SlideShare a Scribd company logo
1 of 43
Download to read offline
ANAESTHESIA
The
word anesthesia is derived from the Greek: meaning
insensible or without feeling.
ANESTHESIA IS BROKEN DOWN INTO 3 MAIN CATEGORIES
LOCAL AND GENERAL. REGIONAL ,ALL OF WHICH AFFECT THE
NERVOUS SYSTEM IN SOME WAY AND CAN BE ADMINISTERED
USING VARIOUS METHODS AND DIFFERENT MEDICATION.
ANAESTHESIA ARE AGENT THAT BRIING ABOUT REVERSIBLE
LOSS OF SENSATION .
(from Greek αν-, an-, "without"; and αἴσθησις, aisthēsis, "sensation"),
traditionally meant the condition of having sensation (including the feeling of
pain) blocked or temporarily taken away. It is a pharmacologically induced and
reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal
muscle reflexes or decreased stress response, or all simultaneously. These
effects can be obtained from a single drug which alone provides the correct
combination of effects, or occasionally a combination of drugs (such as
hypnotics, sedatives, paralytics and analgesics) to achieve very specific
combinations of results. This allows patients to undergo surgery and other
procedures without the distress and pain they would otherwise experience. An
alternative definition is a "reversible lack of awareness," including a total lack of
awareness (e.g. a general anesthetic) or a lack of awareness of a part of the body
such as a spinal anesthetic. The pre-existing word anesthesia was suggested by
Oliver Wendell Holmes, Sr. in 1846 as a word to use to describe this state.
Anaesthesiology is a special branch of medicine. Nurses working in this area
need to have knowledge and skill to care for the patient who is being given
premedication, under anaesthesia and recovering.
ACCORDING TO willims
Loss of feeling in all or part of body with or without loss of
consciousness .the patient was given an injection before
surgery
According to lippen cott
Genral loss of the sense of feeling ,as pain ,heat ,cold,
touch,and other less common varieties of sensation .
According to devis
It is a reversible blocking of pain feeling in whole body or in
a part of it using pharmacology or other methods
GENERAL
ANAESTHESIA
LOCAL
ANAESTHSIA
REGIONAL
ANAESTHESIA
DISSOCIATIVE
ANESTHESIA
Types of anesthesia:
•REGIONAL ANESTHESIA
•GENERAL ANESTHESIA
•LOCAL ANESTHESIA
•DISSOCIATIVE ANESTHESIA.
•REGIONAL ANESTHESIA : Regional anesthesia renders a
larger area of the body insensate by blocking
transmission of nerve impulses between a part of the
body and the spinal cord. Two frequently used types of
regional anesthesia are spinal anesthesia and epidural
anesthesia.
•
LOCAL ANESTHESIA :
Local anesthesia inhibits sensory perception within a specific
location on the body, such as a tooth or the urinary bladder
•SPINAL ANESTHESIA:
• it is achieved by injection 1.8 ml of 5%
lignocaine solution into the subarechnoid apece
through a lumber puncture.other drugs which
can be used are cinchocaine, procaine and
amethocaine. It can cause serious hypotension.
•EPIDURAL ANESTHESIA: It is achieved by
injection 1 to 2 % of lignocaine solution in the
epidural space. It blocks the nerves which
traverse the epidural space. It can cause
hypotension, which is less severe than with
spinal analgesia. For prolonged operations, a
catheter may be passed into the epidural space
for intermittent administration of local
anaesthesia.
GENERAL ANESTHESIA : General anesthesia
refers to inhibition of sensory, motor and
sympathetic nerve transmission at the level of the
brain, resulting in unconsciousness and lack of
sensation. There are three types of general
anaesthesia- spontaneous, controled and
assisted.
These types are based on whether the
patient breathes himself under anaeasthesia, is
ventilated artificially, or breathes himself but needs
assistance periodically.
Induction:
Anaesthesia may be indused by one of the following techniques-
•Intravenouos injection of the following:-
•Thiopentone(2.5%:) short acting(15 to 30 minutes).
•Methohexitone (1%): ultra-short acting(15 to 30) minutes.
•Hexobarbitone(10%) : long acting (30 to 45 minutes).
•Inhalation agents:-
•Nitrous oxide.
•Cyclopropane*
•Halothane
•Ether*
•Trichlorethylene
•Ethyl ghloride
•Rectal instillation:- thiopentone or paraldehyde is instilled into the
rectum through a catheter, as a warmed solution. Alternatively, a
rectal suppository may be used. This method of induction is used in
children.
DISSOCIATIVE ANESTHESIA:
Dissociative anesthesia uses agents that
inhibit transmission of nerve impulses
between higher centers of the brain (such as
the cerebral cortex) and the lower centers,
such as those found within the limbic
system.
GENERAL ANESTHESIA ARE DRUGS THAT BRING ABOUT REVERSIBLE LOSS
OF SENSATION AND CONSCIOUSNESS.
PURPOSES OF ANESTHESIA
1. ANALGESIA ( LOSS OF RESPONSE TO PAIN )
2. AMNESIA ( LOSS OF MEMORY )
3. IMMOBILITY ( LOSS OF MOTOR REFLEXES )
4. HYPNOSIS ( UNCONSCIOUSNESS)
5. PARALYSIS ( SKELETAL MUSCLE RELAXATION )
agent used is a gas like nitrous oxide or volatile vapor
like chloroform, ether, or flothane.
- Inhalational anesthesia depresses the brain from up
[cortex] to down [the medulla] by increasing dose.
INHALATIONAL ANAESTHESIA
Inhalational anesthesia is achieved through
airway tract by facemask, laryngeal mask or
endotracheal tube
1. INHALATIONAL
( A ) GASES
NITROUS OXIDE
A colorless gas with a slightly sweetish odor prepared by heating
ammonium nitrate . It produce light anesthesia without significant
depression of respiration or vasomotor center .
It has the dis advantage that it produces light anesthesia and therefore can
only be used along anesthesia .long term exposure ( like in staff of
operation theater ) to low dose can impair DNA synthesis which may
result in fetal abnormalities when such staff become pregnant.
( B ) LIQUIDS
ETHER-
1. Is a colorless volatile liquid .
2. It is a potent and reliable anesthetic ,good analgesic ,muscle relaxant and
does not depress cardiovascular and respiratory function in therapeutic
doses.
HALOTHANE
Is colorless volatile liquid with a sweet odor .
It is non irritant and non inflammable
Induction is smooth and rapid in 2-5 min surgical anesthesia can be produced
ENFLURANE AND ISOFLURANE
They are metabolized to a lesser extent then halothane - therefore safer
regarding the liver toxicity
They do not sensitize the heart to adrenaline
DESFLURANE AND SEVOFLURANE
Are newer agent which bring about very rapid induction and recovery because
of low solubility in blood but they too have some disadvantages desflurane is
pregnant -may induce coughing and some times laryngospasm .
OXYGEN IN ANESTHESIA
`oxygen should be added routinely to inhalation agents to protect against
hypoxia ( especially when halothane is used ) when O2 is not available
,ether is the safer agent for maintenance of anesthesia.
INTRAVENOUS ANESTHESIA
Iv anesthesia allow an extremely rapid induction because the blood
concentration be raised rapidly -in few second there is loss of consciousness
1. Inducing agents
Thiopentone sodium
Proprofol
2. Dissociative anesthesia
ketamine
3. Neuroleptanalgesia
fentanyl + droperidol
4. Benzodiazepines
diazepam , lorazepam , midazolam
THIOPENTONE SODIUM is used for induction of anesthesia prior to
administration of inhalation anesthesia .
A .PROPOFOL
Is an oily liquid . It is used for induction and maintenance of anesthesia for
short procedures of up to 1 hours duration.
