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.
Premedications
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 labelled (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
• Slow
injection of the drug into the vein till the eye lash reflex is obtained
• 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 I, )
• Breathing
circuits, face mask, inhalation set (Check list I, )
• IV 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, ETCO2
• Anesthesia machine
monitors (Oxygen analyser, gas monitor)
• Emergency drug
tray (Check list II, see).
Any questions be sent to drmmkapur@gmail.com
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