Anesthesia and Pain Management Quiz

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Questions and Answers

What is the recommended dosage range for the maintenance of anesthesia in adults?

0.5–2.5 mcg/kg/min

0.05–2 mcg/kg/min (correct)

1–4 mcg/kg/min

0.1–3 mcg/kg/min

What is a common adverse effect of tramadol?

Pulmonary edema (correct)

Respiratory stimulation

Severe hypotension

Increased gastrointestinal motility

Which patient condition contraindicates the use of tramadol?

Controlled epilepsy

Hypersensitivity to tramadol (correct)

Postoperative pain

Moderate cardiac disease

For a pediatric patient, what is the initial dose of tramadol if no response is noted?

100 mcg/kg Signup and view all the answers

What type of injection is indicated for immediate administration of tramadol at birth?

Intramuscular Signup and view all the answers

What is the maximum total dose of paracetamol that can be administered including the initial bolus?

250 mg Signup and view all the answers

Following surgery, what is the initial bolus dose of paracetamol given for pain management?

100 mg Signup and view all the answers

Which of the following drugs is an alternative for postoperative pain relief that does not affect respiration?

Paracetamol Signup and view all the answers

What is one of the main features used in multimodal systems to reduce drug administration errors?

Standardized color-coded labels Signup and view all the answers

What does the automated dispensing machine primarily enhance in medication management?

First-dose availability Signup and view all the answers

Which of the following is NOT a reason for medication errors mentioned?

Overconfidence in skills Signup and view all the answers

What does a barcode reader assist with in a multimodal system?

Providing auditory and visual verification Signup and view all the answers

Which aspect is improved by using well-built rules in medication management?

Improving technical supplementation Signup and view all the answers

In what way can medication errors specifically related to anesthetic gases be reduced?

Implementing automated drug cabinets Signup and view all the answers

Which of these factors does NOT contribute to medication administration errors?

Effective workspace organization Signup and view all the answers

What is one key benefit of having prefilled syringes for commonly used drugs?

They help reduce documentation errors. Signup and view all the answers

What is the primary goal of general anesthesia?

Inducing hypnosis/unconsciousness Signup and view all the answers

Which agent is commonly used as a sedative-hypnotic in GA induction?

Midazolam Signup and view all the answers

What is the purpose of using a neuromuscular blocking agent (NMBA) during GA?

Facilitate intubation and muscle relaxation Signup and view all the answers

What characterizes Stage I of general anesthesia?

Analgesia while the patient remains conscious Signup and view all the answers

Which method can also be used to sustain general anesthesia besides inhalation?

Total Intravenous Anesthesia (TIVA) Signup and view all the answers

What is the survival time of Mycobacterium Tuberculosis in soda-lime?

3 hours Signup and view all the answers

What is the primary use of rocuronium bromide?

Rapid sequence intubation and routine tracheal intubation Signup and view all the answers

What efficiency does High-Efficiency Particulate Air (HEPA) filters maintain?

Maintained efficiency during wet conditions Signup and view all the answers

What happens during the emergence phase of general anesthesia?

There is a return of consciousness and movement Signup and view all the answers

What is a common contraindication for the use of atracurium?

Hypersensitivity to atracurium or cisatracurium Signup and view all the answers

What is the primary purpose of adjuvant IV agents during GA induction?

Reduce the total dose of individual anesthetic agents Signup and view all the answers

Which area of anesthesia equipment requires cleaning as per manufacturer’s instructions?

Airway Breathing System (ABS) Signup and view all the answers

During which stage of general anesthesia does the patient often exhibit excitement or delirium?

Stage II (Excitement) Signup and view all the answers

What is the maintenance dose of cisatracurium for intubation?

0.03 mg/kg Signup and view all the answers

What is the recommended disinfection method for vials’ rubber stoppers and necks?

Scrubbing with 70% alcohol Signup and view all the answers

Which of the following muscle relaxants has no contraindications for patients with renal impairment?

Cisatracurium Signup and view all the answers

What type of filter includes mechanical filters that stop larger particles?

Type one filters Signup and view all the answers

Why is it important to disinfect peripheral intravenous tubing stopcocks?

To reduce risk of external surface contamination Signup and view all the answers

What is the intubating dose of pancuronium?

0.5 mg/kg Signup and view all the answers

Which type of filter attracts and holds charged particles?

Electrostatic filters Signup and view all the answers

Which adverse effect is common with the use of pancuronium?

Prolonged neuromuscular blockade Signup and view all the answers

What is a precaution to consider when administering rocuronium?

Bronchial asthma Signup and view all the answers

What practice should be standard prior to each use of medication vials?

Disinfecting with 70% alcohol Signup and view all the answers

Which of the following muscle relaxants is metabolized by Hofmann elimination?

Atracurium Signup and view all the answers

What is the primary function of HME/filters in relation to the ETT?

To retain exhaled moisture Signup and view all the answers

Where should the HME/filter be placed to ensure effective patient humidification?

Directly in contact with the ETT port Signup and view all the answers

Which technology is commonly used to produce ultraclean air in operating theatres?

Ultraviolet Germicidal Irradiation (UVGI) Signup and view all the answers

What impacts the efficacy of the UV disinfection process?

The distance from the light source to the surface being disinfected Signup and view all the answers

What is a major advantage of UVGI over traditional systems in operating theatres?

It is cheaper than modern air filtration systems Signup and view all the answers

What is one potential consequence of placing the HME/filter in a distal position?

