A few anaesthetic questions........please help!!?!
Question: A few anaesthetic questions!.!.!.!.!.!.!.!.please help!!!?
why, in a rapid sequence procedure, do anaethnetists use suxemethisone (sorry spelling) rather that other agents!.!.!.!.
what is the difference between a polarising and non depolarising anaesthetic drugs!.!.!.!.eg propofol, sux, etc!.!.!.!.!.
also, with local anaesthtics, what is the difference between marcain and marcain heavy!?
any help would be appreciated, i am in the process of looking all this up for myself, but some of the literature is too medical, or just not clear!.!.!.!.!.!.!.!.!.!.simple format appreciated!!!!!!!!!!!!:-)Www@Answer-Health@Com
what is the difference between a polarising and non depolarising anaesthetic drugs!.!.!.!.eg propofol, sux, etc!.!.!.!.!.
also, with local anaesthtics, what is the difference between marcain and marcain heavy!?
any help would be appreciated, i am in the process of looking all this up for myself, but some of the literature is too medical, or just not clear!.!.!.!.!.!.!.!.!.!.simple format appreciated!!!!!!!!!!!!:-)Www@Answer-Health@Com
Answers:
When anaesthetising patients for emergency surgery, anaesthetists use a process called a "rapid sequence induction"!. The objective is to secure the airway rapidly and prevent soiling of the lungs with gastric contents!.
We call this "the full stomach"!. This indicates that for some reason, the stomach is considered full of material; the patient need not have eaten recently!.
Reasons for having a "full stomach"
Recent meal
Delayed gastric emptying: trauma, acute abdomen, morphine!.
Incompetant lower oesophageal sphincter: obesity, hiatus hernia, pregnancy
The patient goes asleep with the aid of an intravenous induction agent: thiopentone or propofol!. These cause hypnosis and amnesia!.
To rapidly intubate the larynx, it is important to have a high degree of muscle relaxation very quickly!. The drug used for this is suxamethonium!. This acts by causing every muscle in the body to contract, and subsequently relax!. The result of this is the sudden release of a lot of potassium into the bloodstream!.
Suxamethonium is contraindicated if there is hyperkalaemia, as it may cause cardiac arrest!. Because it causes such widespread muscle contraction (rather like "cramping"), patients usually complain of muscle pains the next day!.
It is not conventional to premedicate patients undergoing rapid sequence induction or to administer sedatives such as midazolam or fentanyl prior to the administration of anaesthesia!. The reason for this is that if you are unable to intubate the patient, then the anaesthetic agents will wear off and the patient will wake up within 5 mins, thus not putting the airway at risk!.
We avoid manually ventilating patients undergoing rapid sequence induction, as this inflates the stomach and encourages regurgitation!.
When the anaesthetist is happy that the airway is intact, he administers the remainder of the anaesthetic agents - fentanyl, nitrous oxide and the volatile agent which maintains anaesthesia (e!.g!. isoflurane)!.
A non depolarising neuromuscular blocker may be added now to maintain muscle relaxation for the duration!.
I think the biggest difference between anectine and diprovan is personal preference!.
Marcaine/Sensorcaine (bupivacaine) is an established long-acting local anaesthetic, used for surgical anaesthesia and acute pain management!.
Marcaine is an amide type local anaesthetic, which can be used for a number of techniques, including local infiltration, minor and major nerve blocks, epidural block and arthroscopy!.
Marcaine Spinal and Marcaine Spinal Heavy are indicated for spinal anaesthesia in surgical and obstetric procedures!.
You can find this info almost anywhere online!.
CRNAWww@Answer-Health@Com
We call this "the full stomach"!. This indicates that for some reason, the stomach is considered full of material; the patient need not have eaten recently!.
Reasons for having a "full stomach"
Recent meal
Delayed gastric emptying: trauma, acute abdomen, morphine!.
Incompetant lower oesophageal sphincter: obesity, hiatus hernia, pregnancy
The patient goes asleep with the aid of an intravenous induction agent: thiopentone or propofol!. These cause hypnosis and amnesia!.
To rapidly intubate the larynx, it is important to have a high degree of muscle relaxation very quickly!. The drug used for this is suxamethonium!. This acts by causing every muscle in the body to contract, and subsequently relax!. The result of this is the sudden release of a lot of potassium into the bloodstream!.
Suxamethonium is contraindicated if there is hyperkalaemia, as it may cause cardiac arrest!. Because it causes such widespread muscle contraction (rather like "cramping"), patients usually complain of muscle pains the next day!.
It is not conventional to premedicate patients undergoing rapid sequence induction or to administer sedatives such as midazolam or fentanyl prior to the administration of anaesthesia!. The reason for this is that if you are unable to intubate the patient, then the anaesthetic agents will wear off and the patient will wake up within 5 mins, thus not putting the airway at risk!.
We avoid manually ventilating patients undergoing rapid sequence induction, as this inflates the stomach and encourages regurgitation!.
When the anaesthetist is happy that the airway is intact, he administers the remainder of the anaesthetic agents - fentanyl, nitrous oxide and the volatile agent which maintains anaesthesia (e!.g!. isoflurane)!.
A non depolarising neuromuscular blocker may be added now to maintain muscle relaxation for the duration!.
I think the biggest difference between anectine and diprovan is personal preference!.
Marcaine/Sensorcaine (bupivacaine) is an established long-acting local anaesthetic, used for surgical anaesthesia and acute pain management!.
Marcaine is an amide type local anaesthetic, which can be used for a number of techniques, including local infiltration, minor and major nerve blocks, epidural block and arthroscopy!.
Marcaine Spinal and Marcaine Spinal Heavy are indicated for spinal anaesthesia in surgical and obstetric procedures!.
You can find this info almost anywhere online!.
CRNAWww@Answer-Health@Com