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ANESTHESIA
©Rohit Bhaskar 1
Presented By
Rohit Bhaskar
Physiotherapy Student
At Uttar Pradesh University
Of Medical Sciences
Anesthesia is a way to control pain
during a surgery or procedure by
using medicine called anesthetics. It
can help control your breathing,
blood pressure, blood flow, and
heart rate and rhythm.
©Rohit Bhaskar 2
Anesthesia may be used to
relax you, block pain , make
you sleepy or forgetful and
make you unconscious for
your surgery.
Besides general anesthesia,
other forms of anesthesia
may provide only light
sedation or use injections to
numb only a small area (local
anesthesia) or a larger region
(regional anesthesia) of your
body.
©Rohit Bhaskar 3
PRINCIPLES
Informed Consent
History
Physical Examination
Systemic History
Assessment Of Airway – MALLAMPATI TEST
ASA Physical Status Classification
Preoperative Instructions
Premedications
ALLAY ANXIETY
RELIEVE PAIN
TO DRY SECRETIOS
REDUCE GASTRIC VOLUME & ACIDITY
©Rohit Bhaskar 4
Stages of anesthesia
1. Analgesia
2. Exitement
3. Surgical Anesthesia
4. Medullary paralysis
©Rohit Bhaskar 5
Stage 1
:
(Induction, aka
voluntary
excitement)
is the period between the
initial administration of the
induction agents and loss of
consciousness. During this
stage, the patient progresses
from analgesia without
amnesia to analgesia with
amnesia. Patients can carry
on a conversation at this time.
©Rohit Bhaskar 6
Stage 2
:
(delirium, involuntary
excitement) is the period
following loss of
consciousness and marked by
excited and delirious activity. During
this stage, respirations and heart
rate may become irregular. In
addition, there may be uncontrolled
movements, vomiting, breath
holding, and papillary dilation.
©Rohit Bhaskar 7
Since the combination of spastic movements,
vomiting, and irregular respirations may lead
to airway compromise, rapidly acting drugs
are used to minimize time in this stage and
reach stage 3 as fast as possible.
©Rohit Bhaskar 8
Stage 3 : "surgical
anesthesia"
During this stage, the skeletal muscles
relax, vomiting stops, and respiratory
depression occurs .
Eye movements slow, then stop,
the patient is unconscious and
ready for surgery.
It has been divided into 4 planes:
-eyes initially rolling, then becoming
fixed
-loss of corneal and laryngeal reflexes
-pupils dilate and loss of light reflex
-intercostals paralysis, shallow abdominal
respiration
©Rohit Bhaskar 9
Stage 4 : "overdose“
Is the stage where too much
medication has been given
relative to the amount of
surgical stimulation and the
patient has severe brain stem or
medullary depression. This
results in a cessation of
respiration and potential
cardiovascular collapse. This
stage is lethal without
cardiovascular and respiratory
support.
©Rohit Bhaskar 10
Types ofAnesthesia
-General
Anesthesia
-Regional
Anesthesia
-Local Anesthesia
©Rohit Bhaskar 11
General
Anesthesia :
General anesthesia acts primarily
on the brain and central nervous
system to make the patient
unconscious and unaware.
©Rohit Bhaskar 12
It is administered via the
patient's circulatory system by
a combination of inhaled gas
and injected drugs.
After the initial injection,
anesthesia is maintained with
inhaled gas anesthetics and
additional drugs through an
intravenous line (IV) .
©Rohit Bhaskar 13
Local Anesthesia :
is medicine given to temporarily stop the
sense of pain in a particular area of the
body. A patient remains conscious
during a local anesthetic. For minor
surgery, a local anesthetic can be
administered via injection to the site..
©Rohit Bhaskar 14
However, when a large area
needs to be numbed, or if a
local anesthetic injection will
not penetrate deep enough,
physicians may resort to
regional anesthetics
©Rohit Bhaskar 15
Regional Anesthesia :
involves injection of a local
anesthetic (numbing agent)
around major nerves or the
spinal cord to block pain from
a larger but still limited part of
the body. You will likely receive
medicine to help you relax or
sleep during surgery. Major
types of regional anesthesia
include:
©Rohit Bhaskar 16
Spinal
:
often used for lower abdominal,
pelvic, rectal, or lower extremity
surgery. This type of anesthetic
involves injecting a single dose of the
anesthetic agent directly into the
spinal cord in the lower back, causing
numbness in the lower body.
