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Elisa Bertoja. Consultant in Anaesthesia, UCLH. ABC of Anaesthesia Overview . When does an anaesthesia start ?. Far before theatre. PRE OPERATIVE. INTRA OPERATIVE. POST OPERATIVE. ANAESTHESIA. Mr Ed Burdett. Pre-assessment. PRE OPERATIVE. PMH. CVS: MI 2004 ↑ BP angioplasty 2004

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Elisa Bertoja

Consultant in Anaesthesia, UCLH

ABC of Anaesthesia Overview



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PRE OPERATIVE

INTRA OPERATIVE

POST OPERATIVE

ANAESTHESIA



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Pre-assessment

PRE OPERATIVE


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PMH

CVS: MI 2004 ↑ BP

angioplasty 2004

since then asymptomatic

RS: COPD

CNS: --

GUT: --

GIT: --

Mr Ed Burdett

77 ♂ elective TKR


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Mr Ed Burdett

Th:

Aspirin 75mg od

Simvastatin 10 mg od

Lansoprazole 15 mg od

Atenolol 25 mg od

Paracetamol prn

Ibuprofen prn

NKDA


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Pre-assessment

Further

investigation

Proceed

PRE OPERATIVE


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Pre-assessment

Operating list

Liaise with surgeon

Pre-operative visit

PRE OPERATIVE


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TAILORED ANAESTHESIA

Intubation

TIVA

GA

Sedation

Oral

Nasal

Gas

Fibreoptic

LMA

CSE

Awake

RA

RSI

Asleep

Epidural

Block

Spinal


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Pre-assessment

Operating list

Liaise with surgeon

Pre-operative visit

Anaesthetic room

PRE OPERATIVE


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PRE OPERATIVE

INTRA OPERATIVE

POST OPERATIVE

ANAESTHESIA


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GA

REGIONAL


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Induction

Maintenance

Emergence

GA


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Induction

Maintenance

Emergence

GA


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Temporary unsafe

A: airway

B: breathing

C: cardiovascular

INDUCTION

From a safe condition


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C

B

A

Depth of anaesthesia

Pain management

Liaise with surgeon

MANTENANCE



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C

B

A

Depth of anaesthesia

Pain management

Liaise with surgeon

MANTENANCE



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From a controlled condition

A: airway

B: breathing

Temporary unsafe

C: cardiovascular

EMERGENCE


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Pain management

Patient safety

High standard quality care

POST OP PLAN


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Skills

Pt

Knowledge

Conditions

Surgery

Pre-op

Post-op

Assess

Plan

CHOICES


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Adequacy

Pt consent (informed)

Feasibility

REGIONAL


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C

B

A

Achieved block

Liaise with surgeon

MANTENANCE


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Pain management

Patient safety

High standard quality care

POST OP PLAN


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Skills

Pt

Knowledge

Conditions

Surgery

Pre-op

Post-op

Assess

Plan

CHOICES


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Mr Ed Burdett

Th:

Aspirin 75mg od

Simvastatin 10 mg od

Lansoprazole 15 mg od

Atenolol 25 mg od

Paracetamol prn

Ibuprofen prn

nbm> 6hrs

NKDA