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A.

Thangamani ramalingam
PT, MSc(PSY), MIAP

Anesthesia, or an aesthesia
( from Greek an-, "without";
and aesthesis, "sensation"),
traditionally meant the
condition of having
sensation (including the
feeling of pain) blocked or

Types of anesthesia

local anesthesia
regionalanesthesia
spinal anesthesiaand
epidural anesthesia.
general anesthesia
dissociative anesthesia.

Local anesthesia

Surface anesthesia
Infiltration anesthesia
Nerve block
Field block

Spinal anesthesia

Extra dural
caudal

General anesthesia

Stage
Stage
Stage
Stage

of
of
of
of

analgesia
excitement
surgical anesthesia
impending over dose

local anesthetics
Each of them have the suffix "-caine"
in their names.
procaine
amethocaine
cocaine
lidocaine (also known as Lignocaine)
prilocaine
bupivacaine
levobupivacaine
ropivacaine
mepivacaine
dibucaine

Inhalational anesthetic

Desflurane
Enflurane
Halothane
Isoflurane
Methoxyflurane
Nitrous oxide
Sevoflurane
Xenon(rarely used)

Intravenous
agents -nonBarbiturates
Amobarbital (trade name: Amytal)
opioid

Methohexital (trade name: Brevital)


Thiamylal (trade name: Surital)
Thiopental (trade name: Penthothal,
referred to as thiopentone in the UK)
Benzodiazepines
Diazepam
Lorazepam
Midazolam
Etomidate
Ketamine
Propofol

Intravenous opioid
analgesic agents
following opioids have short
onset and duration of action
and are frequently used
during general anesthesia:
Alfentanil
Fentanyl
Remifentanil
Sufentanil

Buprenorphine

Butorphanol

Diamorphine, (diacetyl morphine, also known as heroin,


not available in U.S.)
The
following
agents
have
longer
onset

Hydromorphone
and duration

Levorphanol of action and are frequently

also called pethidine


in the
UK, New
used Meperidine,
for post-operative
pain
relief
: Zealand,
Australia and other countries

Methadone

Morphine

Nalbuphine

Oxycodone, (not available intravenously in U.S.)

Oxymorphone

Pentazocine

Muscle relaxants

Depolarizing muscle
relaxants
Succinylcholine(also
known
assuxamethoniumin the
UK, New Zealand, Australia
and other countries,
"Celokurin" or "celo" for
short in Europe)

Decamethonium
Non-depolarizing muscle
relaxants

Short acting

Mivacurium
Rapacuronium

Intermediate acting

Atracurium

Cisatracurium
Rocuronium
Vecuronium

Long acting

Alcuronium
Doxacurium
Gallamine
Metocurine
Pancuronium
Pipecuronium
Tubocurarine

Intravenous reversal
agents

Flumazenil, reverses the effects of


benzodiazepines
Naloxone, reverses the effects of
opioids
Neostigmine, helps reverse the effects
of non-depolarizing muscle relaxants
Sugammadex, new agent that is
designed to bind Rocuronium
therefore terminating its action

Complications and risks


General anesthesia
Vomiting
Chest complications
Thrombosis of leg veins
CO retention (cyanosis)
Pain
Toxic effects
2

Spinal anesthesia
Fall in BP due to paralysis of
symp.nervous system
Headache
Meningitis
Vomiting
Toxic reactions
Neurological complications

advantages

Profound relaxation
Retention of consciousness
No chances of chest complications

Pre medication before


anesthesia
Atropine
Hyoscine
Dry up secretions of Resp. tract,
reduce PR,HR, gut motility, sweat
and salivary secretions

Morphine, pethidine& papaveretum


To reduce CNS activity
Chlorpromazine& promezathine
Sedation
Metoclopramide &prochlorperazine
Anti-emetic

Unwanted effects

Depresses resp& cough


Uncaring attitude
Inclination to sleep
Lowers BMR
Stimulates nausea& vomiting
Increased risk of urinary retention
Decreased peristalsis/constipation

Thank you