Anesthesia

Anesthetic can produced:

- muscle relaxation - block transmission of pain nerve impulses - suppress reflexes - can temporarily decrease memory retrieval and recall

Anesthesia is an

artificially induced state of partial or total loss of

sensation.

The depth and effects are

monitored by observing changes in: - respiration - oxygen saturation and end-tidal carbon dioxide level - HR - urine output -BP

Two Major Techniques in Anesthesia

General Anesthesia

Gen. anesthesia
block pain stimulus at the cerebral cortex and induce depression of the CNS that is reversed either by metabolic change and elimination from the body or by pharmacologic means. Gen. Anesthesia is appropriate for: surgery on the head, neck upper torso and back For prolonged surgical procedures For use in clients who are unable to lie quietly for a long period

Stages of General Anesthesia

Used to guide the surgeon in determining

when surgery could begin

The last sense to be depressed during

induction is hearing

Stage 1 Known as induction

The period between the initial
administration of the induction medications and loss of consciousness

During this stage the patient

progresses from analgesia without amnesia to analgesia with amnesia.

Stage 2
Known as excitement stage The period following loss of consciousness and marked
by excited and delirious activity Respiration and pulse rate may become irregular There may be uncontrolled movements. Vomiting, breath holding and pupillary dilation Combination of spastic movements, vomiting and irregular respirations may lead to airway compromise, rapidly acting drugs are used to minimize time in this stage and reach stage 3 as fast as possible

Stage 3

Surgical anesthesia
The skeletal muscles relax and the patients
breathing becomes regular

Eye movements are slow then stop

Stage 4

A.k.a. overdose
The stage where too much medication has
been given and the patient has severe brain stem or medullary depression

This results in a cessation of respiration and

potential cardiovascular collapse

General anesthesia

Used for more extensive procedures or for

procedures that arent amendable to regional anesthesia

The medications used in gen. anesthesia are

given IV or by inhalation.

Can suppress all of your protective reflexes Requires the use of a mask or breathing tube
while youre asleep

Administration of General Anesthesia

Neuroleptic or Balanced anesthesia

Using a combination of agents based on the

clients need with consideration of the type of surgery to be performed Typically achieved by using a combination of an inhalation agent, oxygen, an opiod and a neuromuscular blocking agents

TYPES OF GENERAL ANESTHESIA

Intravenous Anesthesia
- conscious sedation - client experiences an extremely rapid induction - unconciousness generally occurs about 30 seconds after the medication is administered

Used to relax you and make

you feel sleepy Generally includes IV administration of pain medication and mild sedative to minimize any discomfort Medications also caused temporary forgetfulness Used for procedures such as colonoscopy,

Inhalation Anesthesia

A mixture of volatile liquid or gas and oxygen is used

Advantageous because their ease of administration and
elimination through the respiratory system

The mixture is given through mask or through an

endotracheal tube

REGIONAL ANESTHESIA Advantages of Regional

Anesthesia - provides a high level of anesthesia to a selected region of the body while having little aeffect on other areas such as your heart, lungs and brain. - protective reflexes remain intact - helps control postop pain

Used to block
sensation in a particular region of your body, such as the lower half of your body, an eye, or an arm or leg

Epinephrine

Can be added to many local anesthetics in an effort

to prolong the anesthetic effect Causes local blood vessels to constrict thus delaying absorption of the anesthetic agents Can reduce bleeding (vasoconstriction) Should be used with caution Could compromise tissue perfusion, leading to adverse outcomes such as poor circulatory response

Types of Regional Anesthesia

Spinal Anesthesia
Advantages: anesthetic techniques of choice for older adults relatively safe excellent lower-body muscle relaxation adsence of effect on consciousness does not require an empty stomach

Spinal Anesthesia

Can be used for almost any type of major

procedure performed below the level of the diaphragm There is a loss of sensation and paralysis of the toes, feet, legs and then abdomen Slight hypotension

Epidural Anesthesia

Achieved by introduction of an anesthetic

agent into the epidural space Epidural space is entered by a needle at a: - thoracic - lumbar - sacral - caudal interspace

Caudal Anesthesia

Produced by injection of the local

anesthetic into the caudal or sacral canal Commonly used in obstetric clients