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PUTLA MO.   IKAW NANGI-
ANEMIC KA   NGITIM KA NA!
NOH?!       CYANOTIC KA!
            INTUBATE KITA!
 is the state of narcosis,
 analgesia, relaxation and
 loss of reflex
 the client is not arousable
 even to painful stimuli
ANESTHESIOLOGIST- physician trained to
 deliver anesthesia and to monitor patient
 during surgery
ANESTHETIST- health care professional,
 such as a nurse anesthetist, who is trained
 to deliver anesthesia and to monitor the
 patients condition during surgery
ANESTHETIC- the substance such as a
 chemical gas, used to induced anesthesia
1. To produce muscle relaxation
2. Analgesia
3. Loss of memory
4. Artificial sleep
   (unconsciousness)
5. Relieves fear and anxiety
 Physical condition
 Age
 Presence of co-existing disease
 Type, site, duration of surgery
 Anesthesiologist’s preference
 Patient’s preference
1.Beginning
2.Excitement
3.Surgical
4.Medullary
1.GENERAL
  ANESTHESIA
2.REGIONAL
  ANESTHESIA
 General anesthesia
  Loss of all sensation and
    consciousness
 Regional or Local anesthesia
   Loss of sensation in ONE area
    with consciousness present
 Blocks the pain stimulus at the
  cortex
 Total loss of consciousness and
  sensation
 Produces amnesia, analgesia,
  hypnosis and relaxation
WHAT are the
ADVANTAGES:
DISADVANTAGE:
1.   IV INFUSION
2.   INHALATION
    Mask
    Nasal
    Oral
    tracheal
1.   TRANQUILIZERS AND SEDATIVE HYPNOTICS
     (Benzodiazepines)
       a. Midazolam (Dormicum)
       b. Diazepam (Valium)
       c. Chlordiazepoxide (Librium)
       d. Droperidol (Inapsine)
       e. Lorazepam (Ativan)
2.    OPIOIDS (Narcotics)
     a. Morphine
     b. Meperidine HCl (Demerol)
3.    NEUROLEPANALGESICS
     a. Fentanyl (Sublimaze)
     b. Sufentanil
4.    DISSOCIATIVE AGENTS
     a. Ketamine (Ketaralac; Ketajact)
5.  BARBITURATES
   a. Thiopental Na (Pentothal)
   b. Methohexital Na (Brevital)
6. NONBARBITURATES HYPNOTICS
   a. Etomidate (Amidate)
   b. Propofol (Diprivan)
5.  BARBITURATES
   a. Thiopental Na (Pentothal)
   b. Methohexital Na (Brevital)
6. NONBARBITURATES HYPNOTICS
   a. Etomidate (Amidate)
   b. Propofol (Diprivan)
1.       Positioning
2.       IV line
3.       Monitoring
4.       Strap
5.       Rapid acting drugs
            Thiopental (Pentothal)
            Propofol (Diprovan)
            Methohexital (Brevital)
6.       O2 and Gas via mask
7.       Muscle relaxant
            ADULT: Succiniylcholine chloride (Anectine)
            PEDIA:
         ▪     Rocuronium (Zemuron)
         ▪     Atracurium (Tracrium)
         ▪     Vecuronium (Norcuron)
8.       INTUBATION
KEY POINTS DURING INDUCTION!
1. Circulator should remain
2. Gentle and rapid approach
3. Avoid stimulation of the patient (mandatory) “noise
   avoidance”
4. Do not touch patient until anesthesiologist says it is
   safe to do so
5. Precaution: ECG, defib, chest stet, BP
6. Positioning: if obese elevate head to avoid pressure
   (protect diaphragm)
7. If hypotensive- flat
8. Children: circulator- to be less frightening stay close to
   the child
1.    VOLATILE LIQUIDS:
     a. Halothane (Fluothane)
     b. Methoxyflurane (Penthrane)
     c. Enflutane (Ethrane)
     d. Isoflurane (Forane)
     e. Sevoflurane (Ultrane)
     f. Desflurane (Suprane)
2.    GASES:
     a. Nitrous oxide
  Produces loss of sensation in only one
   region of the body and does not cause
   loss of consciousness
 Blocks pain stimulus at its:
  1. Origin
  2. Along afferent neurons
  3. Along the spinal cord
1. TOPICAL – directly applied into
   the area to be desensitized with
   the use of a solution
2. LOCAL INFILTRATION BLOCK –
   blocks only peripheral nerves
   around the area of incision
1.   FIELD BLOCK – areas proximal to
     the incision site is injected and
     infiltrated a barrier (“WALL IN”)
2.   PERIPHERAL NERVE BLOCK –
     anesthetizes individual nerves or
     nerve plexuses rather than all the
     nerves anesthetized by a field
     block
Blocks impulses along the
 spinal cord and nerve roots
 and may occur either in the
 subarachnoid or epidural
 space
1. SPINAL – produces a nerve block in
   the subarachnoid space
2. EPIDURAL – injection of local
   anesthetic into the spinal canal in the
   space surrounding the dura mater
3. CAUDAL (TRANS-SACRAL) –
   produces anesthesia of the perineum
   and occasionally, the lower abdomen
TOPICAL        Applied directly on
               the skin
INFILTRATION   Injected into a
               specific area of skin
NERVE BLOCK Injected around a
               nerve
SPINAL         Low spinal
Subarachnoid   anesthesia
EPIDURAL       Epidural space is
               injected with
               anesthesia
1. Lidocaine (Xylocaine) and
   Mepivacaine (Carbocaine)
2. Bupivacaine (Marcaine)
3. Etidocaine (Duranest)
4. Procaine (Novocaine)
5. Tetracaine (Pontocaine)
1. Procaine (Novocaine)
2. Tetracaine (Pontocaine)
3. Lidocaine (Xylocaine)
4. Bupivacaine (Marcaine)
Anesthesia
Anesthesia
Anesthesia
Anesthesia
Anesthesia
Anesthesia
Anesthesia

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Anesthesia

  • 1. PUTLA MO. IKAW NANGI- ANEMIC KA NGITIM KA NA! NOH?! CYANOTIC KA! INTUBATE KITA!
