Understanding Anesthesia for physiotherapist

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Understanding Anesthesia for physiotherapist

  1. 1. Anesthesia A. Thangamani ramalingam PT, MSc(PSY), MIAP
  2. 2. 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
  3. 3. Types of anesthesia   local anesthesia  regionalanesthesia  spinal anesthesia and  epidural anesthesia.   general anesthesia  dissociative anesthesia.
  4. 4. Local anesthesia     Surface anesthesia Infiltration anesthesia Nerve block Field block
  5. 5. Spinal anesthesia   Extra dural caudal
  6. 6. General anesthesia     Stage of analgesia Stage of excitement Stage of surgical anesthesia Stage of impending over dose
  7. 7. local anesthetics Each of them have the suffix "-caine" in their names. procaine amethocaine cocaine lidocaine (also known as Lignocaine) prilocaine bupivacaine levobupivacaine ropivacaine mepivacaine dibucaine
  8. 8. Inhalational anesthetic         Desflurane Enflurane Halothane Isoflurane Methoxyflurane Nitrous oxide Sevoflurane Xenon (rarely used)
  9. 9. 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
  10. 10. Intravenous opioid analgesic agents following opioids have short onset and duration of action and are frequently used during general anesthesia: Alfentanil Fentanyl Remifentanil Sufentanil 
  11. 11. 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
  12. 12. 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
  13. 13. 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
  14. 14. Complications and risks General anesthesia  Vomiting  Chest complications  Thrombosis of leg veins  CO retention (cyanosis)  Pain  Toxic effects 2
  15. 15. Spinal anesthesia  Fall in BP due to paralysis of symp.nervous system  Headache  Meningitis  Vomiting  Toxic reactions  Neurological complications
  16. 16. advantages    Profound relaxation Retention of consciousness No chances of chest complications
  17. 17. Pre medication before anesthesia Atropine  Hyoscine Dry up secretions of Resp. tract, reduce PR,HR, gut motility, sweat and salivary secretions 
  18. 18. Morphine, pethidine& papaveretum  To reduce CNS activity Chlorpromazine& promezathine  Sedation Metoclopramide &prochlorperazine  Anti-emetic
  19. 19. Unwanted effects        Depresses resp& cough Uncaring attitude Inclination to sleep Lowers BMR Stimulates nausea& vomiting Increased risk of urinary retention Decreased peristalsis/constipation
  20. 20. Thank you

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