General Anesthesia

Question 1

Mention imporatnce if pre-anesthetic medication

Answer 1

1. Amnesia, dec anxiety and facilitate induction
2. Suppress autonomic reflexes, dec salivary and bronchial secretion and gastric motility
3. Potentiate weak anesthetics

Question 2

Inhalation anesthetics are mainly for….., while IV anesthetics are mainly for……

Answer 2

Maintenance
Induction

Question 3

Mention general anesthetics actiong on glutamate and antgonism and mention receptor

Answer 3

Ketamine, nitrous oxide
NMDA

Question 4

MAC is decreased by……., and increased by…….

Answer 4

Opioids, sedative hypnotics, clonidine
Alcohol abuse, catecholamines

Question 5

Mention adverse effects of halothalne

Answer 5

Hypotension, heart bardycardia/arrhythmia, hepatotoxic and malignant hyperthermia
Respiratory depression, dec muscociliray function, uerine relaxation (bleeding) inc ICT (CI head injury and cerebral tumours)

Question 6

……may precipitate ischemia in coronary patients, and ……is used for day surgery.

Answer 6

Isoflurane
Desflurane

Question 7

Mention the new halogenated agent which is not a respiratory irritant & the precaution of using it

Answer 7

Sevoflurane
Degraded by soda lime producing nephrotoxic compound A

Question 8

Mention uses of nitrous oxide

Answer 8

Low potency anesthetic
Effective analgesic (dental, obstetric)
Safest inhalation agent

Question 9

Mention adverse effect of N2O

Answer 9

1. Expands closed gas spaces, inc pressure in middle ear-CI: bowel obstruction, pneumothorax
2. Hypoxia
3. Abuse, euphoria
4. Megaloblastic anemia and abortion , chronic exposure in medical staff

Question 10

Mention clinical uses of thiopental

Answer 10

1. Most widely used IV anesthetic for induction followed by maintenance with ihalation agents for major operation
2. Given alone for short procedures

Question 11

Memtion adverse effects of thiopental

Answer 11

1. Respiratory and CV depression (toxic doses)
2. Severe vasospasm if injected intra-arterially (gangrene)
3. Can precipitate porphyria

Question 12

Mention uses, advantages, disadvatanges of propofol

Answer 12

Induction amd maintenance of anesthsia, concious and deep sedation
A, antiemetic
D, respiratory and CV depression pain at injection site

Question 13

Mention uses of Ketamine

Answer 13

1. Dissociative anesthesia
2. Profound analgesia
3. CV stimulant (can be used in shock states)
4. Potent bronchodilator

Question 14

Mention disadvatanges of Ketamine

Answer 14

Inc cerebral blood flow and intracranial tension, avoided in head injuries
Hallucination and disorientation, emergence phenomenon (blocked by diazepam)

Question 15

GR: BZDs are more commonly used in sedation than anesthsia

Answer 15

Because prolonhed amnesia and sedation can result from anesthetic doses

Question 16

Mention uses of BZDs

Answer 16

1. Conscious sedation
2. Pre-anesthsia
3. Balanced anesthesia, anesthetics adjuncts

Question 17

Mention techniqie of total intravenous anesthsia

Answer 17

Combining opioids with propofol rathrr than an inhalation agent

Question 18

Mention anesthetic used IM

Answer 18

Ketamine