©Rohit Bhaskar 17
Epidural, and caudal
anesthesia:
this anesthetic is similar to a spinal
anesthetic and also is commonly
used for surgery of the lower limbs
and during labor and childbirth.
©Rohit Bhaskar 18
This type of anesthesia involves
continually infusing drugs
through a thin catheter that has
been placed into the space that
surrounds the spinal cord in the
lower back, causing numbness in
the lower body.
©Rohit Bhaskar 19
Nerve blocks :
A local anesthetic is injected near a
specific nerve or group of nerves to
block pain from the area of the body
supplied by the nerve.
©Rohit Bhaskar 20
Nerve blocks are most commonly
used for procedures on the hands,
arms, feet, legs, or face. Example - a
Brachial Plexus block may be used
by your anesthesiologist to provide
anesthesia to your entire arm and
shoulder.
©Rohit Bhaskar 21
Drugs for General
Anesthesia
Atracurium :
is a neuromuscular-blocking agent,
used as an adjuvant in anesthesia.
This medication provides
relaxation of skeletal muscles
during surgery.
©Rohit Bhaskar 22
Cisatracurium Besylate :
is a neuromuscular blocking agent,
used as an adjunct to general
anesthesia .
Desflurane :
is a general anesthetic, prescribed for
induction of anesthesia during surgery.
©Rohit Bhaskar 23
Enflurane :
is a structural isomer of isoflurane,
prescribed for induction and
maintenance of general
anesthesia.
Halothane :
is an inhalational general
anesthetic, prescribed for the
induction and maintenance of
general anesthesia
©Rohit Bhaskar 24
Ketamine :
is a hydrochloride salt, used as an
anesthetic.
Hyoscyamine :
is an anticholinergic agent, used as pain killer
(Belladonna alkaloid). It blocks cardiac vagal
inhibitory reflexes during anesthesia
induction and intubation, used to relax
muscles.
©Rohit Bhaskar 25
Methohexital :
is a barbiturate anesthetic, prescribed
for inducing anesthesia before surgery.
Propofol :
is a general anesthetic, prescribed
for induction and maintenance of
general anaesthesia
©Rohit Bhaskar 26
Rapacuronium :
is a neuromuscular blocker, prescribed as an
adjunct to general anesthesia to facilitate
tracheal intubations.
Rocuronium :
is a neuromuscular blocker, prescribed as an
adjunct to general anesthesia for muscle
relaxation and to provide skeletal muscle
relaxation during surgery or external
breathing.
©Rohit Bhaskar 27
Sevoflurane :
is a halogenated hydrocarbon, acts as a
general anesthetic during surgery either
alone or combined with other
medications. It is given by inhalation. This
helps to produce more effective
anesthesia in some patients.
Succinylcholine :
is a depolarizing muscle relaxant, used
for induction and maintenance of
general anesthesia
©Rohit Bhaskar 28
Drugs for Local Anesthesia
Articane HCl and Epinephrine:
Injection is a local dental anesthetic,
used as an anesthesia for dental
procedures.
©Rohit Bhaskar 29
Benzocaine :
is a local anesthetic used to treat painful
conditions such as mouth ulcers, sore
throat, before inserting instruments into
the rectum or vagina for examination.
Bupivacaine:
is a local anesthetic, used for surgery and
for obstetrical procedures.
©Rohit Bhaskar 30
Lidocaine:
is a local anesthetic,
indicated for local or
regional anesthesia.
Lidocaine and Prilocaine :
is a dermal anesthesia, prescribed for
tingling, pricking or numbness of a
person's skin.
©Rohit Bhaskar 31
Mepivacaine:
is a local anesthetic, prescribed for
inducing local or regional analgesia
and anesthesia during surgical
procedures, labor, or delivery.
Oxethazaine :
is a potent local anesthetic, prescribed
for rapid and effective relief in gastritis,
esophagitis, hiatus hernia, heartburn of
pregnancy and peptic ulcer.
©Rohit Bhaskar 32
Bupivacaine :
is a local anesthetic, used for surgery
and for
obstetrical procedures.
Spinal and Epidural
Anesthesia
©Rohit Bhaskar 33
What are the risks
and complications of
anesthesia?
