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  • Anaesthesia Notes

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    kapil khanal
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    This document discusses various topics related to airway management and anesthesia including: 1) Indications for intubation such as inability to open the mouth and monitoring of anesthesia through both clinical and instrumental means such as monitoring the cardiovascular, respiratory, central nervous, and neuromuscular systems. 2) Oxygen therapy for conditions like documented hypoxia, shock, cardiac/pulmonary issues, and increased metabolic demand. 3) Pre-anesthetic medications like morphine which takes 15-20 minutes for redistribution and acts on the pain pathway. 4) Muscle relaxants including suxamethonium, vecuronium, rocuronium, and atracurium and their

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    Anaesthesia notes

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    This document discusses various topics related to airway management and anesthesia including: 1) Indications for intubation such as inability to open the mouth and monitoring of anesthesia through both clinical and instrumental means such as monitoring the cardiovascular, respiratory, central nervous, and neuromuscular systems. 2) Oxygen therapy for conditions like documented hypoxia, shock, cardiac/pulmonary issues, and increased metabolic demand. 3) Pre-anesthetic medications like morphine which takes 15-20 minutes for redistribution and acts on the pain pathway. 4) Muscle relaxants including suxamethonium, vecuronium, rocuronium, and atracurium and their

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    17 views23 pages

    Anaesthesia Notes

    Uploaded by

    kapil khanal
    This document discusses various topics related to airway management and anesthesia including: 1) Indications for intubation such as inability to open the mouth and monitoring of anesthesia through both clinical and instrumental means such as monitoring the cardiovascular, respiratory, central nervous, and neuromuscular systems. 2) Oxygen therapy for conditions like documented hypoxia, shock, cardiac/pulmonary issues, and increased metabolic demand. 3) Pre-anesthetic medications like morphine which takes 15-20 minutes for redistribution and acts on the pain pathway. 4) Muscle relaxants including suxamethonium, vecuronium, rocuronium, and atracurium and their

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
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    of 23

    Airway management

    Inability to open mouth


    Indications of intubation
    CVP
    BT

    Monitoring of anaesthesia

    Clinical Monitoring

    Instrumental Monitoring
    CVS
    Respi
    CNS
    Neuromuscular
    Others
    Oxygen Therapy
    Documented Hypoxia

    O2 Preoxygenation during GA
    Post anasthesia recovery

    Shock
    Cardiac Failure/ MI

    AECOPD, status asthmaticus


    Pulmonary HTN
    Cor Pulmonale

    Increased metabolic demand


    CO Poisoning
    Severe Trauma
    Redistribution

    Morphine- 15 to 20 min
    Pain Pathway
    Morphine
    Pre anasthetic medications

    Muscle relaxants
    Suxamethonium (2mg/kg)

    Contraindications

    Hyperkalemia

    Renal failure

    Muscular dystrophies, GBS: May cause permanent contractures

    Head injury : Contraindicated in any type of trauma

    Ocular injury, Galucoma

    spinal cord injury

    newborn, infants: in suspecion of undiagnosed muscular dystropies

    tetany

    Burn: upto 1 year

    Shock
    Vecuronium (0.1mg/kg)

    Contraindicated in renal failure , LIVER FAILURE, BILIARY


    FAILURE BUT NOT IN CARDIAC FAILURE
    Rocuronium
     Onset: 60-90 min, used for RSI
     Preferred for ICU
     The only muscle relaxant that can be given IM
    Atracurium
     Hoffman degradation
     Hepatic and renal failure
     Newborn and old
     MG and no reversal
    Neostigmine
    IV anasthetics

    Ketamine (2mg/kg)

    Action onset: 30-60 sec


    Propofol (2mg/kg)

    Action onset: 15 sec

    P of ProPofol
    1. Painful inj

    2. Post inj 6 hrs, no use

    3. Poteniate GABA binding to B subunit of GABA receptor

    4. Prevent emesis

    5. hyPnotic

    6. anti Pruritic

    7. icP, ioP reduction

    8. Poor analgesia and muscle relaxation


    Thiopentone sodium (4mg/kg) Antithyroid

    Action onset: 15 sec

    Inhaled anasthetics
    Halothane

    H of Halothane
    1. Halothane Hepatitis = no use in jaundice
    2. Contraindicated in Head injury
    3. Halothane Heart effect with exogenous adrenaline = no use in aortic stenosis = no use in
    pHeocHromocytoma
    4. THymol Preservative and amber coloured bottle retard the oxidative decomposition by
    light.
    5. Postoperative Hypothermia
    6. Hypoxia and Hypercarbia
    7. Halothane + moisture = corrosion of metals of vapourizers
    8. Halothane is absorbed by rubber tubing of circuits
    Isoflurane and sevoflurane
    LA

    Lignocaine
    Bupivacaine

    Brachial plexus block


    Spinal anasthesia

    Bainbridge reflex
    PAC and PACU

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