Pharmacology 9th Lecture: Anesthesia
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Questions and Answers

What is the primary factor that determines the induction of anesthesia?

  • Depth of CNS depression
  • Consciousness and protective reflexes regained
  • Rate of anesthetic diffusion from the brain
  • Rate of effective concentration of the anesthetic reaching the brain (correct)
  • What is the main difference between induction and recovery?

  • Induction is faster, while recovery is slower
  • Induction involves an increase in CNS depression, while recovery involves its decrease (correct)
  • Induction is the development of surgical anesthesia, while recovery is the regain of consciousness
  • Induction is the administration of anesthesia, while recovery is its discontinuation
  • What is the primary goal of maintenance of anesthesia?

  • To induce surgical anesthesia
  • To regain consciousness
  • To provide pain relief
  • To sustain surgical anesthesia (correct)
  • What is the characteristic of the first stage of anesthesia?

    <p>Reduced sensation of pain with amnesia</p> Signup and view all the answers

    What is the last stage of anesthesia?

    <p>Medullary paralysis</p> Signup and view all the answers

    What happens to the CNS during the progression of anesthesia stages?

    <p>It becomes more depressed</p> Signup and view all the answers

    What is the term for the degree to which the CNS is depressed?

    <p>Depth of anesthesia</p> Signup and view all the answers

    What happens to the patient's consciousness during the first stage of anesthesia?

    <p>It is maintained</p> Signup and view all the answers

    What does the Greek word 'anaesthesia' mean?

    <p>Loss of sensation</p> Signup and view all the answers

    What is the primary characteristic of general anaesthesia?

    <p>Loss of consciousness and sensation of the whole body</p> Signup and view all the answers

    What is the term for the agents that produce general anaesthesia?

    <p>General anaesthetics</p> Signup and view all the answers

    What is the characteristic of regional anaesthesia?

    <p>Loss of sensation in a large, but limited area of the body</p> Signup and view all the answers

    In which stage of general anaesthesia is the patient most responsive?

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

    What is the primary goal of general anaesthesia?

    <p>To allow for easy and painless operation</p> Signup and view all the answers

    What is the term for the drugs used to produce local anaesthesia?

    <p>Local anaesthetics</p> Signup and view all the answers

    What is the state of general anaesthesia characterized by?

    <p>Reversible C.N.S inhibition</p> Signup and view all the answers

    What is the primary goal of ideal general anesthesia?

    <p>To induce anesthesia rapidly and smoothly, and permit rapid recovery of the patient</p> Signup and view all the answers

    What is the term used to describe the use of a combination of drugs to produce rapid induction of anesthesia and to ensure rapid recovery from the effects of GA with fewer side effects?

    <p>Balanced anesthesia</p> Signup and view all the answers

    Which of the following drugs is NOT an example of a pre-anesthetic agent?

    <p>Neuromuscular relaxants (succinylcholine)</p> Signup and view all the answers

    What is the primary role of neuromuscular relaxants in balanced anesthesia?

    <p>To facilitate intubation and relaxation</p> Signup and view all the answers

    What is the classification of general anesthetics based on?

    <p>Route of administration</p> Signup and view all the answers

    What type of anesthetics are used to maintain anesthesia during surgery?

    <p>Inhalational anesthetics</p> Signup and view all the answers

    Which of the following is a non-halogenated inhalation anesthetic?

    <p>Nitrous oxide</p> Signup and view all the answers

    What is the primary advantage of balanced anesthesia?

    <p>Rapid recovery from the effects of GA with fewer side effects</p> Signup and view all the answers

    Which intravenous anesthetic is a carboxylated imidazole?

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

    Which of the following is NOT a characteristic of an ideal general anesthetic drug?

    <p>Has a wide range of adverse effects</p> Signup and view all the answers

    What is the term used to describe the use of a single drug for induction and maintenance of anesthesia?

    <p>None of the above</p> Signup and view all the answers

    What is the advantage of using thiopental, propofol, and etomidate over inhaled agents?

    <p>They produce a smoother and more rapid anesthesia</p> Signup and view all the answers

    Which of the following is a barbiturate intravenous anesthetic?

    <p>Sodium thiopentone</p> Signup and view all the answers

    What is the mechanism of action of benzodiazepines as intravenous anesthetics?

