General Anaesthesia Induction Quiz
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Questions and Answers

What is the most common method of induction for general anesthesia?

  • Intramuscular injection
  • Intravenous injection (correct)
  • Sublingual administration
  • Inhalation of volatile agent

    • Inhalant induction is faster than intravenous injection.

    False

    Name one injectable agent used for inducing general anesthesia.

    ketamine

    General anesthesia may be maintained using __________ after initial induction.

    <p>inhalants</p> Signup and view all the answers

    Match the following inhalant anesthesia characteristics with their descriptions:

    <p>Isoflurane = Fast-acting inhalant anesthetic Induction Chamber = Method for inhalant administration IV Injection = Fastest route for anesthesia induction Premedication = Preparation before inhalant induction</p> Signup and view all the answers

    What is the primary purpose of the cuff in an endotracheal tube?

    <p>To provide a seal and prevent aspiration</p> Signup and view all the answers

    Endotracheal tubes are available only in one standard size for all animals.

    <p>False</p> Signup and view all the answers

    What is the purpose of using laryngoscopes during the placement of an endotracheal tube?

    <p>To increase the visibility of the larynx.</p> Signup and view all the answers

    The size classification of endotracheal tubes is most commonly based on the __________ of the tube.

    <p>internal diameter</p> Signup and view all the answers

    Match the following features with their corresponding characteristics:

    <p>Flexible = Allows for adequate cleaning Cuff = Prevents waste gas leakage Beveled end = Designed for patient end usage Laryngoscope = Improves visibility during tube placement</p> Signup and view all the answers

    Which of the following inhalants has the lowest Minimum Alveolar Concentration (MAC)?

    <p>Methoxyflurane</p> Signup and view all the answers

    A higher blood:gas solubility coefficient indicates faster induction and recovery.

    <p>False</p> Signup and view all the answers

    What does the Minimum Alveolar Concentration (MAC) indicate?

    <p>The lowest concentration that produces no response to painful stimulus in 50% of patients.</p> Signup and view all the answers

    The ideal inhalant for quick induction should have a ________ blood:gas solubility coefficient.

    <p>low</p> Signup and view all the answers

    Match the following inhalants with their MAC values:

    <p>Methoxyflurane = 0.23% Halothane = 0.87% Isoflurane = 1.28% Sevoflurane = 2.1-2.3%</p> Signup and view all the answers

    What is the main advantage of low solubility inhalants?

    <p>They allow for rapid response to anesthetic concentration changes.</p> Signup and view all the answers

    Methoxyflurane would be suitable for use in a non-precision vaporizer without control of delivery amount.

    <p>True</p> Signup and view all the answers

    What type of material are the most commonly used endotracheal tubes made of?

    <p>Flexible material (vinyl plastic)</p> Signup and view all the answers

    Fast-acting inhalants are preferred to ensure ________ during anesthesia.

    <p>quick changes in anesthetic depth and recovery</p> Signup and view all the answers

    What is the importance of an inhalant agent's MAC?

    <p>It indicates the appropriate vaporizer setting for anesthesia.</p> Signup and view all the answers

    What is the recommended flow rate during recovery for both rebreathing and non-rebreathing systems?

    <p>100-200 mL/kg/min</p> Signup and view all the answers

    A vaporizer setting of 1.5 x MAC of isoflurane is used during the maintenance phase of general anesthesia.

    <p>True</p> Signup and view all the answers

    What should you do if the carbon dioxide absorber is not functioning properly?

    <p>Increase the flow rate to act as a non-rebreathing system.</p> Signup and view all the answers

    During the recovery phase, the vaporizer is turned _____ to help increase the removal of inhalants.

    <p>OFF</p> Signup and view all the answers

    Match the following animals with their calculated oxygen flow rate based on their weight:

    <p>3.5 kg cat = 700 mL/min 25 kg dog = 5000 mL/min 10 kg dog = 2000 mL/min 5 kg cat = 1000 mL/min</p> Signup and view all the answers

    What components are included in a partial rebreathing system?

    <p>CO2 absorber</p> Signup and view all the answers

    In non-rebreathing systems, fresh gas mixes with expired air.

    <p>False</p> Signup and view all the answers

    What is the recommended weight limit for patients using rebreathing systems?

    <p>7 kg (15 pounds)</p> Signup and view all the answers

    The _____ volume is the amount of gas passing in and out of the lungs with each breath.

    <p>tidal</p> Signup and view all the answers

    Match the systems with their characteristics:

    <p>Partial Rebreathing System = Recycles exhaled air Non-Rebreathing System = Delivers fresh gas only Oxygen Flow Rate = Crucial for system function CO2 Absorber = Removes expired carbon dioxide</p> Signup and view all the answers

    During which stage of general anesthesia are the highest flow rates required for both types of breathing systems?

    <p>Induction</p> Signup and view all the answers

    Waste gas management is one of the factors influencing the choice between rebreathing and non-rebreathing systems.

    <p>True</p> Signup and view all the answers

    What flow rate is commonly used in the lab for partial rebreathing systems?

    <p>30 mL/kg/min</p> Signup and view all the answers

    Patients under _____ kg are generally recommended to use non-rebreathing systems.

    <p>7</p> Signup and view all the answers

    What is crucial for the proper functioning of both rebreathing and non-rebreathing systems?

