Airway management, regional anaesthesia, pain medicine, critical care pharmacology, and perioperative assessment.
Acute pain management focuses on the perioperative period and acute illness, using multimodal analgesia incorporating non-opioid, opioid, and regional techniques to optimise recovery.
Airway management is the cornerstone of anaesthetic practice, encompassing basic manoeuvres, supraglottic devices, and endotracheal intubation to maintain oxygenation and ventilation.
Emergency anaesthesia carries significantly higher risk than elective cases due to limited time for assessment, unfasted patients, physiological derangement, and the need for rapid sequence induction.
Anaesthesia in pregnancy requires understanding of maternal physiological changes, the risks to mother and foetus, and the specific challenges of obstetric anaesthesia including regional techniques and emergency general anaesthesia.
Perioperative anaphylaxis is a severe, life-threatening hypersensitivity reaction occurring during anaesthesia, most commonly caused by neuromuscular blocking agents, antibiotics, or latex. Immediate adrenaline is life-saving.
The ASA Physical Status Classification system stratifies patients into six grades based on systemic disease severity, providing a standardised framework for communicating anaesthetic risk.
ERAS protocols are multimodal, evidence-based perioperative care pathways that reduce surgical stress, accelerate recovery, and shorten hospital stay across a wide range of surgical specialties.
Epidural anaesthesia involves placement of a catheter in the epidural space for continuous or intermittent local anaesthetic administration, providing analgesia for labour, surgery, and post-operative pain.
Inhalational agents (sevoflurane, desflurane, isoflurane, nitrous oxide) are used for induction and/or maintenance of general anaesthesia, delivered via calibrated vaporisers in a carrier gas mixture.
Intensive care medicine provides multi-organ support for critically ill patients. Core principles include systematic assessment, organ support, early recognition of deterioration, and evidence-based protocolised care.
Intravenous anaesthetic agents are used for induction and maintenance of general anaesthesia. Propofol is the most widely used agent; alternatives include thiopental, ketamine, and etomidate.
Malignant hyperthermia is a rare, life-threatening pharmacogenetic disorder triggered by volatile anaesthetic agents and suxamethonium, causing uncontrolled skeletal muscle hypermetabolism. Treatment is dantrolene.
Mechanical ventilation provides respiratory support for patients unable to maintain adequate gas exchange. Understanding ventilator modes, settings, and lung-protective strategies is essential for safe ICU practice.
Paediatric anaesthesia requires understanding of age-related anatomical and physiological differences, appropriate equipment sizing, and drug dosing to provide safe care for children from neonates to adolescents.
Pain assessment and management is fundamental to anaesthetic and perioperative practice. A multimodal approach using the WHO analgesic ladder and procedure-specific protocols optimises patient outcomes.
PONV affects 30% of all surgical patients and up to 80% of high-risk patients. Risk stratification using the Apfel score guides prophylactic antiemetic therapy, which is most effective as combination treatment.
Preoperative assessment evaluates patient fitness for anaesthesia and surgery, identifies modifiable risk factors, and plans perioperative management to optimise outcomes.
Procedural sedation provides anxiolysis, analgesia, and amnesia for diagnostic and therapeutic procedures outside the operating theatre, requiring standardised safety protocols and monitoring.
Rapid sequence induction (RSI) is an anaesthetic technique designed to minimise the time between loss of consciousness and tracheal intubation, reducing the risk of pulmonary aspiration in patients with a full stomach.
Regional anaesthesia involves the injection of local anaesthetic near specific nerves or nerve plexuses to block sensation in a defined body area, avoiding or supplementing general anaesthesia.
Sedation produces a continuum from minimal anxiolysis to deep sedation, used in ICU, procedural settings, and palliative care. Safe sedation requires appropriate monitoring, training, and rescue capability.
Shock is a state of circulatory failure resulting in inadequate tissue oxygen delivery. Classification into hypovolaemic, cardiogenic, distributive, and obstructive guides targeted resuscitation.
Spinal anaesthesia involves injection of local anaesthetic into the subarachnoid space, producing dense motor and sensory blockade below the level of injection. It is widely used for lower limb and pelvic surgery.