Drugs Used in Anaesthesia

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DRUGS USED IN ANAESTHESIA
BY DR. M.M.RAJAPAKSE MBBS(CEYLON), FFARCS(ENG) CONSULTANT ANAESTHETIST

ANAESTHESIA

GENERAL

REGIONAL ( LOCAL)

GENERAL ANAESTHESIA 1. UNCONSCIOUSNESS 2. ANALGESIA – PAIN RELIEF 3. MUSCLE RELAXATION 4. PHARMACOLOGICALLY PRODUCED 5. REVERSIBLE 6. VITAL FUNCTIONS

1.

2.

OTHER CAUSES OF UNCONSCIOUSNESS LEVELS OF CONSCIOUSNESS

SLEEP /AMNESIA/ HYPNOSIS/ SEDATION/ STUPOR

INDUCTION

RECOVERY

MAINTENANCE

GENERAL ANAESTHETICS DRUGS USED TO PRODUCE UNCONSCIOUSNESS
1. 2.

INTRAVENOUS ANAESTHETICS INHALATIONAL ANAESTHETICS

INTRAVENOUS ANAESTHETICS
A. BARBITURATES-THIOPENTONE SODIUM METHOHEXITONE B. PROPOFOL C. KETAMINE D. ETOMIDATE

INTRAVENOUS ANAESTHETICS
1.RAPID ONSET OF ACTION 2.SHORT DURATION OF ACTION 3.RECOVERY IS DUE TO REDISTRIBUTION. 4.SOME HAVE ANALGESIC PROPERTIES. EG. KETAMINE 5.ADVERSE EFFECTS.

INHALATIONAL ANAESTHETICS A) HALOTHANE B) ISOFLURANE C) DESFLURANE D) SEVOFLURANE

USES OF INHALATIONAL ANAESTHESIA
A. B.

INDUCTION OF CHILDREN MAINTENANCE OF ANAESTHESIA

INHALATIONAL ANAESTHETICS
1.UNPLEASENT ON ADMINISTRATION 2.DELAYED ONSET AND RECOVERY. 3.TOXIC EFFECTS ON ORGANS. 4.ADVERSE EFFECTS.

ANALGESICS NARCOTIC ANALGESICS MORPHINE PETHIDINE FENTANYL, REMIFENTANYL PENTAZOCINE

NON STEROIDAL ANTI INFLAMMATORY DRUGS Eg. SALICYLATES DICLOFENAC SODIUM INDOMETHACINE

MUSCLE RELAXANTS NON DEPOLARIZING TUBOCURARINE PANCURONIUM ATRACURIUM VECURONIUM ROCURONIUM MIVACURIUM BLOCKING AGENTS 25 MINUTES 30 MINUTES 20 MINUTES 20 MINUTES 30 MINUTES 16 MINUTES

COMPLICATIONS DUE TO MUSCLE RELAXANTS (NON-DEPOLARIZING AGENTS) 1.ALLERGIC REACTIONS. 2.HYPOTENSION 3.PROLONGED APNOEA.

CHARACTERISTIC FEATURES
A. B. C.

COMPETES WITH ACETYLCHOLINE DURATION OF ACTION ACTION HAS TO BE REVERSED WITH ANTICHOLIN ESTERASES +ATROPINE EDROPHONIUM, NEOSTIGMINE, PHYSOSTIGMINE PYRIDOSTIGMINE

SUXAMETHONIUM (SCOLINE)
A. B. C.

SHORT DURATION OF ACTION REVERSIBLE ON ITS OWN METABOLISED BY PLASMA CHOLINESTERASES

DEPOLARIZING AGENTS
1.ALLERGIC REACTIONS. 2.MUSCLE PAINS 3.HYPERKALAEMIA 4.RAISED ABD.AND CRANIAL PRESSURE. 5.PROLONGED APNOEA. 6.MALIGNANT HYPERPYREXIA.

INDICATION FOR THE USE OF MUSCLE RELAXANTS
A. B. C. D.

INTUBATION ABDOMINAL AND THORASIC RELAXATION PROLONGED SURGERY INTERMITTENT POSITIVE PRESSURE VENTILATION

COMPLICATIONS DUE TO ANAESTHESIA

A.

B.

C. D. E.

COMPLICATIONS DUE TO THE ADVERSE EFFECTS OR OVERDOSE OF DRUGS COMPLICATIONS DUE TO THE STATE OF UNCONSCIOUSNESS COMPLICATIONS DUE TO MACHINE FAILURE COMPLICATIONS DUE TO PATIENT FACTORS COMPLICATIONS DUE TO THE ANAESTHETIST

COMPLICATIONS DUE TO THE DRUGS 1. CARDIOVASCULAR SYSTEM A. ARRHYTHMIAS B. HYPOTENSION C. CARDIAC ARREST 2. RESPIRATORY SYSTEM A. DEPRESSION B. BRONCHOSPASM

3. LIVER 4. KIDNEY 5. PROLONGED APNOEA

COMPLICATIONS DUE TO PATIENT FACTORS
A. B. C. D.

ISCHAEMIC HEART DISEASE RESPIRATORY DISEASES BLEEDING DISORDERS ANY OTHER ILLNESS

PRE-OPERATIVE ASSESMENT OF THE PATIENTS

COMPLICATION DUE TO MACHINE FAILURE
1. 2. 3.

DECREASE IN OXYGEN SUPPLY FAILURE OF VENTILATORS FAILURE OF THE MONITORING EQUIPMENT

MONITORING DURING ANAESTHESIA
1. 2. 3. 4. 5. PULSE RATE. ECG. OXYGEN SATURATION BLOOD PRESSURE URINE OUTPUT.

6. BODY TEMPERATURE. 7. CENTRAL VENOUS PRESSURE. 8. BLOOD SUGAR. 9. FLUID BALANCE.

COMPLICATIONS DUE TO THE ANAESTHETIST

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