Respiratory
Cardiovascular
CNS
©Rohit Bhaskar 34
©Rohit Bhaskar 35
THANK YOU

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Anesthesia I Types, Stages, Complications - Dr Rohit Bhaskar

  • 1. ANESTHESIA ©Rohit Bhaskar 1 Presented By Rohit Bhaskar Physiotherapy Student At Uttar Pradesh University Of Medical Sciences
  • 2. Anesthesia is a way to control pain during a surgery or procedure by using medicine called anesthetics. It can help control your breathing, blood pressure, blood flow, and heart rate and rhythm. ©Rohit Bhaskar 2
  • 3. Anesthesia may be used to relax you, block pain , make you sleepy or forgetful and make you unconscious for your surgery. Besides general anesthesia, other forms of anesthesia may provide only light sedation or use injections to numb only a small area (local anesthesia) or a larger region (regional anesthesia) of your body. ©Rohit Bhaskar 3
  • 4. PRINCIPLES Informed Consent History Physical Examination Systemic History Assessment Of Airway – MALLAMPATI TEST ASA Physical Status Classification Preoperative Instructions Premedications ALLAY ANXIETY RELIEVE PAIN TO DRY SECRETIOS REDUCE GASTRIC VOLUME & ACIDITY ©Rohit Bhaskar 4
  • 5. Stages of anesthesia 1. Analgesia 2. Exitement 3. Surgical Anesthesia 4. Medullary paralysis ©Rohit Bhaskar 5
  • 6. Stage 1 : (Induction, aka voluntary excitement) is the period between the initial administration of the induction agents and loss of consciousness. During this stage, the patient progresses from analgesia without amnesia to analgesia with amnesia. Patients can carry on a conversation at this time. ©Rohit Bhaskar 6
  • 7. Stage 2 : (delirium, involuntary excitement) is the period following loss of consciousness and marked by excited and delirious activity. During this stage, respirations and heart rate may become irregular. In addition, there may be uncontrolled movements, vomiting, breath holding, and papillary dilation. ©Rohit Bhaskar 7
  • 8. Since the combination of spastic movements, vomiting, and irregular respirations may lead to airway compromise, rapidly acting drugs are used to minimize time in this stage and reach stage 3 as fast as possible. ©Rohit Bhaskar 8
  • 9. Stage 3 : "surgical anesthesia" During this stage, the skeletal muscles relax, vomiting stops, and respiratory depression occurs . Eye movements slow, then stop, the patient is unconscious and ready for surgery. It has been divided into 4 planes: -eyes initially rolling, then becoming fixed -loss of corneal and laryngeal reflexes -pupils dilate and loss of light reflex -intercostals paralysis, shallow abdominal respiration ©Rohit Bhaskar 9
  • 10. Stage 4 : "overdose“ Is the stage where too much medication has been given relative to the amount of surgical stimulation and the patient has severe brain stem or medullary depression. This results in a cessation of respiration and potential cardiovascular collapse. This stage is lethal without cardiovascular and respiratory support. ©Rohit Bhaskar 10
  • 12. General Anesthesia : General anesthesia acts primarily on the brain and central nervous system to make the patient unconscious and unaware. ©Rohit Bhaskar 12
  • 13. It is administered via the patient's circulatory system by a combination of inhaled gas and injected drugs. After the initial injection, anesthesia is maintained with inhaled gas anesthetics and additional drugs through an intravenous line (IV) . ©Rohit Bhaskar 13
  • 14. Local Anesthesia : is medicine given to temporarily stop the sense of pain in a particular area of the body. A patient remains conscious during a local anesthetic. For minor surgery, a local anesthetic can be administered via injection to the site.. ©Rohit Bhaskar 14
  • 15. However, when a large area needs to be numbed, or if a local anesthetic injection will not penetrate deep enough, physicians may resort to regional anesthetics ©Rohit Bhaskar 15
  • 16. Regional Anesthesia : involves injection of a local anesthetic (numbing agent) around major nerves or the spinal cord to block pain from a larger but still limited part of the body. You will likely receive medicine to help you relax or sleep during surgery. Major types of regional anesthesia include: ©Rohit Bhaskar 16
