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8.general anesthetics and local anaesthetics

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8.general anesthetics and local anaesthetics

  1. 1. General anaesthetics (GAs) are drugs which produce reversible loss of all sensations and consciousness. Features of GA are : 1.Reversible loss of consciousness 2.Reversible loss of sensations 3.Analgesia & amnesia 4.Muscle relaxation & abolition of reflexes
  2. 2. Classification 1. Inhalational GA – a) Volatile liquids : Ether Halothane Enflurane Isoflurane Desflurane b) Gas : Nitrous oxide
  3. 3. 2. Parenteral GA – a) Inducing drugs – Thiopentone sodium Propofol Etomidate b) Slow-acting drugs – BZDs : Diazepam, lorazepam Ketamine : Dissociative anesthesia Opioids : Fentanyl, alfentanil
  4. 4. Therapeutic uses :  For operations on head, neck & face  For induction and maintenance of anaesthesia – cardiac catheterization, bronchoscopy  Short procedures – dressing of burns  As an adjuvant to anaesthetics for effective analgesia  Postoperative pain
  5. 5. Complications of GA – A. During anaesthesia :  respiratory depression  salivation, respiratory secretions  cardiac arrhythmias, asystole  fall in BP  aspiration of gastric contents  laryngospasm & asphyxia  delirium, convulsions
  6. 6. B. After anaesthesia :  nausea & vomiting  persisting sedation  pneumonia  organ toxicities – liver & kidney damage  nerve palsies  cognitive defects
  7. 7. LocaL anaestheticsLocaL anaesthetics
  8. 8. LAs are drugs which when applied topically or injected locally, block nerve conduction & cause reversible loss of all sensations in the part supplied by the nerve.
  9. 9.  Cocaine  Lignocaine  Benzocaine  Tetracaine  Procaine  Prilocaine  Bupivacaine  Ropivacaine
  10. 10. Mechanism of action - Local anaesthetics Block voltage-gated Na+ channels No entry of Na+ ions into the cell – no depolarization No generation of action potential No generation and conduction of impulse to CNS Local anaesthesia
  11. 11. Therapeutic uses :  Anaesthetize mucous membrane of the eyes, nose, mouth, cornea, urinary & upper respiratory tracts  Abscess drainage  Surgery – lower & upper limbs, lower abdomen, perineum, caesarean section  Excision of small swellings, suturing of cut wounds, dental procedures
  12. 12. Thank youThank you

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