    <p>GABA receptor agonism</p> Signup and view all the answers

    Which of the following is a non-barbiturate intravenous anesthetic?

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

    What is the brand name of the opioid fentanyl?

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

    Which of the following inhalation anesthetics is a non-flammable halogenated hydrocarbon?

    <p>Isoflurane (Forane)</p> Signup and view all the answers

    What is the primary function of inhalation anesthesia?

    <p>To maintain anesthesia after administration of I.V anesthetics</p> Signup and view all the answers

    Which of the following factors affects the transfer of general anesthetic from the lung to the blood and then to the brain?

    <p>Solubility in blood</p> Signup and view all the answers

    What is the MAC of nitrous oxide (N2O)?

    <p>100</p> Signup and view all the answers

    What is the effect of increasing the anesthetic concentration in the inspired air?

    <p>It increases the rate of induction</p> Signup and view all the answers

    Which of the following inhalation anesthetics is an inorganic agent?

    <p>Nitrous oxide (N2O)</p> Signup and view all the answers

    How does the potency of halothane compare to enflurane?

    <p>Halothane is 2 times more potent than enflurane</p> Signup and view all the answers

    What is the effect of increased pulmonary ventilation on the rate of induction?

    <p>It increases the rate of induction</p> Signup and view all the answers

    Study Notes

    Anesthesia

    • Anesthesia is a Greek word that means "loss of sensation".
    • There are three types of anesthesia: General Anaesthesia, Regional Anaesthesia, and Local Anaesthesia.

    General Anaesthesia

    • General Anaesthesia is a state of reversible CNS inhibition characterized by loss of consciousness, sensation, and motor activity.
    • It can be divided into three stages: Induction, Maintenance, and Recovery.
    • Induction is the period of time from the onset of administration of the potent anesthetic to the development of effective surgical anesthesia in the patient.
    • Maintenance provides a sustained surgical anesthesia.
    • Recovery is the time from discontinuation of administration of anesthesia until consciousness and protective physiologic reflexes are regained.

    Stages of Anesthesia (Depth)

    • Anesthesia can be divided into a series of four stages, each characterized by an increase in CNS depression caused by the accumulation of the anesthetic drug in the brain.
    • The four stages are: Analgesia, Excitement, Surgical Anesthesia, and Medullary Paralysis.
    • Stage I (stage of analgesia) is characterized by reduced sensation of pain, with the patient remaining conscious and conversational.

    Ideal General Anesthesia

    • Ideal general anesthesia should rapidly and smoothly induce anesthesia, permit rapid recovery, and have a wide margin of safety with no adverse effects.

    Balanced Anesthesia

    • Balanced anesthesia is a protocol that uses a combination of different drugs to produce rapid induction of anesthesia and ensure rapid recovery from the effects of GA with fewer side effects.
    • The drugs used in balanced anesthesia include pre-anesthetic agents, induction agents, maintenance agents, and neuromuscular relaxants.

    Classification of General Anesthetics

    • General anesthetics can be classified into two categories based on the route of administration: Inhalation Anesthetics and Intravenous Anesthetics.
    • Inhalation anesthetics include halogenated hydrocarbons (e.g., halothane, enflurane, isoflurane, sevoflurane) and non-halogenated gases (e.g., nitrous oxide, diethylether).
    • Intravenous anesthetics include barbiturates (e.g., sodium thiopentone, methohexitone), non-barbiturates (e.g., propofol, opioids, benzodiazepines, etomidate, ketamine).

    Minimum Alveolar Concentration (MAC)

    • MAC is the minimum alveolar concentration of an anesthetic agent required to eliminate movement among 50% of patients when exposed to skin incision.
    • MAC varies among different anesthetic agents, with higher MAC indicating lower potency (e.g., MAC of N2O = 100, MAC of halothane = 0.75).

    Factors Affecting Transfer of GA

    • The transfer of general anesthesia from lung to blood to brain is affected by several factors, including solubility in blood, anesthetic concentration in the inspired air, pulmonary ventilation, and cardiac output.

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    Description

    This quiz covers the basics of anesthesia, including its definition, types, and effects. It's a part of the 9th lecture in pharmacology.

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