INTRODUCTION TO

ANESTHESIA

Dr. KYAT SIDHARTA, Sp An

DEFINITION
• IDSAI (Mei 2003):
anestesiologi merupakan suatu disiplin dalam
praktek kedokteran yang mengkhususkan
dalam:
A. Penatalaksanaan medis pada pasien pasien
yang dibuat tidak sadar dan atau tidak
merasakan nyeri atau stres emosi selama
prosedur bedah, obstetrik dan medis lain
tertentu.
B. Perlindungan fungsi fungsi kehidupan dan
organ organ vital (jantung, paru ginjal, hati dsb)
dibawah stres prosedur anestetik, bedah dan
medis lainnya
DEFINITION
C. Penatalaksanaan problema dalam
meredakan nyeri
D. Penatalaksanaan resusitasi jantung
paru
E. Penatalaksanaan problema dalam
pengelolaan pulmoner yang akut dan
mengancam
F. Penatalaksanaan pasien pasien sakit
kritis di unit rawat khusus
G. Terapi inhalasi
HISTORY OF ANESTHESIOLOGY

• William T. G. Morton: in Boston, on October

16, 1846, showed the world that ether could
work as an anesthetic.
• Crawford W. Long: administered ether for
removal of two small neck tumors on March
30, 1842
• Joseph Priestley: was the first to prepare nitrous
oxide
• James Young Simpson: an obstitrician from
Edinburgh, who championed the use of
chloroform for relief of pain during operative or
obstetric procedures
HISTORY OF ANESTHESIOLOGY

• John Snow: the first physician to

undertake detailed clinical and
pharmacologic studies of inhaled
anesthetics and is considered the first
anesthesiologist.
• Carl Koller recognized the topical
anesthetic effect of coccaine
• Spinal anesthesia was a term coined in
1885 by Leonard Corning, a neurologist
who administered coccaine into the
subarachnoid space
INTRODUCTION
• Anesthesiology as a medical
specialty:
1. inpatient & outpatient care
2. operating theatres
3. recovery rooms
4. intensive care units
Target of Study

• To understand the role of

anesthesiologists
• To understand the management of
anesthesia and intensive care
• To understand the diseases and its
implications to surgeries and
anesthesia
PREOPERATIVE EVALUATION

• The anesthetic plan

Premedication
Type of Anesthesia: General, Regional,
Monitored Anesthesia Care (MAC)
Intraoperative management:
monitoring, positioning, fluid
management, special technique
Postoperative management: pain control,
intensive care ( post operative ventilation,
hemodynamic monitoring)
PREOPERATIVE EVALUATION

History
• Current problem
• Other known problems
• Medication history: allergies, drug
intolerances, present therapy, non therapeutic
(alcohol, tobacco)
• Previous anesthetics, surgery and obstetric
deliveries
• Family history
• Review of organ systems
• Last oral intake
PREOPERATIVE EVALUATION

Physical Examination
• Vital signs
• Airway
• Heart
• Lungs
• Extremities neurologic examination
PREOPERATIVE EVALUATION
Laboratory evaluation
ASA Classification
Class 1: a normal healthy patient
Class 2: a patient with mild systemic disease and no
functional limitations
Class 3: a patient with moderate to severe systemic disease
that results in some functional limitations
Class 4: a patient with severe systemic disease that is a
constant threat to life and functionally incapacitating
Class 5: moribund patient who is not expected to survive 24
hours with or without surgery
Class 6 : a brain-dead patient whose organs are being
harvested
E: if the procedure is an emergency, the physical status is
followed by “E”