These can be stressful situations. Ideally intubation is immediately followed by knife to skin, with the abdomen prepped before induction. There is a very high incidence of difficult intubation, and of awareness under anaesthesia in these situations. Pre-op AMPLE history Antacids as per local protocol Peri-op Left tilt on table Ensure 16G cannula in situ,Continue reading “Category 1 Section Under GA”
Tag Archives: Propofol
Cardioversion (DCCV)
The procedure itself is very short, but intensely stimulating. Perfect for short acting drugs. Awareness and recall are common, reflecting deep sedation more than true general anaesthesia. Pre-op Usually a day case Check they have been correctly anticoagulated- minimum of preceding 3 weeks May have significant cardiovascular, respiratory disease. Also obesity, diabetes, OSA Check pre-opContinue reading “Cardioversion (DCCV)”
ECT
The procedure itself is very short, so it can be a busy list. Don’t let this compromise your assessment of some fairly complex patients. Pre-op Look at previous ECTs and note the previous doses as a guide Paracetamol Intra-op Small cannula 20/22G Pre-oxygenate Alfentanil – 250-500 mcg (attenuates sympathetic response) Propofol – 0.75-2.5 mg/kg SuxamethoniumContinue reading “ECT”
Day case “hot” lap chole
For the fit and well patient Pre-op Paracetamol Intra-op Propofol – Marsh TCI Remifentanil – Minto TCI Remi on first building up to 6ng/ml, wait two minutes, then propofol 6mcg/ml Atracurium 16G cannula COETT Depth of anaesthesia monitoring 350mcg fentanyl throughout case Post-op Fentanyl 0-200mcg in recovery Regular paracetamol Regular ibuprofen Tramadol or codeine AlternativesContinue reading “Day case “hot” lap chole”