B. DISSOCIATIVE ANESTHESIA
KETAMINE
Ketamine hydrochloride given slow iv produces dissociative anesthesia within
3-5 min which lasts for 10-15 min after a single injection .premedication with
atropine is needed .
C. NEUROLEPT ANALGESIA
FENTANYLE + DROPERIDOL
A combination of a neuroleptic ( droperidol ) with an analgesia ( fentanyl )
it last s for 30-40 min .
It is employed for endoscopies , burn dressing , angiographies ,and other
diagnostic and minor surgical procedures .
STAGE OF GERNAL ANESTHESIA
1. Stage of analgesia
Is from the beginning of inhalation of the anesthetic to consciousness .
2. Stage of delirium
the stage is from loss of consciousness to beginning of surgical anesthesia . It
may be associated with excitement shouting ( speak with very loud voice ) crying
and violent behavior.
3. Stage of surgical anesthesia
the has 4 planes .as anesthesia passes to deeper planes , respiratory depression is
seen ,there is gradual loss of reflexes and relaxation of skeletal muscle .
4. Stage of medularly paralysis
is seen only with overdose . It is the stage of medullary depression – cessation of
breathing circulatory failure and death may follow.
I. Analgesia stage
• Patient conscious
• Spontaneous respiration
• Reflexes present
• Possible small surgery procedures like
dressing change in burns
II. Excitation stage
• Possible uncontrolled movements,
vomiting
• Increase in respiratory rate
III. Anesthesia for surgery
• It begins with lack of lid reflex
• 4 sub stages
• Airway opening necessary
• Possible surgery except for abdominal
opening if no relaxants are used
• Possible end tracheal intubation
IV. intoxication, overdosing
• Respiratory arrest
• If anesthesia not discontinued
possible
cardiac arrest
Local anesthesia –
the administration of an anesthetic agent to one part of the body by local
infiltration or topical application. It is usually administered by the surgeon.
Used for minor procedures if the patient’s cooperation and the
condition warrants
its use.
Local anaesthetic agents can be defined as drugs which are used clinically to
produce reversible loss of sensation in a circumscribed area of the body.
Drugs include Beta-adrenoceptor antagonists, opioid analgesics, anticonvulsants
and antihistamines.
Local anaesthetics can be divided into two groups on the basis of their chemical
structure:
- amides: Lignocaine, prilocaine and bupivacaine
- esters: Amethocaine, benzocaine, cocaine
e.g., amethocaine lozenges for the oropharynx, cocaine for nasal surgery.
Most blocks take 5 – 20 minutes to work.
Local anesthesia are drug s are used that the block nerve conduction when
applied locally to nerve tissue in appropriate concentration . There action is
completely reversible
CLASSIFICATION OF LOCAL ANESTHESIA
A. INJECTABLE
1. SHORT-ACTING PROCAINE ,CHLOROPROCAINE
2. INTERMEDIATE –ACTING - LIGNOCAINE ,
PRILOCAINE
3. LONG-ACTING – TETRACAINE ( AMETHOCAINE ) ,
BUPIVACAINE , DIBUCAINE , ROPIVACAINE ,
ETIDOCAINE.
B. SURFACE ANESTHESIA
LIGNOCAINE ,COCAINE , TETRACAINE,
BENZOCAINE, OXETHAZAINE.
MECHENISM OF ACTION
PREVENT THE GENRATION AND THE
CONDUCTION OF NERVE IMPULSES .THE
PRIMARY MECHENISUM OF ACTION IS
BLOCKADE OF VOLTAGE -GATED SODIUM
CHANNELS .
Regional Anesthesia –
is broadly defined as a reversible loss of sensation in a specific area or region
of the body when a local anaesthetic is injected to purposefully block or
anaesthetize nerve fibres in and around the operative site.
Commonly R.A techniques include:
Spinals (subarachnoid block), epidurals (extradural space) , caudals,
and major peripheral nerve blocks.
- The subarachnoid, epidural or plexus block are called
REGIONAL ANAESTHESIA
- Some called it regional analgesia as patient is conscious.
- Some use sedative with regional analgesia to be
anaesthesia.
- Local anaesthesia means block of peripheral nerve or
tissue infiltration as in lipoma ( slow growing fat cell in a
thin fibrous capsule usually found just below the skin ),
circumcision, teeth, eye even craniotomy
1. HYPERSENSITIVITY REACTION - INCLUDED SKIN RASHES
,DERMATITIS , ASTHAMA, OR RARELY ANAPHYLAXIS
2. C.N.S - DIZZINESS , AUDITORY AND VISIUAL DISTURBANCE ,
MENTAL CONFUSION , DISORIENTATION ,ANXIETY , MUSCLE
TREMORS, CONVULSIONS AND RESPIRATORY FAILURE CAN
RESULT FROM LARGE DOSES INTRAVENOUS DIZAPAM
CONTROLS CONVULSION .
3. C.V.S - HYPOTENTION , BRADYCARDIA , AND ARRHYMIAS MAY
BE ENCOUNTERED . RARELY CARDIAC ARREST CAN
OCCUR.
4. LOCAL IRRITATION - CAN BE SEEN WITH BUPIVACAINE .
WOUND HEALING MAY BE DELAYED
METHODS OF ANESTHESIA
1. Spinal cord: By injection of local drug in sub -
arachnoid space in CSF, this must be bellow L
2
2. Epidural: The drug is injected outside dura [no
puncture] to block the nerve roots at its exit
from spinal cord.
3. Nerve plexus: Cervical, brachial, lumbosacral
4. Peripheral nerve: Radial, ulna, median, sciatic,
femoral, popletial, facial, mandibular.
5. Injection into tissues, skin, subcutaneous.
Spinal anesthesia –
local anesthetic injected
into subarachnoid space at 3rd or 4th lumbar space
- Too high = affects resp. muscles
- Headaches - poss. d/t a in CSF pressure at site of
needle insertion
Spinal Block - subarachnoid membrane (2nd layer of cord)
Epidural Block - outer covering of spinal cord (dura mater)
Caudal Block - sacrum
Saddle Block - Lower end of spinal column - blocks peri area
- clients in labor
Monitor BP with all of the above
1. Anaesthetic machine.
2. Monitoring system.
1. Oxygen gas supply.
2. Nitrous oxide gas supply.
3. Flow meter
4. Vaporizer specific for every agent
5. Mechanical ventilator
6. Tubes for connection.
1. Pulse, ECG
2. Blood pressure
3. Oxygen saturation.
4. End tidal CO2
5. Temperature
6. Urine output, CVP, EEG, bispectral
index, muscle tone, ECHO, drug
concentration
Need
for 2
impo
tools
Anesthetic
machine
monitoring
PREPERATION :
•the suction machine should be checked. Solution catheters and
tips are arranged for.
•The working of the operation table is checked, especially the
mechanism of lowering the head end.
•Nasogastric tubes are kept on the trolly.
•Resuscitation equipment is checked-
(a) O2 cylinder
(b) face mask, ambu valve, bag
(c) laryngoscope
(d) endotracheal tubes
(e) drugs: atropine, adrenaline, sodium bicarbonate,
mephentermine, dopamine, hydrocortisone, pronethazine.
(f) monitoring equipment is checked, e.g. cardioscope with
defibrillator, pulse oximiter, capnometer etc.
MAINTENANCE:
Components of the anaesthesia are anagesia and amnesia. The former is
important, because the patient must not feel any pain. The later is important
because the patient must not recall any events at the time of the operation.
Analgesia is provided by nitrous oxide, trichlorethylene, ether
cyclopropane or pethidine. Sleep is achieved with thiopentone, nitrous
oxide or cyclopropane. Controlled general anaesthesia
needsendotracheal intubation. The vocal cord are paralysed for
intubation with suxamethonium or d-tubocurarine. Muscles relaxation
for artificial ventilation is achieved with intermitlent administration of
suxamethonium, or long acting muscle relaxants like gallamine or d-
tubocurarine. The action of last two drugs are reversed at the end of the
operation with neostigmine. Atropine has to be administered prior to
neostigmine to reduce cardiac slowing, and profuse bronchial and
salivary secretions produced by neostigmine as a side effect
Anesthesia

