suxamethonium work?

Answer 43

It is a nicotinic ACh receptor antagonist

Question 44

What drugs are people given pre-op?

Answer 44

Benzodiazepines, midazolam

Question 45

Examples of inhaled anaesthetics?

Answer 45

N2O, halothane, enflurane, isoflurane, desflurane, sevoflurane

Question 46

Side effect of halothane?

Answer 46

Toxic to liver

Question 47

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

Answer 47

Halothane

Question 48

Why is sevoflurane used the most?

Answer 48

Has the least side effects

Question 49

Types of intravenous GAs?

Answer 49

Thiopental, etomidate, propofol, ketamine, benzodiazepines

Question 50

Most widely used intravenous GA?

Answer 50

propofol

Question 51

Mechanism of local anaesthetics?

Answer 51

Voltage-gated sodium channel block

Question 52

Two main theories of how GAs work?

Answer 52

lipid theory, and protein theory

Question 53

Lipid theory of GAs?

Answer 53

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)

Question 54

Protein theory of GAs?

Answer 54

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

Question 55

What type of proteins do GAs target?

Answer 55

Transmitter receptors, ion channels, transporters and release

Question 56

What do GAs do regarding inhibitory receptors?

Answer 56

Potentiate them, meaning they are stronger (more hyperpolarisation)

Question 57

What do GAs to to excitatory receptors?

Answer 57

Block them

Question 58

How do GAs affect ion channels?

Answer 58

They reduce the frequency of them opening