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Anesthesia and Airway Management

This document discusses various topics related to airway management and anesthesia including: 1) Indications for intubation such as inability to open the mouth and monitoring of anesthesia through both clinical and instrumental means such as monitoring the cardiovascular, respiratory, central nervous, and neuromuscular systems. 2) Oxygen therapy for conditions like documented hypoxia, shock, cardiac/pulmonary issues, and increased metabolic demand. 3) Pre-anesthetic medications like morphine which takes 15-20 minutes for redistribution and acts on the pain pathway. 4) Muscle relaxants including suxamethonium, vecuronium, rocuronium, and atracurium and their

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kapil khanal
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166 views23 pages

Anesthesia and Airway Management

This document discusses various topics related to airway management and anesthesia including: 1) Indications for intubation such as inability to open the mouth and monitoring of anesthesia through both clinical and instrumental means such as monitoring the cardiovascular, respiratory, central nervous, and neuromuscular systems. 2) Oxygen therapy for conditions like documented hypoxia, shock, cardiac/pulmonary issues, and increased metabolic demand. 3) Pre-anesthetic medications like morphine which takes 15-20 minutes for redistribution and acts on the pain pathway. 4) Muscle relaxants including suxamethonium, vecuronium, rocuronium, and atracurium and their

Uploaded by

kapil khanal
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as DOCX, PDF, TXT or read online on Scribd
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Airway management

Inability to open mouth


Indications of intubation
CVP
BT

Monitoring of anaesthesia

Clinical Monitoring

Instrumental Monitoring
CVS
Respi
CNS
Neuromuscular
Others
Oxygen Therapy
Documented Hypoxia

O2 Preoxygenation during GA
Post anasthesia recovery

Shock
Cardiac Failure/ MI

AECOPD, status asthmaticus


Pulmonary HTN
Cor Pulmonale

Increased metabolic demand


CO Poisoning
Severe Trauma
Redistribution

Morphine- 15 to 20 min
Pain Pathway
Morphine
Pre anasthetic medications

Muscle relaxants
Suxamethonium (2mg/kg)

Contraindications

Hyperkalemia

Renal failure

Muscular dystrophies, GBS: May cause permanent contractures

Head injury : Contraindicated in any type of trauma

Ocular injury, Galucoma

spinal cord injury

newborn, infants: in suspecion of undiagnosed muscular dystropies

tetany

Burn: upto 1 year

Shock
Vecuronium (0.1mg/kg)

Contraindicated in renal failure , LIVER FAILURE, BILIARY


FAILURE BUT NOT IN CARDIAC FAILURE
Rocuronium
 Onset: 60-90 min, used for RSI
 Preferred for ICU
 The only muscle relaxant that can be given IM
Atracurium
 Hoffman degradation
 Hepatic and renal failure
 Newborn and old
 MG and no reversal
Neostigmine
IV anasthetics

Ketamine (2mg/kg)

Action onset: 30-60 sec


Propofol (2mg/kg)

Action onset: 15 sec

P of ProPofol
1. Painful inj

2. Post inj 6 hrs, no use

3. Poteniate GABA binding to B subunit of GABA receptor

4. Prevent emesis

5. hyPnotic

6. anti Pruritic

7. icP, ioP reduction

8. Poor analgesia and muscle relaxation


Thiopentone sodium (4mg/kg) Antithyroid

Action onset: 15 sec

Inhaled anasthetics
Halothane

H of Halothane
1. Halothane Hepatitis = no use in jaundice
2. Contraindicated in Head injury
3. Halothane Heart effect with exogenous adrenaline = no use in aortic stenosis = no use in
pHeocHromocytoma
4. THymol Preservative and amber coloured bottle retard the oxidative decomposition by
light.
5. Postoperative Hypothermia
6. Hypoxia and Hypercarbia
7. Halothane + moisture = corrosion of metals of vapourizers
8. Halothane is absorbed by rubber tubing of circuits
Isoflurane and sevoflurane
LA

Lignocaine
Bupivacaine

Brachial plexus block


Spinal anasthesia

Bainbridge reflex
PAC and PACU

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