Anesthesia

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 temporarily taken away

Types of anesthesia

local anesthesia  regionalanesthesia

 spinal anesthesia and epidural anesthesia.

 general anesthesia dissociative anesthesia.

Local anesthesia

Surface anesthesia Infiltration anesthesia Nerve block Field block

Spinal anesthesia

Extra dural caudal

General anesthesia

Stage of analgesia Stage of excitement Stage of surgical anesthesia Stage of impending over dose

local anestheticsEach of them have the suffix "-

caine" in their names.procaineamethocainecocainelidocaine (also known as Lignocaine)prilocainebupivacainelevobupivacaineropivacainemepivacainedibucaine

Inhalational anesthetic

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

Intravenous agents -non-opioid Barbiturates Amobarbital (trade name: Amytal) 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:AlfentanilFentanylRemifentanilSufentanil 

The following agents have longer onset and duration of action and are frequently used for post-operative pain relief:

Buprenorphine Butorphanol Diamorphine, (diacetyl morphine, also known as

heroin, not available in U.S.) Hydromorphone Levorphanol Meperidine, also called pethidine in the UK, New

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 as suxamethonium in 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 CO2 retention (cyanosis) Pain Toxic effects

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 HyoscineDry up secretions of Resp. tract,

reduce PR,HR, gut motility, sweat and salivary secretions

Morphine, pethidine& papaveretum To reduce CNS activityChlorpromazine& promezathine SedationMetoclopramide &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