  • 2.
  • 3.  is the state of narcosis, analgesia, relaxation and loss of reflex  the client is not arousable even to painful stimuli
  • 4. ANESTHESIOLOGIST- physician trained to deliver anesthesia and to monitor patient during surgery ANESTHETIST- health care professional, such as a nurse anesthetist, who is trained to deliver anesthesia and to monitor the patients condition during surgery ANESTHETIC- the substance such as a chemical gas, used to induced anesthesia
  • 5. 1. To produce muscle relaxation 2. Analgesia 3. Loss of memory 4. Artificial sleep (unconsciousness) 5. Relieves fear and anxiety
  • 6.  Physical condition  Age  Presence of co-existing disease  Type, site, duration of surgery  Anesthesiologist’s preference  Patient’s preference
  • 9.  General anesthesia  Loss of all sensation and consciousness  Regional or Local anesthesia  Loss of sensation in ONE area with consciousness present
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15.  Blocks the pain stimulus at the cortex  Total loss of consciousness and sensation  Produces amnesia, analgesia, hypnosis and relaxation
  • 17. 1. IV INFUSION 2. INHALATION  Mask  Nasal  Oral  tracheal
  • 18. 1. TRANQUILIZERS AND SEDATIVE HYPNOTICS (Benzodiazepines) a. Midazolam (Dormicum) b. Diazepam (Valium) c. Chlordiazepoxide (Librium) d. Droperidol (Inapsine) e. Lorazepam (Ativan)
  • 19. 2. OPIOIDS (Narcotics) a. Morphine b. Meperidine HCl (Demerol)
  • 20. 3. NEUROLEPANALGESICS a. Fentanyl (Sublimaze) b. Sufentanil 4. DISSOCIATIVE AGENTS a. Ketamine (Ketaralac; Ketajact)
  • 21. 5. BARBITURATES a. Thiopental Na (Pentothal) b. Methohexital Na (Brevital) 6. NONBARBITURATES HYPNOTICS a. Etomidate (Amidate) b. Propofol (Diprivan)
  • 22. 5. BARBITURATES a. Thiopental Na (Pentothal) b. Methohexital Na (Brevital) 6. NONBARBITURATES HYPNOTICS a. Etomidate (Amidate) b. Propofol (Diprivan)
  • 23. 1. Positioning 2. IV line 3. Monitoring 4. Strap 5. Rapid acting drugs  Thiopental (Pentothal)  Propofol (Diprovan)  Methohexital (Brevital) 6. O2 and Gas via mask 7. Muscle relaxant  ADULT: Succiniylcholine chloride (Anectine)  PEDIA: ▪ Rocuronium (Zemuron) ▪ Atracurium (Tracrium) ▪ Vecuronium (Norcuron) 8. INTUBATION
  • 24.
  • 25.
  • 26. KEY POINTS DURING INDUCTION! 1. Circulator should remain 2. Gentle and rapid approach 3. Avoid stimulation of the patient (mandatory) “noise avoidance” 4. Do not touch patient until anesthesiologist says it is safe to do so 5. Precaution: ECG, defib, chest stet, BP 6. Positioning: if obese elevate head to avoid pressure (protect diaphragm) 7. If hypotensive- flat 8. Children: circulator- to be less frightening stay close to the child
  • 27. 1. VOLATILE LIQUIDS: a. Halothane (Fluothane) b. Methoxyflurane (Penthrane) c. Enflutane (Ethrane) d. Isoflurane (Forane) e. Sevoflurane (Ultrane) f. Desflurane (Suprane)
  • 28. 2. GASES: a. Nitrous oxide
  • 29.  Produces loss of sensation in only one region of the body and does not cause loss of consciousness  Blocks pain stimulus at its: 1. Origin 2. Along afferent neurons 3. Along the spinal cord
  • 30. 1. TOPICAL – directly applied into the area to be desensitized with the use of a solution 2. LOCAL INFILTRATION BLOCK – blocks only peripheral nerves around the area of incision
  • 31. 1. FIELD BLOCK – areas proximal to the incision site is injected and infiltrated a barrier (“WALL IN”) 2. PERIPHERAL NERVE BLOCK – anesthetizes individual nerves or nerve plexuses rather than all the nerves anesthetized by a field block
  • 32.
  • 33.
  • 34. Blocks impulses along the spinal cord and nerve roots and may occur either in the subarachnoid or epidural space
  • 35. 1. SPINAL – produces a nerve block in the subarachnoid space 2. EPIDURAL – injection of local anesthetic into the spinal canal in the space surrounding the dura mater 3. CAUDAL (TRANS-SACRAL) – produces anesthesia of the perineum and occasionally, the lower abdomen
  • 36.
  • 37. TOPICAL Applied directly on the skin INFILTRATION Injected into a specific area of skin NERVE BLOCK Injected around a nerve SPINAL Low spinal Subarachnoid anesthesia EPIDURAL Epidural space is injected with anesthesia
  • 38. 1. Lidocaine (Xylocaine) and Mepivacaine (Carbocaine) 2. Bupivacaine (Marcaine) 3. Etidocaine (Duranest) 4. Procaine (Novocaine) 5. Tetracaine (Pontocaine)
  • 39. 1. Procaine (Novocaine) 2. Tetracaine (Pontocaine) 3. Lidocaine (Xylocaine) 4. Bupivacaine (Marcaine)