Anesthesia Procedures
Preoperative Check
Objectives
· Patient identification and consent check for operation and anesthesia.
· Availability and check functioning of anesthesia machine, intubation sets, drugs, monitors.
· Casenote confirmation of operation decided upon for that particular patient.
Intravenous Induction
Objectives
- To induce loss of awareness rapidly at the start of anesthesia.
- Induction is achieved with intravenous agents (thiopentone 3-5 mg/kg, methohexitone 1-1.5 mg/kg, etomidate 0.3 mg/kg, propofol 1.5-2.5 mg/kg or ketamine 2 mg/kg).
Position
- Supine.
Premedication
Any combination of anxiolite and antisialgogue.
Procedure
- Intravenous cannula inserted into a peripheral vein, preferably on the dorsum of the hand and infusion fluid attached.
- Drugs prepared in syringes and labeled (IV induction agent, muscle relaxant, atropine)
- Patient connected to the monitor for ECG, non-invasive blood pressure (NIBP), and oxygen saturation.
- 100% oxygen by mask before the drugs are injected.
- Small test dose of intravenous induction agent given and effects observed for any anaphylactic reaction.
- Rapid sequence induction technique used in emergency situation where the stomach is full or chances of regurgitation are a potential problem.
- Anesthesia maintained with inhalational agent.
- Tracheal intubation done using muscle relaxant.
Instruments
- Intubation tray
- Anesthesia machine ( check list 1, see page 99 )
- Breathing circuits, face mask, inhalation set ( check list 1, see page 99 )
- 1V cannula, infusion, fluid, spirit and iodine swab, adhesive plaster.
- Drug tray and labels.
- Normal saline bottle for dilution of drugs.
- Induction agents-Thropentone, Propofol, Ketamine.
- Arm boards.
- Patient monitors for ECG, Spo2, NIBP, and ETCO2.
- Anesthesia machine monitors (Oxygen analyser, gas monitor)
- Emergancy drug tray(check list 11, see page 102 ).
Any questions be sent to drmmkapur@gmail.com
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