CME Final Year Medical Students

Analgesia, Anaesthestics and Sedative Agents

Note:
Often my students have asked me what to present for this topic tutorial. I have revised, updated and included a few different links for you to prepare for this presentation.


Objective of this CME topic:

To give students a basic understanding on:
- the definition of pain as defined by the International Association for the Study of Pain (IASP).
(Click here for a list of definitions by IASP).
- the importance of pain management in emergency cases
- the different types of pain management modalities including pharmacological and non-pharmacological measures
- the physiological and psychological effects of pain
- the differences between analgesia and anaesthesia
- the different types of opioids used in emergency department including full agonists and partial agonists
- the different types of sedatives used in emergency department
- the different types of muscle relaxants used in emergency department

Topics for discussion:

TOPIC #1: Pain - In General
Definition by IASP
The importance of pain management in emergency cases
Physiological and psychological effects of pain
The WHO Pain Relief Ladder (click here for a description)
A general overview of the different modalities of pain treatment, divided according to pharmacological and non-pharmacological methods

TOPIC #2: Opioids
Discuss on the pharmacodynamics and pharmacokinetics of these common opioids used:
- Morphine
- Pethidine
- Fentanyl

Click here for the Merck Manual online.

TOPIC #3: Sedative Agents
Discuss on the concept of dissociative anaesthesia
Discuss on the pharmacology of
- Ketamine
- Propofol
- Etomidate
- Midazolam (as a prototype for benzodiazepine)
Know when to use which drugs under the different circumstances


Click here for the Wikipedia Portal Pharmacy and Pharmacology
Click here for the Virtual Anaesthesia Textbook online.

TOPIC #4: Muscle Relaxants
Discuss on the two classes of muscle relaxants - depolarizing and non-depolarizing and the differerences between these two in terms of mechanisms of action, and their basic pharmacodynamic and pharmacokinetics
Discuss pharmacodynamics and pharmacokinetics, and including side effects on
- succinylcholine
- atracurium and the concept of Hofmann elimination
- rocuronium and why it can be used for rapid sequence intubation in emergency department
- vecuronium and the importance of its cardio-stability properties.
- pancuronium - and its vagolytic effects.

Click here for comprehensive resource on rocuronium