More Related Content

What's hot

What's hot (20)

Drugs used in CPR and Emergency.ppsx
Drugs used in CPR and Emergency.ppsxDrugs used in CPR and Emergency.ppsx
Drugs used in CPR and Emergency.ppsx
 
Intra operative care.pptx
Intra operative care.pptxIntra operative care.pptx
Intra operative care.pptx
 
Atropine slideshare
Atropine slideshareAtropine slideshare
Atropine slideshare
 
Legal aspects in OT
Legal aspects in OTLegal aspects in OT
Legal aspects in OT
 
Types of Anesthesia
Types of AnesthesiaTypes of Anesthesia
Types of Anesthesia
 
general anaesthesia
general anaesthesia general anaesthesia
general anaesthesia
 
anesthesia- types of anaesthesia
anesthesia- types of anaesthesiaanesthesia- types of anaesthesia
anesthesia- types of anaesthesia
 
Stage of anesthesia
Stage of anesthesiaStage of anesthesia
Stage of anesthesia
 
General Anesthesia
General AnesthesiaGeneral Anesthesia
General Anesthesia
 
Role of anesthesia nurse in operation theatre
Role of anesthesia nurse in operation theatreRole of anesthesia nurse in operation theatre
Role of anesthesia nurse in operation theatre
 
Anaesthetic techniques
Anaesthetic techniquesAnaesthetic techniques
Anaesthetic techniques
 
Operation theatre and technique(msn)
Operation theatre and technique(msn)Operation theatre and technique(msn)
Operation theatre and technique(msn)
 
Operation theatre hazards
Operation theatre hazardsOperation theatre hazards
Operation theatre hazards
 
General anaesthesia (New) - drdhriti
General anaesthesia (New) - drdhriti General anaesthesia (New) - drdhriti
General anaesthesia (New) - drdhriti
 
Bronchoconstrictor Drugs
Bronchoconstrictor Drugs Bronchoconstrictor Drugs
Bronchoconstrictor Drugs
 
ambu bag.pptx
ambu bag.pptxambu bag.pptx
ambu bag.pptx
 
Critical care nursing
Critical care nursingCritical care nursing
Critical care nursing
 
General anesthesia
General anesthesiaGeneral anesthesia
General anesthesia
 
Reconstructive surgery
Reconstructive surgeryReconstructive surgery
Reconstructive surgery
 
Post operative care
Post operative care Post operative care
Post operative care
 

Similar to Anesthesia

anesthesia ppt medical surgical nursing
anesthesia ppt  medical surgical nursinganesthesia ppt  medical surgical nursing
anesthesia ppt medical surgical nursingDishaThakur53
 
General anesthetics.pptx
General anesthetics.pptxGeneral anesthetics.pptx
General anesthetics.pptxShami Iqbal
 
Drug therapy in Anesthesiology & Resuscitation
Drug therapy in Anesthesiology & ResuscitationDrug therapy in Anesthesiology & Resuscitation
Drug therapy in Anesthesiology & ResuscitationEneutron
 
Chapter 1-intro duction of anesthesia
Chapter  1-intro duction of anesthesiaChapter  1-intro duction of anesthesia
Chapter 1-intro duction of anesthesiaSamuelDaksa
 
Chapter 1-intro duction of anesthesia 22439
Chapter  1-intro duction of anesthesia 22439Chapter  1-intro duction of anesthesia 22439
Chapter 1-intro duction of anesthesia 22439CHERUDUGASE
 
Anesthesia & its types
Anesthesia & its typesAnesthesia & its types
Anesthesia & its typesTushar singh
 
sedation and anesthesia
sedation and anesthesiasedation and anesthesia
sedation and anesthesiaKIMRNBSN
 
Lecture 2-Surgery(Anesthesia).pptx
Lecture 2-Surgery(Anesthesia).pptxLecture 2-Surgery(Anesthesia).pptx
Lecture 2-Surgery(Anesthesia).pptxRida329646
 
General anesthetics
General anestheticsGeneral anesthetics
General anestheticsafia nabila
 
General Anesthetics
General AnestheticsGeneral Anesthetics
General AnestheticsFarazaJaved
 
Introduction to Anaesthesia.pptx
Introduction to Anaesthesia.pptxIntroduction to Anaesthesia.pptx
Introduction to Anaesthesia.pptxGabrielMDOTHI
 
Unit V general anaesthestics.pptx
Unit V general anaesthestics.pptxUnit V general anaesthestics.pptx
Unit V general anaesthestics.pptxSamruddhi Khonde
 