Decreased absolute humidity and temperature of the incoming air Signup and view all the answers

Which of the following statements about UVGI systems is accurate?

Their efficiency is equal to that of traditional filtration systems Signup and view all the answers

Which component of the anesthesia machine is crucial for avoiding hypoxic gas mixtures?

Oxygen flush valve Signup and view all the answers

Which type of lamps are commonly used in UVGI systems?

Low pressure mercury lamps Signup and view all the answers

What is one of the main functions of a scavenging system in anesthesia machines?

To prevent the escape of gases into the operating theatre Signup and view all the answers

Study Notes

Pharmacology of Anesthesia

General anesthesia (GA) is used for most major surgeries
GA aims to achieve hypnosis/unconsciousness, amnesia, analgesia, muscle relaxation, and autonomic/sensory blockade
Stages of GA include analgesia (Stage I), excitement (Stage II), surgical anesthesia (Stage III), and medullary paralysis (Stage IV).
Stage II (Excitement) is often bypassed by proper drug administration
Induction of GA uses IV and/or inhalation agents, often with adjuvant IV agents and neuromuscular blocking agents (NMBA) if endotracheal intubation is planned
Maintenance of GA often uses a primary inhalation technique or a combination of inhalation and IV anesthetic agents to reduce the total dose of any single agent
Emergence from GA is the return of consciousness and movement after discontinuation of anesthetic agents.

Main Types of Medications Used in General Anesthesia

Induction medications to induce and maintain unconsciousness (IV and volatile agents)
Analgesics for pain relief
Muscle relaxants to induce muscle relaxation
Other frequently used medications in anesthesia include medications to quickly reduce memory loss or amnesia, prevent nausea and vomiting, counteract the effects of other medicines, and suppress or stimulate nervous reflexes

Essential Introduction to Pharmacology

Pharmacokinetics (PK) is the study of what the body does to the drug and is divided into absorption, distribution, metabolism, and excretion
Pharmacodynamics (PD) is the study of what the drug does to the body and how it acts, depends on the properties of the medication, or binding of specific receptors and enzymes

Induction Medications

Generally, induction agents are either intravenous or inhalation
Intravenous agents include thiopentone, etomidate, ketamine, and propofol, commonly used to quickly unconscious patients.

Intravenous Anesthetics-Thiopental Sodium

Form: powder for solution for injection
Uses: induction of anesthesia before administering inhalational anesthetics or for short duration procedures
Contraindications: inability to maintain airway, cardiovascular disease, dyspnea, or hypersensitivity

Analgesics

Analgesics vary in mechanism, but are commonly extracted from opium or synthetically created to reduce or remove pain.
Opiate and opioid analgesics are often used in general anesthesia, along with other agents
Examples of commonly used analgesics are morphine, fentanyl, and remifentanil

Antagonists

Opioid antagonists can reverse the effects of opioid analgesics used in anesthesia, such as respiratory depression.
An example of such an antagonist is naloxone hydrochloride.

Muscle Relaxants

Muscle relaxants weaken or relax skeletal muscles, impacting voluntary and involuntary muscles.
Examples of such relaxants include succinylcholine, vecuronium, pancuronium, rocuronium, mivacurium, and cisatracurium

Reversal of Neuromuscular Block

Cholinesterase inhibitors, such as neostigmine methylsulfate, reverse the effects of muscle relaxants and allow for spontaneous respiration.

Medication Errors During Anesthesia

Human error is a factor but there's still a lack of a clear plan for eliminating such errors in the delivery of medicines.
Standardized procedures (e.g., systems for medication identification and storage), customized workspaces, and prefilled syringes for common drugs are ways to reduce errors.
Using barcodes and drug labeling systems, and including a second staff member to verify high-alert medications and narcotics are crucial to preventing such errors

Aseptic technique aims to prevent the spread of potentially pathogenic micro-organisms to susceptible sites to avoid infections.
The approach involves rigorous cleaning and disinfection of equipment and the operating environment
Proper Hand hygiene (HH) is vital and should be performed at several critical points during procedures
Single-use equipment is preferable to reduce contamination, and multiple use tools require thorough cleaning and sterilization between patients.

Cuff Pressure Gauge

Cuff pressure gauge measures pressure in ETT, LMA, LT to ascertain safe pressure limits to prevent complications
It has a luer attachment, rubber hand bulb for inflation, pressure display gauge, and pressure release valve.

Defibrillators

Applying electrical current to the heart can help convert severe cardiac arrhythmias (VF/VT) into a normal sinus rhythm
Defibrillators can provide electricity via pads/electrodes to the chest of patients undergoing cardiac arrest
The device is an indispensable part of cardiopulmonary resuscitation (CPR) procedure and cardiac arrest management.

Laryngoscopes and Blades

Laryngoscopes are instruments used during endotracheal intubation, helping visualize vocal cords, and facilitate intubation
Laryngoscope blades vary in style and may be disposable or reusable, each with distinct advantages, depending on use patterns

Cleaning of the Operating Theatre

Post-patient procedures, cleaning of the room and floor involving potential pathogens is required
This ensures a safe environment for subsequent procedures, and the cleaning schedule and protocol should conform to facility and trust guidelines.
Anaesthetists use PPE, such as gowns, masks, and gloves.

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Description

Test your knowledge on anesthesia maintenance, tramadol use, and pain management strategies. This quiz covers dosages, contraindications, alternative medications, and tools used in medication management. Perfect for healthcare professionals and students alike!