MCI SCREENING EXAM STUFF: Anesthesia

Friday, 16 March 2012

Anesthesia


 ORDER OF SENSATION LOSS IN LOCAL ANAESTHESIA
Temperature
Pain
Touch
Deep pressure


ORDER OF SENSATION LOSS IN SPINAL ANAESTHESIA
Preganglionic b fibres
Cold
Warm
Pin prick
Pain
Touch
Pressure
Motor
Vibration / proprioception

CONTRAINDICATIONS TO SPINAL ANESTHESIA
Hypotension and hypovolemia
Uncooperative and mentally ill person
Infants and children
Vertebral abnormalities
Local sepsis

ELEMENTS OF PRIMARY SURVEY
Airway with cervical spine control
Breathing and ventilation
Circulation with control of hemorrhages
Dysfunction of central nervous system
Exposure in a controlled environment

*Bier’s block- regional anaesthesia that utilizes intravenous injection of the local anaesthetic agent to bring it to the nerve trunks and endings.


*Eutectic Lignocaine + Prilocaine –
Decreases the melting point of the mixture.
Useful in surface anaesthesia.
TEMPE-Topical Eutectic Mixture for Premature Ejaculation


Lignocaine max doseWithout adrenaline   3 mg/kg= 200mg (average adult)
Lignocaine max doseWith adrenaline        7 mg/kg = 500mg (average adult)


Shortest acting muscle relaxant  Succinylcholine < Mivacurium
Longest acting muscle relaxant   Doxacurium > Pipecuronium > Pancuronium > d-Tubocurare.

Longest acting local anesthetist  Dibucaine > Tetracaine > Bupivacaine
Shortest acting anesthetist           Chlorprocaine

*Malignant hyperthermia
autosomal dominant Seen with Halothane, Ether and Succinylcholine
Due to excessive release of Ca++ from sarcoplasmic reticulum.

*Circuit used in spontaneous respiration is Mapleson A 

MUSCLE RELAXANTS
CONDITION
In renal failure
Vecuronium / Atracurium
In hepatic failure
Atracurium
Myasthenia gravis
1/10th Atracurium
Short cases
Atracurium / Ropacurium / Mivacurium
Obstetrics
All except Gallamine
Arterial surgery
Pancuronium    
To reduce blood pressure
Tubocurare
Rapid sequence induction
Rocuronium / Ropacurium
Asthmatics
Pancuronium (avoid Metacurine and Succinylcholine)
Carcinoid tumour
Vecuronium

*Aminoglycosides causing neuromuscular blockade   Neomycin > Streptomycin > Gentamycin

White
Oxygen
Blue
Nitrous oxide
Black
Compressed Air
Yellow
Vacuum

 
GASES
COLOUR CODES
Oxygen
Black body with white shoulders
Nitrous oxide
Blue
Carbon dioxide
Grey
Cyclopropane
Orange
Air
Grey body , black and white quartered shoulders
Entonox
Blue body, white and blue quartered shoulders

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