anesthesia (pppres. made by another person)
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Anesthesia
Anesthesia is anartificially induced
state of partial ortotal loss ofsensation.
Anesthetic can produced:
- muscle relaxation
- block transmission of pain nerveimpulses
- suppress reflexes
- can temporarily decrease memory
retrieval and recall
The depth and effects aremonitored by observing changes in:
- respiration
- oxygen saturation and end-tidalcarbon dioxide level
- HR
- urine output
-BP
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Two Major Techniques in Anesthesia
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General Anesthesia
Gen. anesthesia
block painstimulus at the cerebral
cortex and inducedepression of the CNSthat is reversed eitherby metabolic changeand elimination from
the body or bypharmacologic means.
Gen. Anesthesia is appropriatefor:
surgery on the head,neck upper torso and back
For prolonged surgicalprocedures
For use in clients who are
unable to lie quietly for along period
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Stages of General Anesthesia
Used to guide the surgeon in determiningwhen surgery could begin
The last sense to be depressed duringinduction is hearing
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Stage 1
Known as induction
The period between the initial
administration of the inductionmedications and loss ofconsciousness
During this stage the patient
progresses from analgesiawithout amnesia to analgesia withamnesia.
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Stage 2
Known as excitement stage
The period following loss of consciousness and markedby excited and delirious activity
Respiration and pulse rate may become irregular
There may be uncontrolled movements. Vomiting, breathholding and pupillary dilation
Combination of spastic movements, vomiting andirregular respirations may lead to airway compromise,rapidly acting drugs are used to minimize time in thisstage and reach stage 3 as fast as possible
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Stage 3
Surgical anesthesia
The skeletal muscles relax and the patients
breathing becomes regular
Eye movements are slow then stop
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Stage 4
A.k.a. overdose
The stage where too much medication has
been given and the patient has severe brainstem or medullary depression
This results in a cessation of respiration andpotential cardiovascular collapse
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General anesthesia
Used for more extensive procedures or forprocedures that arent amendable to regional
anesthesia
The medications used in gen. anesthesia aregiven IV or by inhalation.
Can suppress all of your protective reflexes
Requires the use of a mask or breathing tubewhile youre asleep
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Administration of General Anesthesia
Neuroleptic or Balanced anesthesia
Using a combination of agents based on the
clients need with consideration of the type ofsurgery to be performed
Typically achieved by using a combination of aninhalation agent, oxygen, an opiod and aneuromuscular blocking agents
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TYPES OF GENERAL ANESTHESIA
Intravenous Anesthesia
- conscious sedation
- client experiences an
extremely rapid induction- unconciousnessgenerally occurs about 30seconds after themedication is administered
Used to relax you and make
you feel sleepy
Generally includes IVadministration of pain
medication and mild sedative
to minimize any discomfort
Medications also caused
temporary forgetfulness Used for procedures such as
colonoscopy,
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REGIONAL ANESTHESIA
Used to blocksensation in aparticular region ofyour body, such as the
lower half of your body,an eye, or an arm or leg
Advantages of RegionalAnesthesia
- provides a high level of
anesthesia to a selectedregion of the body whilehaving little aeffect on otherareas such as your heart,lungs and brain.
- protective reflexes remainintact
- helps control postop pain
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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 toadverse outcomes such as poor circulatory response
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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
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Spinal Anesthesia
Can be used for almost any type of majorprocedure performed below the level of thediaphragm
There is a loss of sensation and paralysis ofthe toes, feet, legs and then abdomen
Slight hypotension
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Epidural Anesthesia
Achieved by introduction of an anestheticagent into the epidural space
Epidural space is entered by a needle at a:
- thoracic
- lumbar
- sacral
- caudal interspace
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Caudal Anesthesia
Produced by injection of the localanesthetic into the caudal or sacral canal
Commonly used in obstetric clients