anesthesia (pppres. made by another person)

7/31/2019 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

anesthesia (pppres. made by another person)

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