
Contents
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Other relevant pages Other relevant pages
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Online resources Online resources
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Introduction Introduction
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Preoperative examination & tests
Preoperative examination & tests
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Preoperative care aims to ensure that patients Preoperative care aims to ensure that patients
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The preoperative visit The preoperative visit
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Assess past history Assess past history
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Family history Family history
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Assess need for thromboprophylaxis Assess need for thromboprophylaxis
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Tests Tests
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Further reading Further reading
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Premedication Premedication
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Anxiolysis Anxiolysis
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Examples for the 70kg man: Examples for the 70kg man:
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Timing: Timing:
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Children: Children:
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Specific premedications Specific premedications
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Analgesia: Analgesia:
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Antacids: Antacids:
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Antibiotic prophylaxis: Antibiotic prophylaxis:
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Bronchodilators: Bronchodilators:
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Steroids: Steroids:
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Day surgery Day surgery
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Common reasons for cancellation Common reasons for cancellation
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Sedation Sedation
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Definition Definition
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Agents Agents
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Further reading Further reading
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Equipment Equipment
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Inhalational anaesthetic agents Inhalational anaesthetic agents
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Halothane Halothane
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Sevoflurane Sevoflurane
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Isoflurane Isoflurane
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Desflurane Desflurane
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Commonly used IV anaesthetic agents Commonly used IV anaesthetic agents
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Propofol Propofol
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Thiopental sodium Thiopental sodium
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Other IV anaesthetic agents Other IV anaesthetic agents
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Thiopental sodium Thiopental sodium
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Etomidate Etomidate
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Ketamine Ketamine
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Dose example: Dose example:
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Uses: Uses:
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Problems: Problems:
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Further reading Further reading
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Muscle relaxants: neuromuscular blockers Muscle relaxants: neuromuscular blockers
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Depolarizing agents Depolarizing agents
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Dose: Dose:
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IV uses: IV uses:
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Side effects: Side effects:
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Non-depolarizing agents Non-depolarizing agents
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Rocuronium: Rocuronium:
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Vecuronium: Vecuronium:
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Atracurium: Atracurium:
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Note on neuromuscular blockers in those with myasthenia Note on neuromuscular blockers in those with myasthenia
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Further reading Further reading
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Practical conduct of anaesthesia
Practical conduct of anaesthesia
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Induction Induction
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Intravenous: Intravenous:
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Gaseous: Gaseous:
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Indications for gaseous induction Indications for gaseous induction
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Airway control Airway control
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Intubation Intubation
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Muscle relaxation (paralysis with neuromuscular blocking agents) Muscle relaxation (paralysis with neuromuscular blocking agents)
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Short-acting: Short-acting:
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Long-acting: Long-acting:
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Options for maintaining anaesthesia Options for maintaining anaesthesia
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Total intravenous anaesthesia (TIVA) Total intravenous anaesthesia (TIVA)
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Monitoring during anaesthesia
Monitoring during anaesthesia
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Respiration: Respiration:
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BP: BP:
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T°: T°:
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Pulse oximetry: Pulse oximetry:
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ECG: ECG:
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CVP: CVP:
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Further reading Further reading
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Intubation technique
Intubation technique
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Prediction of difficult intubation Prediction of difficult intubation
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Technique Technique
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Remember:
Remember:
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If difficult intubation is predicted If difficult intubation is predicted
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If unable to intubate? If unable to intubate?
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Laryngeal mask airway (LMA) Laryngeal mask airway (LMA)
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Further reading Further reading
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Some complications of anaesthesia
Some complications of anaesthesia
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If unable to intubate? If unable to intubate?
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PLAN A PLAN A
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PLAN B PLAN B
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PLAN C PLAN C
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PLAN D PLAN D
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Atelectasis and pneumonia Atelectasis and pneumonia
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℞: ℞:
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Awareness Awareness
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Incidence: Incidence:
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Bronchospasm Bronchospasm
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Laryngospasm
Laryngospasm
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Malignant hyperthermia
Malignant hyperthermia
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Treatment: Treatment:
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Damage to teeth Damage to teeth
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Suxamethonium apnoea Suxamethonium apnoea
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Shivering Shivering
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Rapid sequence induction (RSI) Rapid sequence induction (RSI)
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Further reading Further reading
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End of anaesthesia and recovery
End of anaesthesia and recovery
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What to do at the end of anaesthesia What to do at the end of anaesthesia
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Recovery Recovery
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Enhanced recovery programmes (ERPs) Enhanced recovery programmes (ERPs)
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Further reading Further reading
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Regional anaesthesia: peripheral nerve blocks
Regional anaesthesia: peripheral nerve blocks
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Continual regional anaesthesia Continual regional anaesthesia
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Locating peripheral nerves Locating peripheral nerves
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Types of local anaesthetic (LA) agents Types of local anaesthetic (LA) agents
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Complications Complications
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LA toxicity: LA toxicity:
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Seizures: Seizures:
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Further reading Further reading
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Regional anaesthesia: neuraxial anaesthesia
Regional anaesthesia: neuraxial anaesthesia
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Spinal anaesthesia Spinal anaesthesia
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Complications of spinal anaesthesia: Complications of spinal anaesthesia:
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Extradural (epidural) anaesthesia Extradural (epidural) anaesthesia
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Complications of epidural anaesthesia Complications of epidural anaesthesia
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Dural puncture: Dural puncture:
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Vessel puncture and inadvertent injection: Vessel puncture and inadvertent injection:
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Hypoventilation: Hypoventilation:
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Epidural haematoma or abscess: Epidural haematoma or abscess:
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Other: Other:
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Benefits of epidural anaesthesia Benefits of epidural anaesthesia
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Caudal (sacral epidural) Caudal (sacral epidural)
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GA or regional anaesthesia? GA or regional anaesthesia?
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Absolute contraindications to all neuraxial anaesthesia: Absolute contraindications to all neuraxial anaesthesia:
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Relative contraindications to all neuraxial anaesthesia: Relative contraindications to all neuraxial anaesthesia:
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Pain Pain
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Methods of analgesia Methods of analgesia
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Chronic pain Chronic pain
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Pain in children Pain in children
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Further reading Further reading
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Vegetative states Vegetative states
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Making the diagnosis Making the diagnosis
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Investigations Investigations
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Management Management
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Cite
Abstract
This chapter describes anaesthesia, including pre-operative assessment (peri-operative medications, examination & tests, ASA classification (American Society of Anesthesiologists), premedication, sedation), equipment and anaesthetic agents (inhalational agents, the ideal IV anaesthetic agent, the ideal inhaled anaesthetic agent, commonly used iv anaesthetic agents, other IV anaesthetic agents, the autonomic system, neuromuscular blockers), and practical conduct of anaesthesia (induction, muscle relaxation, maintenance of anaesthesia, intubation technique, mechanical ventilation, some complications of anaesthesia, aspiration, rapid sequence induction (RSI), end of anaesthesia and recovery, local and regional anaesthesia, pain management, vegetative states).
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