NEET PG Rapid Revision
Anaesthesia One-Liners for NEET PG: Rapid Revision
High-yield anaesthesia one-liners for NEET PG covering general anaesthesia, regional anaesthesia, pain management and critical care.
MedNext Academy | 6 min read
Anaesthesia One-Liners for NEET PG: Rapid Revision
High-yield anaesthesia one-liners for NEET PG covering general anaesthesia, regional anaesthesia, pain management and critical care.
Anaesthesia: rapid revision one-liners for NEET PG
Anaesthesia in NEET PG covers general anaesthesia, regional anaesthesia, local anaesthetics, neuromuscular blocking agents, pain management and critical care concepts. Questions focus on drug pharmacology, airway management and complications of anaesthesia.
These one-liners cover the most frequently tested facts about anaesthetic agents, techniques and peri-operative management.
Must-know one-liners
- Ideal inhalational agent: low blood-gas partition coefficient (faster induction and recovery); desflurane and sevoflurane have the lowest coefficients among commonly used agents
- MAC (minimum alveolar concentration) is the concentration of inhaled anaesthetic that prevents movement in 50% of patients to a standard surgical incision; lower MAC = more potent
- Nitrous oxide has the highest MAC (105%) and is the least potent inhalational agent; used as an adjuvant for analgesia
- Halothane is the most potent inhalational agent (MAC 0.75%); causes hepatotoxicity (halothane hepatitis -- immune-mediated) and malignant hyperthermia
- Sevoflurane is the inhalational agent of choice for inhalational induction in children (pleasant smell, non-irritating); may produce compound A (nephrotoxic) with soda lime
- Desflurane has the lowest blood-gas partition coefficient among potent agents (fastest onset/offset); pungent, not used for inhalational induction; causes sympathetic stimulation
- Isoflurane: least metabolised volatile agent; causes coronary steal phenomenon in patients with coronary artery disease
- Malignant hyperthermia: autosomal dominant; ryanodine receptor (RYR1) mutation; triggered by succinylcholine and volatile agents; treated with dantrolene
- Malignant hyperthermia signs: rapidly rising temperature, muscle rigidity, hypercarbia, tachycardia, elevated CK
- Propofol: IV induction agent of choice; ultra-short acting; causes pain on injection and hypotension; antiemetic properties; propofol infusion syndrome (PRIS) with prolonged use
- Thiopentone (thiopental): ultra-short-acting barbiturate; redistributes to fat (not metabolised) accounting for short duration; contraindicated in porphyria and status asthmaticus
- Ketamine: dissociative anaesthetic; preserves airway reflexes, increases HR and BP; causes emergence delirium/hallucinations; bronchodilator; analgesic at sub-anaesthetic doses
- Ketamine is the induction agent of choice in haemodynamically unstable patients and in bronchospasm
- Etomidate: minimal cardiovascular depression; adrenocortical suppression (inhibits 11-beta-hydroxylase); used for induction in cardiac-compromised patients
- Succinylcholine: the only depolarising neuromuscular blocker; causes fasciculations, raised IOP, raised intragastric pressure, hyperkalaemia; short duration (5-10 min) due to plasma cholinesterase
- Succinylcholine is contraindicated in burns (> 24 hours), denervation injuries, upper motor neuron lesions and hyperkalaemia (risk of lethal hyperkalaemia)
- Non-depolarising neuromuscular blockers (vecuronium, rocuronium, atracurium, cisatracurium): competitive antagonists at nicotinic receptors; reversed by neostigmine + glycopyrrolate
- Sugammadex: modified gamma-cyclodextrin that encapsulates rocuronium and vecuronium; provides rapid, complete reversal without cholinergic side effects
- Rocuronium: rapid onset non-depolarising agent; can replace succinylcholine for rapid-sequence intubation when reversed with sugammadex
- Atracurium: undergoes Hofmann degradation (organ-independent elimination); safe in renal and hepatic failure; laudanosine metabolite may cause seizures
- Lignocaine (lidocaine): amide local anaesthetic; fastest onset among amide LAs; also used as an antiarrhythmic (class IB); maximum dose 4.5 mg/kg (7 mg/kg with adrenaline)
- Bupivacaine: long-acting amide local anaesthetic; high cardiotoxicity (resistant to resuscitation); intralipid (lipid emulsion) is the rescue treatment for bupivacaine toxicity
- Ropivacaine: long-acting amide local anaesthetic with less cardiotoxicity than bupivacaine; preferred for epidural use
- Local anaesthetic toxicity: CNS excitation (tinnitus, metallic taste, seizures) followed by CNS and cardiovascular depression
- Spinal anaesthesia: injected into the subarachnoid space at L3-L4 or L4-L5 (below the conus medullaris at L1-L2); rapid onset, dense block
- Total spinal: high spinal anaesthesia causing respiratory arrest, hypotension and loss of consciousness; medical emergency
- Epidural anaesthesia: injected into the epidural space; slower onset than spinal; catheter allows continuous infusion; less hypotension
- Complications of spinal/epidural anaesthesia: post-dural puncture headache (PDPH), hypotension, urinary retention, epidural haematoma, infection
- PDPH: headache worsened by sitting up and relieved by lying down; treated with bed rest, fluids, analgesics and epidural blood patch if persistent
- Difficult airway: Cannot Intubate Cannot Oxygenate (CICO) situation requires emergency surgical airway (cricothyrotomy)
