Introduction to Anaesthesia

Question 1

What is Anaesthesia?

Answer 1

Greek for “loss of sensation”… with or without loss of consciousness.
When under anaesthesia, you can’t move, form memories, or feel pain.

Question 2

What does the ‘triad of anaesthesia’ consist of?

Answer 2

Hypnosis - Unconscious element

Analgesia - Pain relief element

Muscle relaxation - Paralysis

Question 3

True or False?

GA means the patient is unconscious

Answer 3

TRUE

Question 4

How is GA administered?

Answer 4

Either intravenous (IV) drugs called induction agents e.g. Propofol or anaesthetic gasses (Volatile agents)

Question 5

Local Anaesthesia

• Administration
• Use

Answer 5

Injected into the tissue to numb the specific location requiring minor surgery and post-operative pain relief.

Question 6

Nerve Block

• Administration
• Use

Answer 6

Infiltrated into deeper nerves and used to numb larger areas than LA

Question 7

Regional Anaesthesia

• Administration
• Use
• Benefit
• Patient awareness

Answer 7

• A local anaesthetic is injected in a specific region of the body, leading to numbness or pain relief for deeper operations where more extensive numbness is needed
• Great at reducing post-operative pain.
• Patient is awake or sedated

Question 8

Spinal Anaesthesia

• Administration region
• Direction of effect
• Primary uses

Answer 8

Injected into the ‘sub-arachnoid space’ in the spine and numbs from the inject site down

Primarily used for:

• Caesarean sections
• Joint replacements

Question 9

Epidural Anaesthesia

• Administration equiptment and region
• Primary uses

Answer 9

A small catheter is inserted into the epidural space in the spine
Continuous infusion of local anaesthetic is administered down the catheter

Primarily used for:

• Post operative Pain Relief
• Caesarean sections following a failure to progress with natural delivery

Question 10

Sedation

• Medication effect
• Patient awareness

Answer 10

Medicine that makes you feel sleepy and relaxes you both physically and mentally; it’s sometimes used to keep you calm during less invasive but painful and unpleasant procedures

Patient is semi-conscious

Question 11

Which organisation published the guidelines for checking an anaesthetic machine?

Answer 11

AAGBI - The Association of Anaesthetists of Great Britain & Ireland 2012

Question 12

Which items of monitoring make up the minimum required monitoring for a patient having a general anaesthetic?

Answer 12

1) Pulse oximeter - SpO2
2) Non-Invasive Blood Pressure - NIBP
3) ECG
4) Temperature
5) Capnography for breathing analysis
6) Peripheral Nerve Stimulator (if neuromuscular blocking drugs used)

Question 13

Induction agents are identified using…

Answer 13

Yellow labels

Question 14

Name four induction agents

Answer 14

Propofol
Ketamine
Thiopental Sodium
Etomidate

Question 15

Propofol

Answer 15

Emulsion containing 1% propofol in a lipid medium

Can be painful on injection

Sometimes used with lidocaine (LA) added

Dose – 1-2.5 mg/kg

Onset time – 30 seconds Offset time – 3-7 minutes

Metabolised by the liver

Causes hypnosis

Side effects – hypotension, bradycardia, respiratory depressant, reduced sensitivity of the upper airway

Consider egg allergy

Question 16

Gas induction is preferred in which circumstances?

Answer 16

• Paediatrics
• IV Drug user
• Needle-phobic
• Stridor

Onset is slower – 30 seconds - 2 minutes
Once the patient has been induced, intravenous access will be established immediately

Question 17

Airway equipment for GA

Answer 17

• Endotracheal tube
• Laryngeal Mask
• Facemask

Question 18

Name three volatile gases

Answer 18

• Sevoflurane (yellow)
• Isoflurane (purple)
• Desflurane (blue)

Question 19

What drug is given to reverse the effects of muscle relaxant?

Answer 19

Neostigmine

Question 20

Which gas is used as a carrier gas?

Answer 20

Nitrous oxide

Question 21

Reversal and Emergence from Anaesthesia

Answer 21

1) Confirm that neuromuscular function is adequate
2) Discontinue anaesthetic drugs and administer 100 % oxygen
3) Suction the airway carefully to remove accumulated secretions and other debris
4) Ensure that the patient is breathing adequately
5) Place the patient in a suitable recovery position
6) Assess the patient’s wakefulness, and ability to maintain and protect an airway