General Anesthesia

Question 1

What is anesthesia?

Answer 1

A state of temporary induced loss of sensation or awareness

Including analgesia

Paralysis

(Hypnosis, analgesia, muscle relaxation)

Question 2

What are the phases of General anesthesia?

Answer 2

Before surgery
During surgery
After surgery

Before surgery
Anxiolysis and amnesia (benzodiazepines)
Analgesia (PCM, NSAIDS, morphine)
Gastric contents (antacid, PPI, H2 blocker, metoclopramide)

During surgery
Induction of unconsciousness (fentanyl+propofol, sevoflurane)
Maintenance of unconsciousness (sevoflurane, isoflurane, propofol+remifentanil)

After surgery
Pain relief (epidural infusion, IV morphine, PCM NSAID)
Postop nausea and vomiting (metoclopramide, ondansetron, dexamethasone)

Question 3

What is dissociative anesthesia?

Answer 3

Profound analgesia

And anterograde amnesia

Minimal hypnosis

KETAMINE

Question 4

What are the inhalational anesthetics?

Answer 4

Fluorinated hydrocarbons

Nitrous oxide

Question 5

What are the IV anesthetics?

Answer 5

Rapid
Slow

Rapid
Thiopentone sodium
Methohexitone
Propofol
Etomidate

Slow
Ketamine
Benzodiazepines

Question 6

What are the muscle relaxants?

Answer 6

Depolarizing
Non depolarizing

Depolarizing
Suxamethonium

Non depolarizing
Curiums (atracurium)
Roniums (vecuronium, rocuronium)

Question 7

What are the side effects of rapid induction inhalational anesthetics?

Answer 7

Diffusion hypoxia

Entonox both anesthetic and analgesic

Rapid recovery

Airspace expansions

Bone marrow suppression with NO

Pungent irritation with isoflurane (sevoflurane is very pleasant)

Respiratory depression

Hypotension

Coronary steal regional myocardial ischemia (not in sevoflurane)

Question 8

What are the important points on propofol ?

Answer 8

Rapid induction

Rapid recovery

CNS depression

Anticonvulsant

Depress gag reflex

Hypotension

Hypopnea

Question 9

What are the important points on thiopentone?

Answer 9

Short acting barbiturate

Rapid induction

Long recovery

Nausea and vomiting

Not analgesic

Anticonvulsant

Reduced intracranial pressure

Hypotension

Hypopnea

Question 10

What are the important points on ketamine?

Answer 10

Dissociative anesthesia

Profound analgesia

Short acting

Tachycardia

Hypertension

No muscle relaxation

Increases intracranial pressure

Hallucinations

Don’t give in pregnancy