Ppt on anaesthesia
Ppt on anaesthesiaPpt on anaesthesia
Ppt on anaesthesiaShiva Kumar
 
General anesthetics and local anesthetics
General anesthetics and local anestheticsGeneral anesthetics and local anesthetics
General anesthetics and local anestheticsAswin Palanisamy
 
Anaesthesia power point
Anaesthesia power pointAnaesthesia power point
Anaesthesia power pointRemya Krishnan
 
General Anaethetics & Pre-anaethetics.pptx
General Anaethetics & Pre-anaethetics.pptxGeneral Anaethetics & Pre-anaethetics.pptx
General Anaethetics & Pre-anaethetics.pptxManish Gautam
 

Similar to Anesthesia (20)

anesthesia ppt medical surgical nursing
anesthesia ppt  medical surgical nursinganesthesia ppt  medical surgical nursing
anesthesia ppt medical surgical nursing
 
General anesthetics.pptx
General anesthetics.pptxGeneral anesthetics.pptx
General anesthetics.pptx
 
Drug therapy in Anesthesiology & Resuscitation
Drug therapy in Anesthesiology & ResuscitationDrug therapy in Anesthesiology & Resuscitation
Drug therapy in Anesthesiology & Resuscitation
 
Chapter 1-intro duction of anesthesia
Chapter  1-intro duction of anesthesiaChapter  1-intro duction of anesthesia
Chapter 1-intro duction of anesthesia
 
Chapter 1-intro duction of anesthesia 22439
Chapter  1-intro duction of anesthesia 22439Chapter  1-intro duction of anesthesia 22439
Chapter 1-intro duction of anesthesia 22439
 
Anesthesia & its types
Anesthesia & its typesAnesthesia & its types
Anesthesia & its types
 
sedation and anesthesia
sedation and anesthesiasedation and anesthesia
sedation and anesthesia
 
Lecture 2-Surgery(Anesthesia).pptx
Lecture 2-Surgery(Anesthesia).pptxLecture 2-Surgery(Anesthesia).pptx
Lecture 2-Surgery(Anesthesia).pptx
 
Anesthesia surgery.pptx
Anesthesia surgery.pptxAnesthesia surgery.pptx
Anesthesia surgery.pptx
 
General anesthetics
General anestheticsGeneral anesthetics
General anesthetics
 
General anesthetics(VK)
General anesthetics(VK)General anesthetics(VK)
General anesthetics(VK)
 
General Anesthetics
General AnestheticsGeneral Anesthetics
General Anesthetics
 
Introduction to Anaesthesia.pptx
Introduction to Anaesthesia.pptxIntroduction to Anaesthesia.pptx
Introduction to Anaesthesia.pptx
 
Unit V general anaesthestics.pptx
Unit V general anaesthestics.pptxUnit V general anaesthestics.pptx
Unit V general anaesthestics.pptx
 
Anesthetics
AnestheticsAnesthetics
Anesthetics
 
Ppt on anaesthesia
Ppt on anaesthesiaPpt on anaesthesia
Ppt on anaesthesia
 
General anesthetics and local anesthetics
General anesthetics and local anestheticsGeneral anesthetics and local anesthetics
General anesthetics and local anesthetics
 
Anaesthesia power point
Anaesthesia power pointAnaesthesia power point
Anaesthesia power point
 
ga-170603164733.pptx
ga-170603164733.pptxga-170603164733.pptx
ga-170603164733.pptx
 
General Anaethetics & Pre-anaethetics.pptx
General Anaethetics & Pre-anaethetics.pptxGeneral Anaethetics & Pre-anaethetics.pptx
General Anaethetics & Pre-anaethetics.pptx
 

More from OM VERMA

otalgia- JUN 2023 OM VERMA.pdf
otalgia- JUN 2023 OM VERMA.pdfotalgia- JUN 2023 OM VERMA.pdf
otalgia- JUN 2023 OM VERMA.pdfOM VERMA
 
POISIONING JUN 2023
POISIONING JUN 2023POISIONING JUN 2023
POISIONING JUN 2023OM VERMA
 
public relation.pdf
public relation.pdfpublic relation.pdf
public relation.pdfOM VERMA
 
PRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfPRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfOM VERMA
 
practical application of genetics in nursing OM VERMA 2022 slide.pdf
practical application of genetics in nursing  OM VERMA 2022 slide.pdfpractical application of genetics in nursing  OM VERMA 2022 slide.pdf
practical application of genetics in nursing OM VERMA 2022 slide.pdfOM VERMA
 
Neural tube defects and the role of folic acid in Lowering the Risk.pdf
Neural tube defects and the role of folic acid in Lowering the Risk.pdfNeural tube defects and the role of folic acid in Lowering the Risk.pdf
Neural tube defects and the role of folic acid in Lowering the Risk.pdfOM VERMA
 
MULTIPLE ALLOTS ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdf
MULTIPLE ALLOTS  ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdfMULTIPLE ALLOTS  ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdf
MULTIPLE ALLOTS ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdfOM VERMA
 
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...OM VERMA
 
Maternal prenatal and genetic influences on development of defect and disease...
Maternal prenatal and genetic influences on development of defect and disease...Maternal prenatal and genetic influences on development of defect and disease...
Maternal prenatal and genetic influences on development of defect and disease...OM VERMA
 
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdf
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdfMATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdf
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdfOM VERMA
 
infertility.pdf
infertility.pdfinfertility.pdf
infertility.pdfOM VERMA
 
Inborn Errors of Metablism.pdf
Inborn Errors of Metablism.pdfInborn Errors of Metablism.pdf
Inborn Errors of Metablism.pdfOM VERMA
 
Huntington Disease and Mental illness.pdf
Huntington Disease and Mental illness.pdfHuntington Disease and Mental illness.pdf
Huntington Disease and Mental illness.pdfOM VERMA
 
Hematological Disorders.pdf
Hematological Disorders.pdfHematological Disorders.pdf
Hematological Disorders.pdfOM VERMA
 
genetic testing inneanates and childern.pdf
genetic testing inneanates and childern.pdfgenetic testing inneanates and childern.pdf
genetic testing inneanates and childern.pdfOM VERMA
 
HUMAN GENOME PROJECT AND GENE THERAPY.pdf
HUMAN GENOME PROJECT AND GENE THERAPY.pdfHUMAN GENOME PROJECT AND GENE THERAPY.pdf
HUMAN GENOME PROJECT AND GENE THERAPY.pdfOM VERMA
 
PRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfPRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfOM VERMA
 
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdf
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdfREVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdf
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdfOM VERMA
 
sex linked inheritance error of transmission.pdf
sex linked inheritance error of transmission.pdfsex linked inheritance error of transmission.pdf
sex linked inheritance error of transmission.pdfOM VERMA
 
The eugenics Movement.pdf
The eugenics Movement.pdfThe eugenics Movement.pdf
The eugenics Movement.pdfOM VERMA
 

