perio 3b

Question 1

Anaesthesia

Monitoring

Answer 1

• ECG
• Non-Invasive/Invasive BP
• Pulse Oximetry (Sp02)
• Capnography
• Temperature
• BIS
• CVP

Question 2

Types of Anaesthetics:

Answer 2

• General
• Local Infiltration
• Regional
• Spinal/Epidural
• Sedation

Question 3

General Anaesthesia

Answer 3

A reversible, unconscious state characterised by amnesia/sedation, analgesia and
suppression of reflexes (anaesthetic triad)

Question 4

Induction and Maintenance:

General Anaesthesia

Answer 4

• IV induction (Propofol, Thiopental)
• Inhalation agents - Volatiles (Sevoflurane, Isoflurane)
• Non-volatile (Nitrous oxide, Xenon)

Question 5

General AnaesthesiaAnalgesics

Answer 5

• Opioid analgesics - monitor for PONV (use of antiemetics)
• Important to provide pain relief during procedure and monitor physiological
  changes

Question 6

Muscle Relaxants

Answer 6

Achieved by blocking neuromuscular activity at the motor end plate of skeletal
muscles.

Question 7

Muscle RelaxantsDepolarising

Answer 7

• Suxamethonium - short-acting (30-60 seconds) and lasts 3-5minutes
• Often used in emergency airway management
• Onset - fasciculation/ muscle twitching

Question 8

Muscle Relaxants Non-Depolarising

Answer 8

• Longer acting and used to maintain paralysis for duration of procedure if
  required (i.e. rocuronium, atracurium)
• Reversal drugs (Neostigmine - bradycardia, Sugammadex) may be used to
  terminate affect … may need nerve stimulator assessment

Question 9

Local/Regional Anaesthetic

Answer 9

• Use of local anaesthetic drugs (lignocaine, bupivacaine, ropivacaine) to
  block sensory nerve pathways
• May be used in conjunction with general anaesthetic
  disadvantages:

Question 10

Local/Regional Anaesthetic includes

Answer 10

regional nerve blocks, infiltration at site of surgery, sprays, topical gels etc.,

Question 11

Local/Regional Anaesthetic advantages

Answer 11

• minimal respiratory impairment- less nausea and vomiting (reduces need for opioids)- more rapid mobilisation and discharge

Question 12

Local/Regional Anaesthetic disadvantages:

Answer 12

• limit to volume able to be used

- can take time to work

Question 13

Spinal: anaesthesia

Answer 13

Single administration of local anaesthetic directly into

subarachnoid space - usually L3-4 or L4-L5

Question 14

Epidural aneasthesia

Answer 14

: Intermittent/continuous injection of local through

catheter that is inserted in Epidural space

Question 15

Spinal/Epidural Anaesthesia

Answer 15

• Onset can cause hypotension (ensure BP monitoring)
• Patient must position back in c-shape to maximise space
  between spinous process
• post-operative neurological monitoring required = ice test