General Anesthesia Overview
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General Anesthesia Overview

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Questions and Answers

What is the primary purpose of volatile anesthetics during a surgical procedure?

  • To eliminate pain entirely
  • To maintain normal blood pressure
  • To induce immediate unconsciousness
  • To offer good minute-to-minute control over the depth of anesthesia (correct)

    • Stage II of anesthesia involves a patient experiencing complete loss of consciousness.

    False

    What role do opioids, such as fentanyl, play during anesthesia?

    They are used for pain management in conjunction with inhalation agents.

    The stage characterized by severe depression of respiratory and vasomotor centers is Stage ___.

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

    Which stage of anesthesia is described as having regular respiration and relaxation of skeletal muscles?

    <p>Stage III</p> Signup and view all the answers

    Recovery from anesthesia typically involves the reverse of induction processes.

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

    What does MAC stand for in anesthesiology?

    <p>Minimal Alveolar Anesthetic Concentration</p> Signup and view all the answers

    Match the stages of anesthesia with their characteristics:

    <p>Stage I = Analgesia and reduced awareness of pain Stage II = Excitement and delirium Stage III = Surgical anesthesia with relaxation of muscles Stage IV = Severe respiratory and vasomotor depression</p> Signup and view all the answers

    Balanced anesthesia typically includes a mixture of ___ and intravenous agents.

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

    It is acceptable to allow a patient to remain in Stage II during a surgical procedure.

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

    What is a primary reason for using general anesthesia?

    <p>To ensure loss of response and perception of external stimuli</p> Signup and view all the answers

    Halogenated hydrocarbons are used exclusively for intravenous delivery of general anesthetics.

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

    Name one category of preanesthetic medication.

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

    The process of administration of anesthetics typically begins with the ______ stage, where the patient is induced into a state of unconsciousness.

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

    Match the following types of anesthetics with their method of delivery:

    <p>Propofol = Intravenous Halothane = Inhalation Benzodiazepines = Sedation preanesthesia Opioids = Pain relief</p> Signup and view all the answers

    Which of the following is NOT a stage of anesthesia?

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

    Muscle relaxants are used to enhance muscle tone during surgery.

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

    What is a key patient factor to consider before administering anesthetics?

    <p>Cardiovascular function</p> Signup and view all the answers

    Anesthesia administered via the ______ method involves inhaled volatile agents.

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

    What is the primary purpose of using preanesthetic medications?

    <p>To calm the patient and relieve pain</p> Signup and view all the answers

    What is the primary goal of general anesthesia?

    <p>Minimizing the effects of anesthetic agents</p> Signup and view all the answers

    General anesthesia results in the patient being aware of their surroundings during a surgical procedure.

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

    Which receptor do most intravenous anesthetics predominantly act upon?

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

    General anesthesia is characterized by unconsciousness, analgesia, and __________.

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

    Match the anesthetic agents with their classifications:

    <p>Nitrous Oxide = Inhalational anesthetic Propofol = Intravenous anesthetic Ketamine = NMDA receptor antagonist Benzodiazepines = CNS depressant</p> Signup and view all the answers

    What can increased concentrations of enflurane cause?

    <p>Muscle twitching</p> Signup and view all the answers

    Inhalation anesthetics are used primarily for inducing anesthesia.

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

    What is one potential side effect of general anesthesia related to body temperature?

    <p>Exposure to a cold environment</p> Signup and view all the answers

    General anesthetics can target potassium channels, glycine receptors, and __________ receptors.

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

    Which of the following describes the mechanism of action of inhalational anesthetics?

    <p>They facilitate GABA-mediated action at GABAA receptors</p> Signup and view all the answers

    Which inhalation anesthetic is known for having a low blood:gas partition coefficient?

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

    Nitrous Oxide is a volatile anesthetic.

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

    What is the primary characteristic of intravenous anesthetics like Propofol?

    <p>Rapid induction and recovery</p> Signup and view all the answers

    The risk associated with anesthetics is indicated by their steep dose-response curves and narrow __________.

    <p>therapeutic indices</p> Signup and view all the answers

    Match the following intravenous anesthetics with their characteristics:

    <p>Propofol = Rapid recovery and antiemetic action Thiopental = High lipid solubility leading to rapid sedation Methohexital = Fast induction drug commonly used in general anesthesia Barbiturates = Older class of anesthetics with prolonged effects</p> Signup and view all the answers

    Which factor does NOT affect the speed of induction for inhalation anesthetics?

    <p>Body weight</p> Signup and view all the answers

    Recovery is faster with anesthetics that have a high blood:gas partition coefficient.

