Understanding Anesthesia for physiotherapist
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Transcript of Understanding Anesthesia for physiotherapist
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