Types of anesthesia Flashcards
what is the triad of anesthesia
- unconsciousness (hypnosis/ amnesia)
- analgesia
- muscle relaxation (paralysis)
what are features of a good anesthetic (5)
- Abolish pain
- Be completely reversible
- Be safe
- Provide good operating conditions
- Acceptable to the patient
what is general anesthesia
drug induced reversible depression of the CNS, resulting in loss of response to and perception of all external stimuli.
- The ability to independently maintain ventilatory function is often impaired
what is regional anesthesia
the art of rendering a part of the body insensible to pain for surgical operation to be conducted- while the patient maintains their airway and breathing on their own
what is the classification of anesthesia (3)
- general anesthesia
- regional anesthesia
- sedation
what airway adjuvants can be done with GA (3)
- GA with Face mask
- GA with supraglottic Airways
- GA with ETT
what are types of regional anesthesia (2)
- Neuraxial (Spinal, Epidural…)
- Nerve blocks
- Brachial plexus, wrist, penile, inguinal, sciatic, femoral, ankle blocks,
what is conscious sedation
it is a minimally depressed level of consciousness that retains the patients ability to independently and continuously maintain an airway and respond appropriately to physical stimulation/verbal command.
what are the phases of GA (3)
- induction
- maintenance
- recovery
what medication can you use for induction (4)
- IV
- propofol
- Thiopental
- Ketamine
- etomidate
- opioids - Gas
- Sevoflurane
- halothane - Muscle relaxants
- Suxamethonium
- Vecuronium
- Rocuronium - Analgesic: multimodal
what drugs do you use for maintenance of GA (2)
- IV
- Gas
- sevoflurane
- halothane
- isoflurane
- desflurane
what makes up induction
it from the beginning of anesthesia administration up until surgical anesthesia begins
what are surgical procedure indications for performing GA (4)
- Requiring profound muscle relaxation
- Duration more than 3hrs
- Incision above umbilicus
- Inability to provide comfort with local/regional anesthesia
what are indications for sedation (5)
- Anxiety and phobia
- Medical conditions potentially aggravated by stress
- Medical conditions affecting patient’s ability to cooperate
- Special needs
- Relief of muscle spasm
how do you cause recovery of GA
reversal of muscle relaxants
what are indications of GA (2)
- by surgical procedure
- by patient
what are patient indications for performing GA (4)
- Airway protection
- Respiratory failure
- Unstable clinical state
- Inability to cooperate/understand regional
what are advantages of GA (6)
- Rapid onset
- Titration is possible
- Airway is guaranteed
- Patient cooperation in not absolutely essential
- Patient is unconscious
- Amnesia is present
what are disadvantages of GA (7)
- Patient is unconscious
- Protective reflexes depressed
- Vital signs are depressed
- Advanced training required
- Special equipment required
- Recovery area should be available
- Intraoperative complications are more likely to occur during GA
what are disadvantages of RA (6)
- Pain on injection
- In Spinal anesthesia, there is significant hypotension
- Post dural-puncture headache
- Loss of sphincter function for a period of time
- Risk of nerve damage
- Infection of the spine if unsterile
what is spinal anesthesia
aims at achieving controlled level of sensory and motor blockade by administration of local anesthetic drug into the subarachnoid space.
what are the types of sedation (3)
- minimal
- conscious
- deep
what are advantages of regional anesthesia (6)
- Less confusion post op
- Better pain control
- Less risk for PONV
- Fast return to feeds
- Less impact of cardiopulmonary function
- Less risk for chest infections
what are examples of local anesthetics (2)
- esters
- tetracaine
- procaine - amides
- lidocaine/ lignocaine
- bupivacaine
what are examples of procedures for sedation (8)
- Reduction
- Fracture, dislocation - Electrical cardioversion
- Insertion of chest tube
- CT/MRI
- FB removal
- LP
- Foley catheter placement
- Laceration repair
what are medications for conscious sedation (3)
- benzodiazepines
- opioids
- anesthetics
what benzodiazepines can be used for conscious sedation (2)
- midazolam
- diazepam
what opioids can be used for conscious sedation (3)
- fentanyl
- morphine
- pethidine
what anesthetics can be used for conscious sedation (3)
- thiopental
- ketamine
- propofol