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

    What potential side effect can occur during the induction of anesthesia using Propofol?

    <p>Marked hypotension</p> Signup and view all the answers

    Desflurane and sevoflurane are examples of __________ anesthetics.

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

    Which of the following is a major factor in eliminating inhalation anesthetics?

    <p>Redistribution from brain to blood</p> Signup and view all the answers

    Study Notes

    General Anesthesia

    • Reversible state of CNS depression where the patient loses response and perception of external stimuli
    • Used for surgical and medical procedures
    • Offers benefits such as sedation, reduced anxiety, lack of awareness, amnesia, skeletal muscle relaxation, suppression of undesirable reflexes, and analgesia
    • Low therapeutic indices
    • Modern anesthetics act more rapidly and achieve deep anesthesia quickly

    Stages of Anesthesia

    • Induction: period between administering anesthetic and achieving effective surgical anesthesia
    • Induction typically starts with IV anesthetic like propofol
    • Maintenance: patient is surgically anesthetized and anesthesiologist monitors and adjust anesthetic dose based on vital signs and response to stimuli
    • Recovery: involves withdrawing anesthetic mixture and monitoring patient's return to consciousness

    Depth of Anesthesia

    • Divided into four stages
    • Each stage characterized by increased CNS depression
    • Stage I: Analgesia, amnesia and reduced awareness of pain
    • Stage II: Disinhibition, excitement, patient experiences delirium and possibly violent behavior, avoid this stage
    • Stage III: Surgical anesthesia, regular respiration, relaxation of skeletal muscles, eye reflexes decrease progressively until eye movements cease and pupil is fixed
    • Stage IV: Medullary depression/paralysis, severe depression of respiratory and vasomotor centers, death can rapidly ensue

    Anesthesia Overview

    • Three main objectives: minimize deleterious effects of anesthetics, sustain physiologic homeostasis during surgery, improve postoperative outcomes
    • Depress the central nervous system
    • IV and inhalational administration preferred

    Molecular Actions

    • Most IV anaesthetics act through GABAA receptor
    • NO, Ketamine and Xenon likely to produce unconsciousness via inhibition of NMDA receptor and glutamate receptors

    Mechanism of Action

    • CNS depressants
    • Increase firing threshold of CNS neurons by acting on ion channels and receptor targets
    • Increase chlorine conductance and reduce cell firing by facilitating GABA-mediated action at GABAA receptors
    • General anaesthetics can also target potassium, glycine, and serotonin receptors

    General Effects of Anesthesia

    • CNS Effects: decreased vascular resistance and increased cerebral blood flow, can cause increased intracranial pressure
    • Hemodynamic Effects: decrease in systemic arterial BP, direct vasodilation, myocardial depression
    • Respiratory depression
    • Malignant hyperthermia
    • Nausea and vomiting
    • Postoperative pneumonia

    Inhalation Anesthetics

    • Mainstay of anesthesia
    • Primarily used for maintaining anesthesia after administering an IV agent
    • Depth of anesthesia can be rapidly altered by changing the concentration of the drug
    • Reversible because most are rapidly eliminated from the body by exhalation
    • Steep dose-response curves and narrow therapeutic indices
    • Potency roughly proportional to lipid solubility

    Current Inhalation Anesthetics

    • Nitrous Oxide (a gaseous anesthetic)
    • Vapourised liquid halogenated hydrocarbons (halothane, desflurane, enflurane, isoflurane, and sevoflurane)
    • Speed of induction dependent on several factors: solubility, inspired gas partial pressure, ventilation rate, pulmonary blood flow, and arteriovenous concentration gradient
    • Elimination: inhaled agents redistributed from the brain to the blood, from blood to alveolar air, and eliminated through the lungs

    Recovery

    • Recovery rate from anesthesia using agents with low blood: gas partition coefficients are faster than anaesthetics with high blood solubility
    • Low blood solubility leads to shorter recovery time

    Intravenous Anesthetics

    • Propofol: produces anesthesia and recovery rapidly, has antiemetic action, commonly used component of balanced anesthesia, can cause marked hypotension during induction
    • Barbiturates: Thiopental and methohexital, high lipid solubility, promote rapid entry into the brain, result in surgical anesthesia in one circulation time

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    Related Documents

    General Anaesthetics PDF

    Description

    This quiz covers the essentials of general anesthesia, including its definition, stages, and depth. Learn about the induction, maintenance, and recovery phases of anesthesia, as well as the benefits and risks associated with its use. Test your understanding of this critical aspect of surgical medicine.

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