Induction of anaesthesia

Hool, Alison J.; Kitson, Ross M.

doi:10.1016/j.mpaic.2009.10.016

« Previous Next »Anaesthesia & intensive care medicine
Volume 11, Issue 1 , Pages 25-31, January 2010

Induction of anaesthesia

Alison J Hool MBChB FRCA is a Specialist Registrar in the North West Deanery. She qualified from the University of Sheffield and spent time working in emergency medicine in the UK and New Zealand before training in anaesthesia. Conflicts of interest: none declared

Ross M Kitson FRCA DICM PGDip is a Consultant in anaesthesia and critical care at Tameside Hospital, Manchester. He qualified from the University of Leeds and trained for a dual CCT in anaesthesia and ICM in the West Midlands. His interests include infection control on ICU and high frequency oscillation. Conflicts of interest: none declared

Abstract

Induction of anaesthesia aims to produce a rapid, smooth transition from consciousness to unconsciousness by achieving adequate concentration of anaesthetic agents in the central nervous system. Careful planning is required, which includes pre-operative assessment, consent and explanation to the patient, and checking of all equipment and drugs. There are two main methods of inducing anaesthesia: inhalational and intravenous. The choice will depend upon patient and surgical factors as well as the anaesthetist's preference and experience. Rapid sequence induction is a modified induction technique (usually intravenous, but can be inhalational) used when there is increased risk of aspiration of gastric contents. At induction of anaesthesia, there is great physiological change; the complications that can occur can be classified into drug-related and airway-related. Once anaesthesia has been induced, the patient's airway must be maintained; a variety of airway maintenance techniques are available, including endotracheal intubation and laryngeal mask airway.

Keywords: complications of induction, inhalational induction, intra-venous induction, rapid sequence induction