Intro Flashcards
Define general anaesthesia
State of controlled unconsciousness Stages = Awake/ Conscious Anaesthetised Dead Not a physiological process - drugs used where overdose could kill
Describe general anaesthesia in terms of its component parts
- The Triad of general anaesthesia:
1. Analgesia
2. Unconsciousness
3. Muscle Relaxation
while being physiologically stable
What is our job and how do we do it?
AIM: To anticipate, mitigate and minimise the risk of morbidity or mortality by
- Adequate preparation
- Stabilisation
- Protocol planning
- Delivery
- Monitoring during peri anaesthetic period
Day one skills with regards to anaesthesia
- Ensure patent airways
- Give oxygen
- Know how to apply IPPV (intermittent positive pressure ventilation - electronic or bag
- IV catheter - give drugs IV
- Basic CPCR - cardiopulmonary cerebral resuscitation: ABCD: airway, breathing, circulation, drugs
What is ASA status?
The attempt to classify the risk of anaesthesia according to the physiological status of the patient in order to know the fitness of patient before surgery and therefore evaluate the risk.
ASA 1 and 2 are classified as healthy
3-5 are sick
ASA 1 = normal healthy animal
ASA 2 = mild systemic disease
ASA 3 = moderate systemic disease
ASA 4 = severe systemic disease, constant life threat
ASA 5 = moribund, not expected to survive following 24 hrs
What are considerations you must think about before GA
- ASA status of the patient = Fitness of patient before surgery
- Aim of anaesthesia
- Nature of the procedure
- Surrounding
- Equipment
- Knowledge
- Helpers: number and qualification
- All these influence how you should go about GA
Outline the process of general anaesthesia:
The anaesthetising continuum…
- Pre anaesthesia/ op clinical exam
- Premedication
- Induction
- Maintenance
- Recovery - most dangerous
What is balanced anaesthesia?
Anaesthesia produced by safe doses of two or more agents or methods of anaesthesia, each of which contributes to the total desired effect
Idea of balanced = utilise different drugs to try and reduce dose of each to keep near safe dose limit, rather than go to dangerous. Reduce side effect and optimise analgesia. Often routine is more than 2 drugs.
- Reduction of the dose of each component
- Reduction of the side effects
- Optimised post-operative analgesia
- In general, surgery can use up to 6 drugs for balanced anaesthesia
Analgesia in anaesthetic protocol. What to think about and when needed
- Can give pre emptive analgesia?- analgesia before elective procedure occurs e.g. nuture will mean the amount of analgesia required later will be less. (balanced approach)
- Want it during recovery - often forgotten about e.g. opioids don’t last very long
- If can’t give pre emptive then will need more efficacious analgesics to get on top of pain than if elective
What dictates the anaesthetic agent used?
The nature of the procedure
-duration
- pain?
Localisation e.g. head/ neck might not be able to use X
- Recovery time. Do we want that animal home later that day or to stay in hostpital?