Total Intravenous Anaesthesia (TIVA/TCI), Inhalational Anaesthesia and Depth of Anaesthesia Monitoring — WACS Viva & Clinical Scenarios (General Anaesthesia)

Exam-style total intravenous anaesthesia (tiva/tci), inhalational anaesthesia and depth of anaesthesia monitoring viva scenarios with examiner probes and model…

Scenarios covered

• SCENARIO 1: A 38-year-old female with a strong family history of malignant hyperthermia is booked for elective laparoscopic cholecystectomy. Dedicated TCI syringe drivers are unavailable in your facility. Describe your step-by-step plan for providing a safe manual total intravenous anaesthetic (TIVA) using propofol and fentanyl.
• SCENARIO 2: A 68-year-old male with severe ischemic cardiomyopathy (left ventricular ejection fraction 25%) is undergoing elective open repair of an infrarenal abdominal aortic aneurysm. Compare and defend your choice between an inhalational-based technique and a target-controlled total intravenous anaesthesia (TIVA/TCI) regimen in this patient.
• SCENARIO 3: During an elective 5-hour pelvic exenteration under propofol-remifentanil TIVA and rocuronium muscle relaxation, the Bispectral Index (BIS) suddenly rises from 42 to 78, accompanied by acute hypertension (BP 185/105 mmHg) and tachycardia (HR 115 bpm). The surgical field is deeply stimulating. Outline your diagnostic algorithm and therapeutic intervention.
• SCENARIO 4: A 4-year-old child presents for foreign body extraction from the bronchus. You choose an inhalational technique with sevoflurane. Detail the pharmacokinetic and physical principles governing inhalational induction, uptake, distribution, and emergence, highlighting factors that alter the speed of induction in this child.