More from OM VERMA (20)

otalgia- JUN 2023 OM VERMA.pdf
otalgia- JUN 2023 OM VERMA.pdfotalgia- JUN 2023 OM VERMA.pdf
otalgia- JUN 2023 OM VERMA.pdf
 
POISIONING JUN 2023
POISIONING JUN 2023POISIONING JUN 2023
POISIONING JUN 2023
 
public relation.pdf
public relation.pdfpublic relation.pdf
public relation.pdf
 
PRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfPRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdf
 
practical application of genetics in nursing OM VERMA 2022 slide.pdf
practical application of genetics in nursing  OM VERMA 2022 slide.pdfpractical application of genetics in nursing  OM VERMA 2022 slide.pdf
practical application of genetics in nursing OM VERMA 2022 slide.pdf
 
Neural tube defects and the role of folic acid in Lowering the Risk.pdf
Neural tube defects and the role of folic acid in Lowering the Risk.pdfNeural tube defects and the role of folic acid in Lowering the Risk.pdf
Neural tube defects and the role of folic acid in Lowering the Risk.pdf
 
MULTIPLE ALLOTS ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdf
MULTIPLE ALLOTS  ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdfMULTIPLE ALLOTS  ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdf
MULTIPLE ALLOTS ( ALLELES ) AND BLOOD GROUPS OM VERMA 2023.pdf
 
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...
MENDALIAN THEORY OF INHERITANCE AND MULTIPLE BLOOD ALLOTS AND BLOOD GROUPS 20...
 
Maternal prenatal and genetic influences on development of defect and disease...
Maternal prenatal and genetic influences on development of defect and disease...Maternal prenatal and genetic influences on development of defect and disease...
Maternal prenatal and genetic influences on development of defect and disease...
 
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdf
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdfMATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdf
MATERNAL AGE,MATERNAL DRUG THERAPY PRENATAL TEST AND DIAGNOSIS.pdf
 
infertility.pdf
infertility.pdfinfertility.pdf
infertility.pdf
 
Inborn Errors of Metablism.pdf
Inborn Errors of Metablism.pdfInborn Errors of Metablism.pdf
Inborn Errors of Metablism.pdf
 
Huntington Disease and Mental illness.pdf
Huntington Disease and Mental illness.pdfHuntington Disease and Mental illness.pdf
Huntington Disease and Mental illness.pdf
 
Hematological Disorders.pdf
Hematological Disorders.pdfHematological Disorders.pdf
Hematological Disorders.pdf
 
genetic testing inneanates and childern.pdf
genetic testing inneanates and childern.pdfgenetic testing inneanates and childern.pdf
genetic testing inneanates and childern.pdf
 
HUMAN GENOME PROJECT AND GENE THERAPY.pdf
HUMAN GENOME PROJECT AND GENE THERAPY.pdfHUMAN GENOME PROJECT AND GENE THERAPY.pdf
HUMAN GENOME PROJECT AND GENE THERAPY.pdf
 
PRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdfPRENATAL TESTING AND DIAGNOSIS.pdf
PRENATAL TESTING AND DIAGNOSIS.pdf
 
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdf
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdfREVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdf
REVIEW OF CELLULAR DIVISION MITOSIS AND MEIOSIS 2023.pdf
 
sex linked inheritance error of transmission.pdf
sex linked inheritance error of transmission.pdfsex linked inheritance error of transmission.pdf
sex linked inheritance error of transmission.pdf
 
The eugenics Movement.pdf
The eugenics Movement.pdfThe eugenics Movement.pdf
The eugenics Movement.pdf
 

Recently uploaded

The Best Diet for Preventing and Managing Kidney Stones .pptx
The Best Diet for Preventing and Managing Kidney Stones .pptxThe Best Diet for Preventing and Managing Kidney Stones .pptx
The Best Diet for Preventing and Managing Kidney Stones .pptxBarshaBarsha6
 
Disseminated Intravascular Coagulation.ppt
Disseminated Intravascular Coagulation.pptDisseminated Intravascular Coagulation.ppt
Disseminated Intravascular Coagulation.pptSameer Jain
 
Immediate care of newborn, midwifery and obstetrical nursing
Immediate care of newborn, midwifery and obstetrical nursingImmediate care of newborn, midwifery and obstetrical nursing
Immediate care of newborn, midwifery and obstetrical nursingNursing education
 
Presentation for Alzheimers Disease.pptx
Presentation for Alzheimers Disease.pptxPresentation for Alzheimers Disease.pptx
Presentation for Alzheimers Disease.pptxravisutar1
 
Discover the Art Deco Style at Spa Dental
Discover the Art Deco Style at Spa DentalDiscover the Art Deco Style at Spa Dental
Discover the Art Deco Style at Spa DentalA-dec Australia
 
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...Compliatric Where Compliance Happens
 
Weighing the Risks and Benefits: Angioplasty at Gokuldas Hospitals
Weighing the Risks and Benefits: Angioplasty at Gokuldas HospitalsWeighing the Risks and Benefits: Angioplasty at Gokuldas Hospitals
Weighing the Risks and Benefits: Angioplasty at Gokuldas HospitalsGokuldas Hospital
 
The future of change - strategic translation
The future of change - strategic translationThe future of change - strategic translation
The future of change - strategic translationHelenBevan4
 
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdf
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdfPreventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdf
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdfAditiAlishetty
 
Emergency ambulance portal-PPT-3g2pqy.pptx
Emergency ambulance portal-PPT-3g2pqy.pptxEmergency ambulance portal-PPT-3g2pqy.pptx
Emergency ambulance portal-PPT-3g2pqy.pptxdragonaklevel7
 
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWAT
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWATBURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWAT
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWATNehaKewat
 
EHR Market Growth is The Boom Over - Jasper Colin
EHR Market Growth is The Boom Over - Jasper ColinEHR Market Growth is The Boom Over - Jasper Colin
EHR Market Growth is The Boom Over - Jasper ColinJasper Colin
 
Incentive spirometry powerpoint presentation
Incentive spirometry powerpoint presentationIncentive spirometry powerpoint presentation
Incentive spirometry powerpoint presentationpratiksha ghimire
 
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...Oleg Kshivets
 
Nursing Diagnosis: The Second Phase of The Nursing Process
Nursing Diagnosis: The Second Phase of The Nursing ProcessNursing Diagnosis: The Second Phase of The Nursing Process
Nursing Diagnosis: The Second Phase of The Nursing ProcessRommel Luis III Israel
 
Your Radiotherapy Destination Gokuldas Hospital.
Your Radiotherapy Destination Gokuldas Hospital.Your Radiotherapy Destination Gokuldas Hospital.
Your Radiotherapy Destination Gokuldas Hospital.Gokuldas Hospital
 
