39283 - Anaesthesia and Analgesia

Learning outcomes

At the end of the module, the student will have acquired, within the scope of their competencies, knowledge of the pathophysiology, functional and instrumental diagnostic assessment, and clinical aspects of general surgery.

Course contents

1. Introduction to Anesthesiology

• The role of the anesthesiologist in perioperative care.
• Principles of anesthesia, analgesia, and procedural sedation.
• Patient safety and perioperative risk management.

2. Physiology and Pharmacology of Anesthesia

• Physiological responses to anesthesia and surgery.
• Pharmacology of anesthetic agents:
  • intravenous and inhalational anesthetics;
  • opioids;
  • local anesthetics;
  • neuromuscular blocking agents and reversal drugs.
• Pharmacological monitoring and drug safety.

3. Anesthetic Techniques

• General anesthesia: principles, indications, contraindications, and management.
• Regional anesthesia:
  • topical anesthesia;
  • local infiltration anesthesia;
  • peripheral nerve blocks;
  • spinal and epidural anesthesia.
• Procedural sedation.

4. Patient Assessment and Monitoring

• Preoperative assessment and patient optimization.
• American Society of Anesthesiologists (ASA) Physical Status Classification.
• Standard intraoperative monitoring:
  • electrocardiography (ECG);
  • blood pressure monitoring;
  • pulse oximetry;
  • capnography.
• Principles of airway management.

5. Pain Physiology and Assessment

• Neurophysiology and pathophysiology of pain.
• Acute and chronic pain.
• Pain assessment using validated pain scales.
• Clinical impact of pain on patient outcomes.

6. Pain Management

• Principles of multimodal analgesia.
• Non-opioid analgesics.
• Opioids.
• Regional analgesic techniques.
• Postoperative pain management.
• Organization and role of the Acute Pain Service (APS).

7. Complications and Patient Safety

• Complications of general and regional anesthesia.
• Local anesthetic systemic toxicity (LAST).
• Postoperative nausea and vomiting (PONV).
• Allergic reactions and perioperative emergencies.
• Prevention of adverse events and patient safety principles.

Readings/Bibliography

Lecture slides and educational materials provided by the instructor constitute the primary learning resource for the course.

For further study and in-depth coverage of the topics addressed, students are encouraged to consult the following textbooks:

• Butterworth J.F., Mackey D.C., Wasnick J.D. Morgan & Mikhail's Clinical Anesthesiology. 7th Edition. McGraw-Hill Education, 2022.
• Pardo M.C., Miller R.D. Basics of Anesthesia. 8th Edition. Elsevier, 2022.
• Gropper M.A., Eriksson L.I., Fleisher L.A., Cohen N.H., Leslie K., Johnson-Akeju O. (Eds.). Miller's Anesthesia. 10th Edition. Elsevier, 2024.

Students are also encouraged to consult current evidence-based clinical practice guidelines and consensus statements published by leading scientific societies, including:

• European Society of Anaesthesiology and Intensive Care (ESAIC)
• American Society of Anesthesiologists (ASA)
• International Association for the Study of Pain (IASP)

Recommended Scientific Journals

• Anesthesiology
• British Journal of Anaesthesia
• European Journal of Anaesthesiology and Intensive Care
• Regional Anesthesia & Pain Medicine
• Pain
• Anaesthesia
• Journal of Clinical Anesthesia

These resources provide comprehensive coverage of the physiological and pharmacological principles of anesthesia, contemporary anesthetic techniques, perioperative medicine, and evidence-based approaches to acute and chronic pain management.

Teaching methods

The course is delivered through interactive lectures designed to provide students with the fundamental principles of anesthesia, analgesia, perioperative medicine, and pain management.

Teaching activities are complemented by the discussion of clinical cases and the analysis of clinical scenarios, with particular emphasis on preoperative assessment, the selection of anesthetic and analgesic techniques, patient monitoring, and the management of acute and chronic pain.

During the lectures, multimedia teaching resources, international clinical practice guidelines, selected scientific articles, and clinical decision-making algorithms are used to facilitate the understanding of the pathophysiological, pharmacological, and clinical principles of anesthesia and pain management.

The course promotes an evidence-based medicine (EBM) approach, fostering the development of clinical reasoning, the integration of theoretical knowledge with clinical practice, and the acquisition of competencies focused on patient safety and quality of care.

Assessment methods

Assessment consists of an oral examination, which may include the discussion of clinical cases, and is designed to evaluate the achievement of the course learning objectives.

The examination assesses the student's ability to:

• describe the physiological and pharmacological principles of anesthesia and analgesia;
• discuss the indications, contraindications, advantages, and limitations of general, regional, and local anesthesia;
• explain the pathophysiological mechanisms underlying acute and chronic pain and the principles of pain assessment and management;
• demonstrate knowledge of perioperative patient evaluation, monitoring, and safety;
• apply theoretical knowledge to the analysis and management of common clinical scenarios in anesthesiology and pain medicine.

Assessment is based on the accuracy and completeness of the knowledge acquired, the appropriate use of scientific terminology, the ability to integrate concepts across the topics covered, and the clinical reasoning skills demonstrated during the examination.

The final grade is expressed on a 30-point scale (out of 30).

Teaching tools

The course is supported by both traditional and digital teaching resources designed to facilitate learning and promote the integration of theoretical knowledge with clinical practice.

Teaching tools include:

• lecture slides and educational materials provided by the instructor;
• recommended textbooks and selected scientific articles;
• international clinical practice guidelines and consensus statements published by major scientific societies (ESAIC, ASA, IASP);
• multimedia resources illustrating anesthetic techniques, perioperative monitoring, regional anesthesia, and pain management procedures;
• clinical cases and evidence-based decision-making algorithms discussed during lectures to enhance clinical reasoning and the application of theoretical concepts.

These teaching tools are intended to promote active learning, encourage critical appraisal of the scientific literature, and support the application of evidence-based principles in anesthesia, perioperative medicine, and pain management.

Office hours

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