Induction and maintenance of anaesthesia
Specialist training is required for all general anaesthesia procedures. Drugs for general anaesthesia should only be administered by or under the direct supervision of personnel experienced in their use and only in locations where resuscitation equipment is available. Personnel should have adequate training in anaesthesia and airway management.
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Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Prescribing Notes:
- Propofol is contra-indicated in patients who are allergic to eggs, nuts or soya and should be used with caution in patients with epilepsy due to increased risk of convulsions.
- Propofol is used in sub-anaesthetic doses by infusion for sedation.
History Notes
27/10/2022
East Region Formulary content agreed.
Profopol, clonidine or dexmedetomidine alone, or in combination.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Profopol or midazolam alone, or in combination.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Prescribing Notes:
- Propofol is contra-indicated in patients who are allergic to eggs, nuts or soya and should be used with caution in patients with epilepsy due to increased risk of convulsions.
- Propofol is used in sub-anaesthetic doses by infusion for sedation.
History Notes
27/10/2022
East Region Formulary content agreed.
Inhaled anaesthetics can be used with or without nitrous oxide in oxygen.
Dose as per specialist.
Inhaled anaesthetics can be used with or without nitrous oxide in oxygen.
Dose as per specialist.
Prescribing Notes:
- Sevoflurane is associated with fewer adverse induction effects and can be used for rapid inhalational induction in place of intravenous agents.
- All volatile anaesthetic agents (e.g. isoflurane, sevoflurane) can trigger malignant hyperthermia; nitrous oxide does not trigger malignant hyperthermia.
- Adequate scavenging or external venting should be used.
- Use of absorption breathing systems can permit use of low fresh gas flow techniques which can result in significant economies with these agents.
History Notes
27/10/2022
East Region Formulary content agreed.
Nitrous oxide through anaesthetic machine with oxygen, or as Entonox or Equanox (nitrous oxide + oxygen).
Seek expert advice and see BNF.
Prescribing Notes:
- Nitrous oxide (maximum dose, 70% in oxygen) is used for sedation or pain relief as:
- Entonox or Equanox (containing 50% nitrous oxide and 50% oxygen) fixed dose.
- Relative analgesia (nitrous oxide 0-70% in oxygen) variable dose.
- Entonox (or Equanox) and RA (Relative Analgesia) should be used in well ventilated areas.
- Please see local neurosurgery protocols for the use of methoxyflurane (Penthrox) for short term procedures.
- Please see local Emergency department protocols for the use of methoxyflurane (Penthrox) for Emergency relief of moderate to severe pain in conscious adult patients with trauma and associated pain (usually involving limb injury, and subsequent procedures including splinting, manipulation, or reduction).
History Notes
12/06/2024
Methoxyflurane, Penthrox added for Specialist Use only in the Emergency department, ERFC Dec 23.
27/10/2022
East Region Formulary content agreed.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
History Notes
27/10/2022
East Region Formulary content agreed.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Morphine 50mg/50ml and 100mg/50ml should be used in PCA only.
Dose as per specialist.
Morphine 50mg/50ml and 100mg/50ml should be used in PCA only.
Dose as per specialist.
Morphine 50mg/50ml and 100mg/50ml should be used in PCA only.
Dose as per specialist.
Morphine 50mg/50ml and 100mg/50ml should be used in PCA only.
Dose as per specialist.
Remifentanil 5mg powder for solution for injection vials should be used in ICU only.
Dose as per specialist.
Remifentanil 5mg powder for solution for injection vials should be used in ICU only.
Dose as per specialist.
Remifentanil 5mg powder for solution for injection vials should be used in ICU only.
Dose as per specialist.
Remifentanil 5mg powder for solution for injection vials should be used in ICU only.
Dose as per specialist.
History Notes
27/10/2022
East Region Formulary content agreed.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Dose as per specialist.
Prescribing Notes:
- Propofol is contra-indicated in patients who are allergic to eggs, nuts or soya and should be used with caution in patients with epilepsy due to increased risk of convulsions.
- Propofol is used in sub-anaesthetic doses by infusion for sedation.
- Thiopental is used in patients suffering from epilepsy or those who are allergic to propofol. It is contra-indicated in patients allergic to barbiturates or suffering porphyria.
TEST CHANGE AGAIN
History Notes
27/10/2022
East Region Formulary content agreed.