Understanding Cholera: Epidemiology, Prevention, and Control.pdf
Understanding Cholera: Epidemiology, Prevention, and Control.pdfUnderstanding Cholera: Epidemiology, Prevention, and Control.pdf
Understanding Cholera: Epidemiology, Prevention, and Control.pdfSasikiranMarri
 
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are Heard
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are HeardAdvance Directives and Advance Care Planning: Ensuring Patient Voices Are Heard
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are HeardVITASAuthor
 
AMIKINHAL Presentation Journal Club (3).pptx
AMIKINHAL Presentation Journal Club (3).pptxAMIKINHAL Presentation Journal Club (3).pptx
AMIKINHAL Presentation Journal Club (3).pptxDileepRedemption
 

Recently uploaded (20)

The Best Diet for Preventing and Managing Kidney Stones .pptx
The Best Diet for Preventing and Managing Kidney Stones .pptxThe Best Diet for Preventing and Managing Kidney Stones .pptx
The Best Diet for Preventing and Managing Kidney Stones .pptx
 
Disseminated Intravascular Coagulation.ppt
Disseminated Intravascular Coagulation.pptDisseminated Intravascular Coagulation.ppt
Disseminated Intravascular Coagulation.ppt
 
Immediate care of newborn, midwifery and obstetrical nursing
Immediate care of newborn, midwifery and obstetrical nursingImmediate care of newborn, midwifery and obstetrical nursing
Immediate care of newborn, midwifery and obstetrical nursing
 
Presentation for Alzheimers Disease.pptx
Presentation for Alzheimers Disease.pptxPresentation for Alzheimers Disease.pptx
Presentation for Alzheimers Disease.pptx
 
Discover the Art Deco Style at Spa Dental
Discover the Art Deco Style at Spa DentalDiscover the Art Deco Style at Spa Dental
Discover the Art Deco Style at Spa Dental
 
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...
2024 Compliatric Webinar Series - OSV Overview and Panel Discussion April 202...
 
Weighing the Risks and Benefits: Angioplasty at Gokuldas Hospitals
Weighing the Risks and Benefits: Angioplasty at Gokuldas HospitalsWeighing the Risks and Benefits: Angioplasty at Gokuldas Hospitals
Weighing the Risks and Benefits: Angioplasty at Gokuldas Hospitals
 
The future of change - strategic translation
The future of change - strategic translationThe future of change - strategic translation
The future of change - strategic translation
 
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdf
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdfPreventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdf
Preventing Common Nutritional Deficiencies In Poultry Flocks (PPT).pdf
 
Emergency ambulance portal-PPT-3g2pqy.pptx
Emergency ambulance portal-PPT-3g2pqy.pptxEmergency ambulance portal-PPT-3g2pqy.pptx
Emergency ambulance portal-PPT-3g2pqy.pptx
 
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWAT
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWATBURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWAT
BURNS AND ITS MANAGEMENT.pptx PREPARED BY NEHA KEWAT
 
EHR Market Growth is The Boom Over - Jasper Colin
EHR Market Growth is The Boom Over - Jasper ColinEHR Market Growth is The Boom Over - Jasper Colin
EHR Market Growth is The Boom Over - Jasper Colin
 
Sarah A Reed: A Rennaissance Women her spirit lives one 153 Years Later
Sarah A Reed: A Rennaissance Women her spirit lives one 153 Years LaterSarah A Reed: A Rennaissance Women her spirit lives one 153 Years Later
Sarah A Reed: A Rennaissance Women her spirit lives one 153 Years Later
 
Incentive spirometry powerpoint presentation
Incentive spirometry powerpoint presentationIncentive spirometry powerpoint presentation
Incentive spirometry powerpoint presentation
 
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
Esophageal Cancer: Artificial Intelligence, Synergetics, Complex System Analy...
 
Nursing Diagnosis: The Second Phase of The Nursing Process
Nursing Diagnosis: The Second Phase of The Nursing ProcessNursing Diagnosis: The Second Phase of The Nursing Process
Nursing Diagnosis: The Second Phase of The Nursing Process
 
Your Radiotherapy Destination Gokuldas Hospital.
Your Radiotherapy Destination Gokuldas Hospital.Your Radiotherapy Destination Gokuldas Hospital.
Your Radiotherapy Destination Gokuldas Hospital.
 
Understanding Cholera: Epidemiology, Prevention, and Control.pdf
Understanding Cholera: Epidemiology, Prevention, and Control.pdfUnderstanding Cholera: Epidemiology, Prevention, and Control.pdf
Understanding Cholera: Epidemiology, Prevention, and Control.pdf
 
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are Heard
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are HeardAdvance Directives and Advance Care Planning: Ensuring Patient Voices Are Heard
Advance Directives and Advance Care Planning: Ensuring Patient Voices Are Heard
 
AMIKINHAL Presentation Journal Club (3).pptx
AMIKINHAL Presentation Journal Club (3).pptxAMIKINHAL Presentation Journal Club (3).pptx
AMIKINHAL Presentation Journal Club (3).pptx
 

