Anaesthetisiology

Type of Anaesthesia

• General Anaesthesia
  
• Regional Anaesthesia
  
  • Spinal
    
  • Epidural
    
  • Caural
    
  • Nerve block
    
• Local Aneasthesia
  

 

The Drugs Used in GA

Induction Agent – To put patient into deep sleep

• Intravenous injection
  
  • Thiopental
    
  • Propofol
    
  • Etomidate (old age & cardiac problem)
    

 

Induction Agent

• Inhalation
  
  • Nitrous Oxide
    
• Volatile Agent
  
  • Sevorane
    
  • Isoflourane
    
  • Desflouran
    

To keep patient in deep sleep condition throughout the surgery.

 

Muscle Relaxant

• Long Acting
  
  • Tracium
    
  • Mivacuron
    
  • Esmeron
    
• Short Acting
  
  • Scoline
    

 

Analgesic

• For pain relief
  
  • Dynastat
    
  • Fentanyl
    
• Dangerous Drugs
  
  • Pethedine
    
  • Morphine
    
  • Suphenta
    

 

Endotrachial Tube (ETT)

• Usual Endotrachial Tube
  
  • Abdominal Surgury-Supine Position
    
  • Orthopaedic
    
• Oral Rae
  
  • Operation o the face, eye, ENT or neuro surgery
    
• Nasal Rae
  
  • Surgery on the neck (Thyroid)
    
  • Dental
    
• Around (Flexometalic Tube)
  
  • Thyroid, neuro & PCNL (prone position)
    
• Double Lumen Tube
  
  • Thoracotomy
    

 

Selection of the Tube

• Female – 7
  
• Male – 7.5
  

 

Preparation for Intubation

• Fasted
  
  • 4 hours – drinks
    
  • 6 hours – solid food
    

To prevent aspiration during intubation & after extubation

• Pre-oxygenation
  
  • To remove all the air in the lung and fill up the lung with 100% oxygen to prevent hypoxia during intubation.
    

 

Reversal of Patient

• To help the patient gains back their muscle tone by help to clear the residual effect of muscle relaxant.
  
  • Atropine 1mg – dry up the secretion in the throat
    
  • Neostigmine 2.5mg – to washout the residual effect of muscle relaxant.
    

 

Post Op Pain Management

• Patient Control Anaesthesia (PCA)
  
• Epidural – Chirocaine top up
  
• IV infusion – morphine
  
• Voltaren suppository – body weight