- Cormack-Lehane grading: Grade I (full view of glottis), Grade II (partial view), Grade III (epiglottis only), Grade IV (no glottic structures visible)
- Mallampati classification: Class I (full view of soft palate, fauces, uvula), Class IV (hard palate only visible); higher class predicts difficult intubation
- RSI (rapid-sequence induction): pre-oxygenation, cricoid pressure (Sellick manoeuvre), rapid-acting induction agent + succinylcholine/rocuronium, intubation without bag-mask ventilation
- Laryngeal mask airway (LMA): supraglottic airway device; does not protect against aspiration; useful in difficult airway management
- ASA physical status classification: I (healthy), II (mild systemic disease), III (severe systemic disease), IV (life-threatening), V (moribund), VI (brain-dead organ donor)
- Capnography: end-tidal CO2 (ETCO2) monitoring; gold standard for confirming endotracheal tube placement; normal ETCO2 is 35-45 mmHg
- Pulse oximetry measures SpO2 using the Beer-Lambert law; unreliable in carbon monoxide poisoning (falsely high), methhaemoglobinaemia and severe anaemia
- Morphine: gold standard opioid analgesic; causes respiratory depression, miosis, constipation, histamine release, nausea; reversed by naloxone
- Fentanyl: synthetic opioid, 100 times more potent than morphine; does not cause histamine release; used in balanced anaesthesia and as a patch for chronic pain
- WHO analgesic ladder: Step 1 (non-opioid: paracetamol/NSAID), Step 2 (weak opioid: tramadol/codeine), Step 3 (strong opioid: morphine/fentanyl); adjuvants at any step
- Glasgow Coma Scale (GCS): Eye (1-4) + Verbal (1-5) + Motor (1-6) = 3-15; intubation indicated at GCS <= 8
- The triad of anaesthesia: hypnosis (unconsciousness), analgesia (pain relief) and muscle relaxation
- Awareness under anaesthesia: occurs in 0.1-0.2% of general anaesthetics; BIS (bispectral index) monitoring helps prevent it; BIS 40-60 is the target range
- Midazolam: water-soluble benzodiazepine; most commonly used for premedication, procedural sedation and as an adjunct in general anaesthesia; flumazenil reverses it
- Tramadol: synthetic opioid analgesic that also inhibits serotonin and noradrenaline reuptake; risk of seizures; avoid with SSRIs (serotonin syndrome risk)
- Laryngospasm: spasm of the vocal cords during anaesthesia; treated with jaw thrust, positive pressure ventilation and succinylcholine if refractory
- Brachial plexus block approaches: interscalene (shoulder surgery), supraclavicular (upper limb), infraclavicular, axillary (forearm and hand surgery)
- Central venous pressure (CVP): normal 2-6 mmHg; measured via internal jugular or subclavian vein catheter; guides fluid management
- Hypothermia during anaesthesia is the most common thermal disturbance; forced-air warming is the most effective prevention method
- The Mapleson D breathing system (Bain circuit) is most efficient for controlled ventilation; Mapleson A (Magill) is most efficient for spontaneous ventilation
How to use these one-liners
Anaesthesia one-liners are best organised by drug class: inhalational agents, IV induction agents, neuromuscular blockers, local anaesthetics and opioids. For each drug, know the mechanism, key side effects and specific indications or contraindications.
Pay special attention to emergency scenarios: malignant hyperthermia, local anaesthetic toxicity, total spinal and difficult airway management. These are high-yield topics that test your ability to manage life-threatening situations.
Key mnemonics
Malignant hyperthermia triggers: SUX and volatile agents. Treatment = Dantrolene (DAN for Dantrolene, cool the patient).
Local anaesthetic types: Amides have 2 letter 'i's in the name (lidocaine, bupivacaine, ropivacaine); Esters have 1 'i' or none (procaine, cocaine, tetracaine).
GCS Motor scale: 6 = Obeys commands, 5 = Localises, 4 = Withdrawal, 3 = Abnormal flexion, 2 = Extension, 1 = None.
Revision schedule
Anaesthesia is a smaller subject but has a high marks-to-effort ratio. Revise these one-liners every 4-5 days, covering pharmacology in one session and techniques/complications in the next. In the final week, one complete run-through every 2 days is sufficient. Focus on drug side effects and emergency management -- these account for the majority of questions.
Frequently Asked Questions
How many anaesthesia questions appear in NEET PG?
Typically 5-8 questions. Pharmacology of anaesthetic agents (especially side effects), airway management, regional anaesthesia and critical care basics are the most commonly tested.
How important is pharmacology within anaesthesia?
It is the single most important area. Know the pharmacology of inhalational agents (MAC, side effects), IV induction agents, neuromuscular blockers and local anaesthetics thoroughly.
Are critical care questions part of anaesthesia?
Yes, basic critical care concepts (ventilator settings, shock management, GCS, ABG interpretation) may appear under anaesthesia. These overlap with medicine and surgery.
Should I study a dedicated anaesthesia textbook?
For NEET PG, Ajay Yadav or the anaesthesia sections of standard textbooks are sufficient. Focus on pharmacology, airway management and complications rather than detailed surgical anaesthesia techniques.
Inside MedNext for this topic
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- 80,000+ MCQ bank
- 15 study modes
- Growing visual cheat sheets
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Continue reading
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