Anesthesia

  • 1.
  • 3.
  • 4. The word anesthesia is derived from the Greek: meaning insensible or without feeling. ANESTHESIA IS BROKEN DOWN INTO 3 MAIN CATEGORIES LOCAL AND GENERAL. REGIONAL ,ALL OF WHICH AFFECT THE NERVOUS SYSTEM IN SOME WAY AND CAN BE ADMINISTERED USING VARIOUS METHODS AND DIFFERENT MEDICATION. ANAESTHESIA ARE AGENT THAT BRIING ABOUT REVERSIBLE LOSS OF SENSATION .
  • 5. (from Greek αν-, an-, "without"; and αἴσθησις, aisthēsis, "sensation"), traditionally meant the condition of having sensation (including the feeling of pain) blocked or temporarily taken away. It is a pharmacologically induced and reversible state of amnesia, analgesia, loss of responsiveness, loss of skeletal muscle reflexes or decreased stress response, or all simultaneously. These effects can be obtained from a single drug which alone provides the correct combination of effects, or occasionally a combination of drugs (such as hypnotics, sedatives, paralytics and analgesics) to achieve very specific combinations of results. This allows patients to undergo surgery and other procedures without the distress and pain they would otherwise experience. An alternative definition is a "reversible lack of awareness," including a total lack of awareness (e.g. a general anesthetic) or a lack of awareness of a part of the body such as a spinal anesthetic. The pre-existing word anesthesia was suggested by Oliver Wendell Holmes, Sr. in 1846 as a word to use to describe this state. Anaesthesiology is a special branch of medicine. Nurses working in this area need to have knowledge and skill to care for the patient who is being given premedication, under anaesthesia and recovering.
  • 6. ACCORDING TO willims Loss of feeling in all or part of body with or without loss of consciousness .the patient was given an injection before surgery According to lippen cott Genral loss of the sense of feeling ,as pain ,heat ,cold, touch,and other less common varieties of sensation . According to devis It is a reversible blocking of pain feeling in whole body or in a part of it using pharmacology or other methods
  • 8. Types of anesthesia: •REGIONAL ANESTHESIA •GENERAL ANESTHESIA •LOCAL ANESTHESIA •DISSOCIATIVE ANESTHESIA.
  • 9.
  • 10. •REGIONAL ANESTHESIA : Regional anesthesia renders a larger area of the body insensate by blocking transmission of nerve impulses between a part of the body and the spinal cord. Two frequently used types of regional anesthesia are spinal anesthesia and epidural anesthesia. •
  • 11.
  • 12.
  • 13. LOCAL ANESTHESIA : Local anesthesia inhibits sensory perception within a specific location on the body, such as a tooth or the urinary bladder
  • 14.
  • 15. •SPINAL ANESTHESIA: • it is achieved by injection 1.8 ml of 5% lignocaine solution into the subarechnoid apece through a lumber puncture.other drugs which can be used are cinchocaine, procaine and amethocaine. It can cause serious hypotension.
  • 16.
  • 17. •EPIDURAL ANESTHESIA: It is achieved by injection 1 to 2 % of lignocaine solution in the epidural space. It blocks the nerves which traverse the epidural space. It can cause hypotension, which is less severe than with spinal analgesia. For prolonged operations, a catheter may be passed into the epidural space for intermittent administration of local anaesthesia.
  • 18.
  • 19. GENERAL ANESTHESIA : General anesthesia refers to inhibition of sensory, motor and sympathetic nerve transmission at the level of the brain, resulting in unconsciousness and lack of sensation. There are three types of general anaesthesia- spontaneous, controled and assisted. These types are based on whether the patient breathes himself under anaeasthesia, is ventilated artificially, or breathes himself but needs assistance periodically.
  • 20.
  • 21. Induction: Anaesthesia may be indused by one of the following techniques- •Intravenouos injection of the following:- •Thiopentone(2.5%:) short acting(15 to 30 minutes). •Methohexitone (1%): ultra-short acting(15 to 30) minutes. •Hexobarbitone(10%) : long acting (30 to 45 minutes). •Inhalation agents:- •Nitrous oxide. •Cyclopropane* •Halothane •Ether* •Trichlorethylene •Ethyl ghloride •Rectal instillation:- thiopentone or paraldehyde is instilled into the rectum through a catheter, as a warmed solution. Alternatively, a rectal suppository may be used. This method of induction is used in children.
  • 22.
  • 23. DISSOCIATIVE ANESTHESIA: Dissociative anesthesia uses agents that inhibit transmission of nerve impulses between higher centers of the brain (such as the cerebral cortex) and the lower centers, such as those found within the limbic system.
  • 24. GENERAL ANESTHESIA ARE DRUGS THAT BRING ABOUT REVERSIBLE LOSS OF SENSATION AND CONSCIOUSNESS. PURPOSES OF ANESTHESIA 1. ANALGESIA ( LOSS OF RESPONSE TO PAIN ) 2. AMNESIA ( LOSS OF MEMORY ) 3. IMMOBILITY ( LOSS OF MOTOR REFLEXES ) 4. HYPNOSIS ( UNCONSCIOUSNESS) 5. PARALYSIS ( SKELETAL MUSCLE RELAXATION )
  • 25. agent used is a gas like nitrous oxide or volatile vapor like chloroform, ether, or flothane. - Inhalational anesthesia depresses the brain from up [cortex] to down [the medulla] by increasing dose. INHALATIONAL ANAESTHESIA Inhalational anesthesia is achieved through airway tract by facemask, laryngeal mask or endotracheal tube
  • 26. 1. INHALATIONAL ( A ) GASES NITROUS OXIDE A colorless gas with a slightly sweetish odor prepared by heating ammonium nitrate . It produce light anesthesia without significant depression of respiration or vasomotor center . It has the dis advantage that it produces light anesthesia and therefore can only be used along anesthesia .long term exposure ( like in staff of operation theater ) to low dose can impair DNA synthesis which may result in fetal abnormalities when such staff become pregnant. ( B ) LIQUIDS ETHER- 1. Is a colorless volatile liquid . 2. It is a potent and reliable anesthetic ,good analgesic ,muscle relaxant and does not depress cardiovascular and respiratory function in therapeutic doses.
  • 27. HALOTHANE Is colorless volatile liquid with a sweet odor . It is non irritant and non inflammable Induction is smooth and rapid in 2-5 min surgical anesthesia can be produced ENFLURANE AND ISOFLURANE They are metabolized to a lesser extent then halothane - therefore safer regarding the liver toxicity They do not sensitize the heart to adrenaline DESFLURANE AND SEVOFLURANE Are newer agent which bring about very rapid induction and recovery because of low solubility in blood but they too have some disadvantages desflurane is pregnant -may induce coughing and some times laryngospasm .
  • 28. OXYGEN IN ANESTHESIA `oxygen should be added routinely to inhalation agents to protect against hypoxia ( especially when halothane is used ) when O2 is not available ,ether is the safer agent for maintenance of anesthesia. INTRAVENOUS ANESTHESIA Iv anesthesia allow an extremely rapid induction because the blood concentration be raised rapidly -in few second there is loss of consciousness 1. Inducing agents Thiopentone sodium Proprofol 2. Dissociative anesthesia ketamine 3. Neuroleptanalgesia fentanyl + droperidol 4. Benzodiazepines diazepam , lorazepam , midazolam