    <p>Oxygen flow rate</p> Signup and view all the answers

    Study Notes

    General Anaesthesia Induction

    • General anaesthesia can be induced by intravenous injection or direct inhalation of a volatile agent.
    • Intravenous injection is the most common induction method.
    • Common intravenous induction agents include:
      • Ketamine/diazepam (ket/val)
      • Propofol
      • Alfaxalone
      • Butorphanol/diazepam (neuroleptanalgesia)
    • Induction with inhalants is more gradual than intravenous injection.
    • Induction can be achieved by fast-acting inhalant anesthetics (eg. isoflurane).
    • Induction with inhalants may be administered by mask or induction chamber.

    Inhalant Induction Cautions

    • Inhalant induction not practical in large patients.
    • Significant inhalant waste.
    • Can be stressful to the patient.
    • Slower process, more adverse effects in certain patients (eg. poor respiratory function).
    • Delayed control of the airway.

    Solubility Coefficient (SC)

    • SC refers to the distribution of anesthetic vapor between blood and gas (alveoli).
    • SC expressed as a blood:gas solubility coefficient.
    • Low blood:gas SC indicates inhalant is not very soluble in blood.
    • High blood:gas SC indicates inhalant is readily soluble in blood.
    • SC influences induction speed and recovery.
    • Low SC, faster induction and recovery.
    • High SC, slower induction and recovery.
    • Ideal to have "fast-acting" inhalants for quicker induction, changes in anesthetic depth, and recovery.

    Minimum Alveolar Concentration (MAC)

    • MAC is the lowest concentration of anesthetic that produces no response to painful stimulus in 50% of patients.
    • Used to determine average vaporizer setting for surgical anesthesia.
    • Indicates the inhalant's "strength."
    • Low MAC, potent agent (small amount required for anesthesia).
    • High MAC, more agent required for anesthetic effect.
    • MAC acts as a guideline for the vaporizer setting.
    • 1 x MAC generally produces light anesthesia.
    • 1.5 x MAC produces surgical depth of anesthesia.
    • 2 x MAC produces deep anesthesia.

    Endotracheal Tubes (ET Tubes)

    • ET tubes deliver anesthetic gas from the machine to the patient.
    • Made of flexible material (vinyl plastic).
    • Most commonly used tubes have a beveled end.
    • Available in different sizes, classified by internal diameter (mm).
    • Can have a cuff for sealing between the tube and the patient’s trachea.
    • Uncuffed tubes preferred in small patients (birds).

    ET Tube Benefits

    • Prevent leakage of waste gas around the cuff.
    • Reduce aspiration risk.

    ET Tube Cautions

    • Don't completely rely on the cuff to prevent aspiration.
    • Avoid overinflating the cuff.
    • Monitor and remove the ET tube during recovery.

    Laryngoscopes

    • Increase visibility of the larynx when placing an ET tube.

    Anesthetic Delivery Systems

    • Designed to deliver volatile gas anesthetic to and from patients via a breathing circuit.
    • Deliver gas via partial and total rebreathing systems.

    Partial Rebreathing System

    • Includes CO2 absorber, unidirectional valves, pop-off valve, reservoir bag, pressure gauges, and soda lime.
    • Patients recycle or rebreath exhaled air (minus carbon dioxide).
    • Fresh gas and expired air mixing is re-breathed.
    • Oxygen flow rate crucial.

    Non-rebreathing System

    • Flow of gas from fresh gas source to the patient during inspiration.
    • Fresh gas delivered during exhalation to push expired gas out.
    • High oxygen flow rates ensure no rebreathing of expired air.
    • No mixing of fresh gas and expired air.
    • Every breath is fresh gas.

    Choosing a Rebreathing System

    • Decision based on patient size, convenience, cost, control of anesthetic depth, and waste gases.
    • Patient respiratory muscles are key for gas movement through the system.
    • Equipment resistance can be challenging for smaller animals.
    • Rebreathing systems recommended for patients weighing 7 kg (15 pounds) or over.
    • Non-rebreathing systems recommended for patients under 7 kg.
    • Oxygen flow rate is crucial for both systems.

    Flow Rates During Induction

    • Highest flow rates during mask induction: ~ 300 ml/kg/min.
    • Chamber induction: ~ 5 L/min.
    • Injectable induction: ~ 200 ml/kg/min.

    Flow Rates During Maintenence

    • Partial Rebreathing Systems: 20-200 ml/kg/min.
    • Non-rebreathing Systems: 200-300 ml/kg/min (similar to minute ventilation).

    Flow Rates During Recovery

    • Higher flow rates to increase removal of inhalant: ~ 100-200 ml/kg/min.

    Key Concepts Summary

    • Vaporizer setting: 1.5 x MAC for isoflurane during maintenance.
    • Non-rebreathing system: High flow rates can be used to create a non-rebreathing system.
    • Non-rebreathing system and CO2 absorber: Non-rebreathing system can't convert to rebreathing system.
    • Inhalant concentration: Actual inhalant concentration is affected by rebreathing.
    • Anesthetic Machine Regulation: Oxygen flow meter and vaporizer are regulated during induction, maintenance, and recovery.

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    Description

    This quiz covers the essential concepts of general anaesthesia induction, including various methods like intravenous injection and inhalation. It discusses common agents used in induction and highlights cautions associated with inhalant induction. Test your knowledge on the solubility coefficient and its implications in anaesthesia.

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