General Anaesthesia Induction

Quick Answer

General anaesthesia induction is the transition from consciousness to unconsciousness with loss of protective airway reflexes, requiring controlled manipulation of physiology and airway management. Rapid sequence induction (RSI) is the standard technique for patients with aspiration risk, using preoxygenation, cricoid pressure (10 Newtons), propofol (2-3 mg/kg) or thiopental (4-5 mg/kg), succinylcholine (1.5 mg/kg) or rocuronium (1.2 mg/kg), and avoiding positive pressure ventilation until intubation confirmed. Preoxygenation with 100% oxygen for 3-5 minutes extends safe apnoea time from 2 minutes to 8-10 minutes in healthy adults. Difficult airway management requires a structured approach: Plan A (optimal direct laryngoscopy with bougie or video laryngoscopy), Plan B (second-generation supraglottic airway), Plan C (front-of-neck access). Aspiration prophylaxis includes sodium citrate 0.3 M 30 mL PO, ranitidine 50 mg IV, metoclopramide 10 mg IV. Total intravenous anaesthesia (TIVA) with propofol infusion (target effect-site concentration 4-6 μg/mL) plus remifentanil (0.05-0.2 μg/kg/min) provides stable anaesthesia without volatile agents, useful for neurosurgery, PONV prophylaxis, and malignant hyperthermia-susceptible patients. Indigenous patients may have higher rates of obesity and difficult airways, requiring careful airway assessment, culturally safe consent processes, and planning for potential difficult intubation scenarios. [1-10]