  • 29. THIOPENTONE SODIUM is used for induction of anesthesia prior to administration of inhalation anesthesia . A .PROPOFOL Is an oily liquid . It is used for induction and maintenance of anesthesia for short procedures of up to 1 hours duration. B. DISSOCIATIVE ANESTHESIA KETAMINE Ketamine hydrochloride given slow iv produces dissociative anesthesia within 3-5 min which lasts for 10-15 min after a single injection .premedication with atropine is needed . C. NEUROLEPT ANALGESIA FENTANYLE + DROPERIDOL A combination of a neuroleptic ( droperidol ) with an analgesia ( fentanyl ) it last s for 30-40 min . It is employed for endoscopies , burn dressing , angiographies ,and other diagnostic and minor surgical procedures .
  • 30. STAGE OF GERNAL ANESTHESIA 1. Stage of analgesia Is from the beginning of inhalation of the anesthetic to consciousness . 2. Stage of delirium the stage is from loss of consciousness to beginning of surgical anesthesia . It may be associated with excitement shouting ( speak with very loud voice ) crying and violent behavior. 3. Stage of surgical anesthesia the has 4 planes .as anesthesia passes to deeper planes , respiratory depression is seen ,there is gradual loss of reflexes and relaxation of skeletal muscle . 4. Stage of medularly paralysis is seen only with overdose . It is the stage of medullary depression – cessation of breathing circulatory failure and death may follow.
  • 31. I. Analgesia stage • Patient conscious • Spontaneous respiration • Reflexes present • Possible small surgery procedures like dressing change in burns II. Excitation stage • Possible uncontrolled movements, vomiting • Increase in respiratory rate III. Anesthesia for surgery • It begins with lack of lid reflex • 4 sub stages • Airway opening necessary • Possible surgery except for abdominal opening if no relaxants are used • Possible end tracheal intubation IV. intoxication, overdosing • Respiratory arrest • If anesthesia not discontinued possible cardiac arrest
  • 32.
  • 33. Local anesthesia – the administration of an anesthetic agent to one part of the body by local infiltration or topical application. It is usually administered by the surgeon. Used for minor procedures if the patient’s cooperation and the condition warrants its use. Local anaesthetic agents can be defined as drugs which are used clinically to produce reversible loss of sensation in a circumscribed area of the body. Drugs include Beta-adrenoceptor antagonists, opioid analgesics, anticonvulsants and antihistamines. Local anaesthetics can be divided into two groups on the basis of their chemical structure: - amides: Lignocaine, prilocaine and bupivacaine - esters: Amethocaine, benzocaine, cocaine e.g., amethocaine lozenges for the oropharynx, cocaine for nasal surgery. Most blocks take 5 – 20 minutes to work. Local anesthesia are drug s are used that the block nerve conduction when applied locally to nerve tissue in appropriate concentration . There action is completely reversible
  • 34. CLASSIFICATION OF LOCAL ANESTHESIA A. INJECTABLE 1. SHORT-ACTING PROCAINE ,CHLOROPROCAINE 2. INTERMEDIATE –ACTING - LIGNOCAINE , PRILOCAINE 3. LONG-ACTING – TETRACAINE ( AMETHOCAINE ) , BUPIVACAINE , DIBUCAINE , ROPIVACAINE , ETIDOCAINE. B. SURFACE ANESTHESIA LIGNOCAINE ,COCAINE , TETRACAINE, BENZOCAINE, OXETHAZAINE.
  • 35. MECHENISM OF ACTION PREVENT THE GENRATION AND THE CONDUCTION OF NERVE IMPULSES .THE PRIMARY MECHENISUM OF ACTION IS BLOCKADE OF VOLTAGE -GATED SODIUM CHANNELS .
  • 36. Regional Anesthesia – is broadly defined as a reversible loss of sensation in a specific area or region of the body when a local anaesthetic is injected to purposefully block or anaesthetize nerve fibres in and around the operative site. Commonly R.A techniques include: Spinals (subarachnoid block), epidurals (extradural space) , caudals, and major peripheral nerve blocks. - The subarachnoid, epidural or plexus block are called REGIONAL ANAESTHESIA - Some called it regional analgesia as patient is conscious. - Some use sedative with regional analgesia to be anaesthesia. - Local anaesthesia means block of peripheral nerve or tissue infiltration as in lipoma ( slow growing fat cell in a thin fibrous capsule usually found just below the skin ), circumcision, teeth, eye even craniotomy
  • 37. 1. HYPERSENSITIVITY REACTION - INCLUDED SKIN RASHES ,DERMATITIS , ASTHAMA, OR RARELY ANAPHYLAXIS 2. C.N.S - DIZZINESS , AUDITORY AND VISIUAL DISTURBANCE , MENTAL CONFUSION , DISORIENTATION ,ANXIETY , MUSCLE TREMORS, CONVULSIONS AND RESPIRATORY FAILURE CAN RESULT FROM LARGE DOSES INTRAVENOUS DIZAPAM CONTROLS CONVULSION . 3. C.V.S - HYPOTENTION , BRADYCARDIA , AND ARRHYMIAS MAY BE ENCOUNTERED . RARELY CARDIAC ARREST CAN OCCUR. 4. LOCAL IRRITATION - CAN BE SEEN WITH BUPIVACAINE . WOUND HEALING MAY BE DELAYED
  • 38. METHODS OF ANESTHESIA 1. Spinal cord: By injection of local drug in sub - arachnoid space in CSF, this must be bellow L 2 2. Epidural: The drug is injected outside dura [no puncture] to block the nerve roots at its exit from spinal cord. 3. Nerve plexus: Cervical, brachial, lumbosacral 4. Peripheral nerve: Radial, ulna, median, sciatic, femoral, popletial, facial, mandibular. 5. Injection into tissues, skin, subcutaneous.
  • 39. Spinal anesthesia – local anesthetic injected into subarachnoid space at 3rd or 4th lumbar space - Too high = affects resp. muscles - Headaches - poss. d/t a in CSF pressure at site of needle insertion Spinal Block - subarachnoid membrane (2nd layer of cord) Epidural Block - outer covering of spinal cord (dura mater) Caudal Block - sacrum Saddle Block - Lower end of spinal column - blocks peri area - clients in labor Monitor BP with all of the above
  • 40. 1. Anaesthetic machine. 2. Monitoring system. 1. Oxygen gas supply. 2. Nitrous oxide gas supply. 3. Flow meter 4. Vaporizer specific for every agent 5. Mechanical ventilator 6. Tubes for connection. 1. Pulse, ECG 2. Blood pressure 3. Oxygen saturation. 4. End tidal CO2 5. Temperature 6. Urine output, CVP, EEG, bispectral index, muscle tone, ECHO, drug concentration Need for 2 impo tools Anesthetic machine monitoring
  • 41. PREPERATION : •the suction machine should be checked. Solution catheters and tips are arranged for. •The working of the operation table is checked, especially the mechanism of lowering the head end. •Nasogastric tubes are kept on the trolly. •Resuscitation equipment is checked- (a) O2 cylinder (b) face mask, ambu valve, bag (c) laryngoscope (d) endotracheal tubes (e) drugs: atropine, adrenaline, sodium bicarbonate, mephentermine, dopamine, hydrocortisone, pronethazine. (f) monitoring equipment is checked, e.g. cardioscope with defibrillator, pulse oximiter, capnometer etc.
  • 42. MAINTENANCE: Components of the anaesthesia are anagesia and amnesia. The former is important, because the patient must not feel any pain. The later is important because the patient must not recall any events at the time of the operation. Analgesia is provided by nitrous oxide, trichlorethylene, ether cyclopropane or pethidine. Sleep is achieved with thiopentone, nitrous oxide or cyclopropane. Controlled general anaesthesia needsendotracheal intubation. The vocal cord are paralysed for intubation with suxamethonium or d-tubocurarine. Muscles relaxation for artificial ventilation is achieved with intermitlent administration of suxamethonium, or long acting muscle relaxants like gallamine or d- tubocurarine. The action of last two drugs are reversed at the end of the operation with neostigmine. Atropine has to be administered prior to neostigmine to reduce cardiac slowing, and profuse bronchial and salivary secretions produced by neostigmine as a side effect