Podcast
Questions and Answers
What is a primary benefit of using Ketamine as an anaesthetic drug?
What is a primary benefit of using Ketamine as an anaesthetic drug?
What is a common side effect of Ketamine that users should be cautious about?
What is a common side effect of Ketamine that users should be cautious about?
What is the purpose of supplementing Ketamine with fentanyl or morphine during anaesthesia?
What is the purpose of supplementing Ketamine with fentanyl or morphine during anaesthesia?
Which of the following is a key characteristic of Propofol?
Which of the following is a key characteristic of Propofol?
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What combination is referred to as Ketofol?
What combination is referred to as Ketofol?
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What is a significant disadvantage of using thiopentone?
What is a significant disadvantage of using thiopentone?
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Which of the following agents is specifically noted for causing muscle rigidity when administered in high doses?
Which of the following agents is specifically noted for causing muscle rigidity when administered in high doses?
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For which of the following agents is there a risk of hyperkalaemia?
For which of the following agents is there a risk of hyperkalaemia?
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What is a noted concern with the use of morphine/midazolam infusion?
What is a noted concern with the use of morphine/midazolam infusion?
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What is the initial dosing recommendation for fentanyl in an infusion?
What is the initial dosing recommendation for fentanyl in an infusion?
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What is a significant risk of administering standard doses of anaesthetic agents to trauma patients?
What is a significant risk of administering standard doses of anaesthetic agents to trauma patients?
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Which anaesthetic agent is reported to have a quick onset but is also a potent vasodilator?
Which anaesthetic agent is reported to have a quick onset but is also a potent vasodilator?
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How does ketamine differ from thiopentone and propofol in terms of analgesic properties?
How does ketamine differ from thiopentone and propofol in terms of analgesic properties?
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Which paralytic is noted for being the fastest in onset and shortest in return of neuromuscular function?
Which paralytic is noted for being the fastest in onset and shortest in return of neuromuscular function?
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What is the main advantage of using rocuronium in trauma care?
What is the main advantage of using rocuronium in trauma care?
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What is the most significant reason for preferring fentanyl over morphine in trauma anaesthesia?
What is the most significant reason for preferring fentanyl over morphine in trauma anaesthesia?
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Which combination is commonly used for maintenance of balanced anaesthesia?
Which combination is commonly used for maintenance of balanced anaesthesia?
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Why was ketamine traditionally considered contraindicated in traumatic head injuries?
Why was ketamine traditionally considered contraindicated in traumatic head injuries?
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Study Notes
Anaesthetic Agents
- Induction of general anesthesia in trauma patients often uses reduced doses of common agents, titrated to effect. Standard elective doses can cause cardiovascular collapse by removing the compensatory sympathetic response to shock.
- Propofol, thiopentone, and ketamine are commonly used in rural Australia.
- Thiopentone, a barbiturate, has a fast onset but can cause hypotension. It's not commonly used.
- Propofol, a GABA agent, has a rapid onset and recovery, and antiemetic properties.
- Ketamine, an NMDA antagonist, produces dissociative anesthesia while maintaining some brain stem function (like respiration) and provides analgesia, unlike thiopentone and propofol. Ketamine helps maintain the sympathetic response to shock. Standard doses can have a direct myocardial depressant effect, so reduced titrated doses in cases of shock are recommended. Traditional teaching considered it contraindicated in traumatic head injuries due to concerns about raised intracranial pressure, but current research shows no proof of worsening outcomes.
- Fentanyl is the recommended opioid for trauma anesthesia due to its potency, shorter onset, and less histamine release compared to morphine.
- Rocuronium and suxamethonium are main paralytics. Rocuronium is useful for both rapid sequence intubation and maintaining neuromuscular blockade. Suxamethonium has the fastest onset and shortest neuromuscular recovery of the two.
Maintenance of Balanced Anesthesia
- Balanced anesthesia is typically achieved by infusing an induction agent with an analgesic (like morphine or fentanyl). Midazolam is often combined.
- Propofol with fentanyl is another common option.
- A ketamine infusion alone can provide balanced anesthesia, but often requires fentanyl/morphine supplementation for tachycardia and hypertension.
- Ketofol (a ketamine/propofol mix) is another option, which combines the benefits of the two while reducing their side effects, primarily the hypotension of propofol.
Trauma Anesthesia Dosing and Maintenance Table
- Tables provide dosing information for different drugs used in both induction and maintenance phases of anesthesia in a trauma setting, highlighting benefits and precautions. This includes drugs like Ketamine, Propofol, Thiopentone, Fentanyl, Rocuronium, and Suxamethonium. Key considerations include seizure control, analgesic effects, cardiovascular collapse risk, and recovery time, among other benefits and precautions.
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Description
Explore the use of anaesthetic agents during the induction of general anesthesia in trauma patients. This quiz covers key agents such as propofol, thiopentone, and ketamine, focusing on their effects and considerations in emergency situations. Test your knowledge on dosages, advantages, and contraindications associated with each agent.