40 Questions
What is the primary factor that determines the induction of anesthesia?
Rate of effective concentration of the anesthetic reaching the brain
What is the main difference between induction and recovery?
Induction involves an increase in CNS depression, while recovery involves its decrease
What is the primary goal of maintenance of anesthesia?
To sustain surgical anesthesia
What is the characteristic of the first stage of anesthesia?
Reduced sensation of pain with amnesia
What is the last stage of anesthesia?
Medullary paralysis
What happens to the CNS during the progression of anesthesia stages?
It becomes more depressed
What is the term for the degree to which the CNS is depressed?
Depth of anesthesia
What happens to the patient's consciousness during the first stage of anesthesia?
It is maintained
What does the Greek word 'anaesthesia' mean?
Loss of sensation
What is the primary characteristic of general anaesthesia?
Loss of consciousness and sensation of the whole body
What is the term for the agents that produce general anaesthesia?
General anaesthetics
What is the characteristic of regional anaesthesia?
Loss of sensation in a large, but limited area of the body
In which stage of general anaesthesia is the patient most responsive?
Induction
What is the primary goal of general anaesthesia?
To allow for easy and painless operation
What is the term for the drugs used to produce local anaesthesia?
Local anaesthetics
What is the state of general anaesthesia characterized by?
Reversible C.N.S inhibition
What is the primary goal of ideal general anesthesia?
To induce anesthesia rapidly and smoothly, and permit rapid recovery of the patient
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?
Balanced anesthesia
Which of the following drugs is NOT an example of a pre-anesthetic agent?
Neuromuscular relaxants (succinylcholine)
What is the primary role of neuromuscular relaxants in balanced anesthesia?
To facilitate intubation and relaxation
What is the classification of general anesthetics based on?
Route of administration
What type of anesthetics are used to maintain anesthesia during surgery?
Inhalational anesthetics
Which of the following is a non-halogenated inhalation anesthetic?
Nitrous oxide
What is the primary advantage of balanced anesthesia?
Rapid recovery from the effects of GA with fewer side effects
Which intravenous anesthetic is a carboxylated imidazole?
Etomidate
Which of the following is NOT a characteristic of an ideal general anesthetic drug?
Has a wide range of adverse effects
What is the term used to describe the use of a single drug for induction and maintenance of anesthesia?
None of the above
What is the advantage of using thiopental, propofol, and etomidate over inhaled agents?
They produce a smoother and more rapid anesthesia
Which of the following is a barbiturate intravenous anesthetic?
Sodium thiopentone
What is the mechanism of action of benzodiazepines as intravenous anesthetics?
GABA receptor agonism
Which of the following is a non-barbiturate intravenous anesthetic?
Propofol
What is the brand name of the opioid fentanyl?
Sublimaze
Which of the following inhalation anesthetics is a non-flammable halogenated hydrocarbon?
Isoflurane (Forane)
What is the primary function of inhalation anesthesia?
To maintain anesthesia after administration of I.V anesthetics
Which of the following factors affects the transfer of general anesthetic from the lung to the blood and then to the brain?
Solubility in blood
What is the MAC of nitrous oxide (N2O)?
100
What is the effect of increasing the anesthetic concentration in the inspired air?
It increases the rate of induction
Which of the following inhalation anesthetics is an inorganic agent?
Nitrous oxide (N2O)
How does the potency of halothane compare to enflurane?
Halothane is 2 times more potent than enflurane
What is the effect of increased pulmonary ventilation on the rate of induction?
It increases the rate of induction
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.
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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