  • 17. Spinal : often used for lower abdominal, pelvic, rectal, or lower extremity surgery. This type of anesthetic involves injecting a single dose of the anesthetic agent directly into the spinal cord in the lower back, causing numbness in the lower body. ©Rohit Bhaskar 17
  • 18. Epidural, and caudal anesthesia: this anesthetic is similar to a spinal anesthetic and also is commonly used for surgery of the lower limbs and during labor and childbirth. ©Rohit Bhaskar 18
  • 19. This type of anesthesia involves continually infusing drugs through a thin catheter that has been placed into the space that surrounds the spinal cord in the lower back, causing numbness in the lower body. ©Rohit Bhaskar 19
  • 20. Nerve blocks : A local anesthetic is injected near a specific nerve or group of nerves to block pain from the area of the body supplied by the nerve. ©Rohit Bhaskar 20
  • 21. Nerve blocks are most commonly used for procedures on the hands, arms, feet, legs, or face. Example - a Brachial Plexus block may be used by your anesthesiologist to provide anesthesia to your entire arm and shoulder. ©Rohit Bhaskar 21
  • 22. Drugs for General Anesthesia Atracurium : is a neuromuscular-blocking agent, used as an adjuvant in anesthesia. This medication provides relaxation of skeletal muscles during surgery. ©Rohit Bhaskar 22
  • 23. Cisatracurium Besylate : is a neuromuscular blocking agent, used as an adjunct to general anesthesia . Desflurane : is a general anesthetic, prescribed for induction of anesthesia during surgery. ©Rohit Bhaskar 23
  • 24. Enflurane : is a structural isomer of isoflurane, prescribed for induction and maintenance of general anesthesia. Halothane : is an inhalational general anesthetic, prescribed for the induction and maintenance of general anesthesia ©Rohit Bhaskar 24
  • 25. Ketamine : is a hydrochloride salt, used as an anesthetic. Hyoscyamine : is an anticholinergic agent, used as pain killer (Belladonna alkaloid). It blocks cardiac vagal inhibitory reflexes during anesthesia induction and intubation, used to relax muscles. ©Rohit Bhaskar 25
  • 26. Methohexital : is a barbiturate anesthetic, prescribed for inducing anesthesia before surgery. Propofol : is a general anesthetic, prescribed for induction and maintenance of general anaesthesia ©Rohit Bhaskar 26
  • 27. Rapacuronium : is a neuromuscular blocker, prescribed as an adjunct to general anesthesia to facilitate tracheal intubations. Rocuronium : is a neuromuscular blocker, prescribed as an adjunct to general anesthesia for muscle relaxation and to provide skeletal muscle relaxation during surgery or external breathing. ©Rohit Bhaskar 27
  • 28. Sevoflurane : is a halogenated hydrocarbon, acts as a general anesthetic during surgery either alone or combined with other medications. It is given by inhalation. This helps to produce more effective anesthesia in some patients. Succinylcholine : is a depolarizing muscle relaxant, used for induction and maintenance of general anesthesia ©Rohit Bhaskar 28
  • 29. Drugs for Local Anesthesia Articane HCl and Epinephrine: Injection is a local dental anesthetic, used as an anesthesia for dental procedures. ©Rohit Bhaskar 29
  • 30. Benzocaine : is a local anesthetic used to treat painful conditions such as mouth ulcers, sore throat, before inserting instruments into the rectum or vagina for examination. Bupivacaine: is a local anesthetic, used for surgery and for obstetrical procedures. ©Rohit Bhaskar 30
  • 31. Lidocaine: is a local anesthetic, indicated for local or regional anesthesia. Lidocaine and Prilocaine : is a dermal anesthesia, prescribed for tingling, pricking or numbness of a person's skin. ©Rohit Bhaskar 31
  • 32. Mepivacaine: is a local anesthetic, prescribed for inducing local or regional analgesia and anesthesia during surgical procedures, labor, or delivery. Oxethazaine : is a potent local anesthetic, prescribed for rapid and effective relief in gastritis, esophagitis, hiatus hernia, heartburn of pregnancy and peptic ulcer. ©Rohit Bhaskar 32
  • 33. Bupivacaine : is a local anesthetic, used for surgery and for obstetrical procedures. Spinal and Epidural Anesthesia ©Rohit Bhaskar 33
  • 34. What are the risks and complications of anesthesia? Respiratory Cardiovascular CNS ©Rohit Bhaskar 34