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Introduction to Sedation,Anaesthesia, Analgesia.
Tom Woodcock FRCAAugust 2008.
 
 
Sedation, anaesthesia and analgesia.
•
Anaesthesia 
is a drug-induced reversiblecoma in which the patient
 – 1/ does not move in response to a noxiousstimulus (spinal cord effect) – 2/ has no explicit recall of the noxious event (braineffect).
•Anaesthetised patients are not “asleep”!
 
 
Sedation, anaesthesia and analgesia.
•In dose-finding studies, anaesthesia has been induced when the patientstops obeying commands or loses lash reflex.•Maintenance doses of anaesthesia prevent movement in response tosurgical stimulus (typically groin incision for hernia or varicose veinsurgery). – Minimum infusion rate for IV agents, minimum alveolarconcentration for volatile agents. – MIR and MAC are spinal cord phenomena, brain dead organdonors have normal MIR or MAC requirements.•Most anaesthetic combinations are additive.
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