39 - Daycare anaesthetic agents

1. Alfentanyl
2. Propofol
3. Isoflurane (congener)
4. Midazolam
5. Mivacurium
6. Sevoflurane

5 - drugs used in general anaesthesia

A general anaesthetic (or anesthetic, see spelling differences) drug is an anaesthetic drug that brings about a reversible loss of consciousness. These drugs are generally administered by an anesthesia provider in order to induce or maintain general anaesthesia to facilitate surgery.

Drugs given to induce or maintain general anaesthesia are either given as:

• Gases or vapors (inhalational anaesthetics)
• Injections (intravenous anaesthetics)

Most commonly these two forms are combined, with an injection given to induce anaesthesia and a gas used to maintain it, although it is possible to deliver anaesthesia solely by inhalation or injection.

Inhalational anaesthetic substances are either volatile liquids or gases and are usually delivered using an anaesthesia machine. An anaesthesia machine allows composing a mixture of oxygen, anaesthetics and ambient air, delivering it to the patient and monitoring patient and machine parameters. Liquid anaesthetics are vaporized in the machine.

Many compounds have been used for inhalation anaesthesia, but only a few are still in widespread use. Desflurane, isoflurane and sevoflurane are the most widely used volatile anaesthetics today. They are often combined with nitrous oxide. Older, less popular, volatile anesthetics, include halothane, enflurane, and methoxyflurane. Researchers are also actively exploring the use of xenon as an anaesthetic.

Injection anaesthetics are used for induction and maintenance of a state of unconsciousness. Anaesthetists prefer to use intravenous injections as they are faster, generally less painful and more reliable than intramuscular or subcutaneous injections. Among the most widely used drugs are:

• Propofol
• Etomidate
• Barbiturates such as methohexital and thiopentone/thiopental
• Benzodiazepines such as midazolam and diazepam (commonly known as Valium)
• Ketamine is used in the UK as "field anaesthesia", for instance at a road traffic incident, and is more frequently used in the operative setting in the US.

The volatile anaesthetics are a class of general anaesthetic drugs. They share the property of being liquid at room temperature, but evaporating easily for administration by inhalation (some experts make a distinction between volatile and gas anesthetics on this basis, but both are treated in this article, since they probably do not differ in mechanism of action). All of these agents share the property of being quite hydrophobic (i.e., as liquids, they are not freely miscible with in water, and as gases they dissolve in oils better than in water

1 - anaesthesia mcqs - 1 to 12

1) Ether day was

a. 1846 16^th Oct

b. 1846 16^th Aug

c. 1847 16^th Oct

d. 1847 16^th Aug

Answer (a) 1846 Oct 16^th

Reference Ajay Yadav Page 16

2) Epileptogenic Anaesthetic Agent is

a. Enflurane

b. Nitrous Oxide

c. Ether

d. None of the above

Answer (a) Enflurane

Reference: Ajay Yadav 61

3) A potent and Long Acting LA is

a. Bupivacine

b. Procaine

c. Lignocain

d. None of the above

Answer (a) Bupivacine

Reference: KDTripathi 5^th Edition Page 326

4) All of the following are used for Surface Anaesthesia Except

a. Cocaine

b. Prilocaone

c. Lidocaine

d. Bupivacine

Answer (a) Bupivacine

Reference : KDTripathi 5^th Edition Page 324, 327

5) During General Anaesthesia, Functional Residual Capacity decreases by

a. 5 %

b. 5 to 10 %

c. 10 to 15 %

d. 15 to 20 %

Answer (d) 15 to 20 %

Reference: Ajay Yadav 1^st Edition Page 7

6) Which is incorrect about CVP

a. Seldinger’s technique is used

b. Ideal vessel is Radial Artery

c. Normal CVP is 3 to 10 cm of H₂O or 2 to 8 mm of Hg

d. CVP more than 20 mm of H2O indicates Right Heart Failure

Answer (b) Ideal Vessel is Radial Artery

Reference: Ajay Yadav 1^st Edition Page 46

7) Pulse oximeter used to measure

a. Oxygen saturation

b. Oxygen content

c. partial pressure of Oxygen

d. all of the above

Answer a) Oxygen Saturation

Reference: Ajay Yadav 47

8) Analgesia of choice in a pregnant women in CVS disease complicating pregnancy is

a. Spinal Anaesthesia

b. Epidural Anaesthesia

c. General Anaesthesia

d. Local Anaesthesia

Answer B) Epudiral Anaesthesia

Reference: Dutta 4^th Edition Page 296

9) An anesthetist orders a new attendant to bring the oxygen cylinder. He will ask the attendant to identify the correct cylinder by following color code:

a. Black cylinder with white shoulders.

b. Black cylinder with gray shoulders.

c. White cylinder with black shoulders.

d. Grey cylinder with white shoulders.

Answer A).Black cylinder with white shoulders.

Reference Understanding Anaesthesia Equipments - 4th Edition Dorsch and Dorsch Page 13

10) A 25 years old male is undergoing incision and drainage of abscess under general anesthesia with spontaneous respiration. The most efficient anaesthetic circuit is:

a. Mapleson A.

b. Mapleson B.

c. Mapleson C.

d. Mapleson D.

Answer A). Mapleson A.

Reference Understanding Anaesthesia Equipments - 4th Edition Dorsch and Dorsch . Page 209

11) A 38 year old man is posted for extraction of last molar tooth under general anaesthesia as a day care case. He wishes to resume his work after 6 hours. which one of the following induction agents is preferred:

a. Thiopentone sodium

b. Ketamine.

c. Diazepam.

d. Propofol

Answer D). Propofol

Reference Clinical Anaesthesia 3rd Edition - Morgan Page 173

12) At the end of a balanced anaesthesia technique with non-depolarizing muscle relaxant, a patient recovered spontaneously from the effect of muscle relaxant without any reversal. Which is the most probable relaxant the patient had received?

a. Pancuronium.

b. Gallamine.

c. Atracurium.

d. Vecuronium.

Answer C).Atracurium.

Reference Clinical Anaesthesia 3rd Edition - Morgan Page 191