Anesthesia is a state of controlled, temporary loss of sensation or awareness induced for therapeutic purposes. It may involve analgesia, paralysis, amnesia, or unconsciousness. There are different stages of anesthesia from initial induction to recovery. General anesthesia uses inhaled gases or intravenous drugs to cause unconsciousness, while local anesthesia uses topical or injected drugs to block sensory nerves and relieve pain in a specific area without unconsciousness. Careful monitoring is needed during anesthesia and recovery due to risks like nausea, vomiting, hypotension, and hypothermia.

1. By:- Ravikant Sir

2. ANESTHESIA
• Artificially induced complete/ partial loss of Sensation.
(With or without loss of consciousness)
• Anesthesia is a state of controlled, temporary loss of
sensation or awareness that induced for Therapeutic
purposes.
• It may include :-
– Analgesia -Relief from pain
– Paralysis-Muscle relaxation
– Amnesia -Loss of memory
– Unconsciousness.

3. ANESTHESIA: CLINICAL USES
• General Anesthesia triad sign –
• Hypnosis (produce sleep)
• Analgesia
• Muscle-relaxant
• Amnesia

4. STAGES OF ANESTHESIA
• Also called Guedel’s classification of anesthesia
(given by Arther Ernest Guedel in 1937)
• Stage-I :- stage of Analgesia Induction. It includes
Disorientation/ Confusion.
• Stage-II :- Stage of Delirium /Excitement- Loss of
Eye lash reflex, Automatic respiration.

5. STAGES OF ANESTHESIA
• Stage- III :- Stage of Surgical anesthesia, Loss of eye
ball movement, swallowing reflex, gag reflex,
laryngeal reflex, loss of all reflex and muscle
relaxation.
• Best marker to assess the onset of surgical anesthesia
s – Gag reflex i.e. assessed in every 3 min.
• Stage –IV (overdose/toxicity) stage of medullary
paralysis, supress of respiration and pupil dilation.

6. STAGES OF ANESTHESIA
STAGES RESPIRATION PULSE B.P PUPIL REACTION TO
LIGHT
STAGE-1 IRREGULAR IRREGULAR NORMAL
STAGE-2 IRREGULAR FAST & IRREGULAR HIGH
STAGE-3 DEEP BREATHING STEADY & SLOW NORMAL
STAGE-4 SHALLOW BREATH THREADY PULSE LOW

7. ANESTHESIA RECOVERY
The time after anesthesia is called emergence. It requires careful
monitoring because of risk of complication, SUCH AS :-
• Nausea and vomiting are reported at 10-15 %
• Need for airway support in 7-10 %
• Urinary retention-more common in those over 50 years of age- 3-
4%
• Hypotension in 3-4%.
• Hypothermia, shivering and confusion are also common in the
immediate post-operative period because of the lack of muscle
movement-2-3%

8. ANESTHESIA RECOVERY
• First reflex appear(after 24 hour) after General
anesthesia recovery is Laryngeal reflex than
swallowing reflex than coughing reflex.
• First reflex re-appear in spinal anesthesia is
Planter reflex. Late reflex reappear- Deep tendon
reflex (2-3 week.)

9. ANESTHETICS classification
GENERAL ANESTHESTHETICS LOCAL
ANESTHETICS
INHALATIONAL INTRA VENOUS • Lidocaine
• Cocaine
• Xylocaine
• Procaine
• lignocaine
GAS VOLATILE LIQUID •Diazepam
•Theopentone sodium
(3-5 mg/kg)
•Propofol
•Fentanyl
•Midazolam
Nitrous oxide
Ether
Halothane
Lorazepam
Chloroform
Isoflurane
Desflurane
Sevoflurane
Ether
Halothane
Chloroform
Topical/ Surface
Infiltration
Nerve block
Epidural anesthesia
Spinal anesthesia

10. GENERAL ANESTHETICS
• General anesthesia suppresses central nervous
system and results in unconsciousness OR lack
of sensation.
• G.A given by using either injected or inhaled drugs

11. LOCAL/REGIONAL ANESTHETICS
• Lidocaine, cocaine, Xylocaine, Procaine, lignocaine
• Topical  on skin
• Infiltration  block sensory nerve endings.
• Nerve block  Injective local anesthetic around nerve
or nerve plexus.
• Spinal anesthesia  between L2 –L4.
• Epidural  Spinal subdural space

12. Twilight anesthesia
• It is an anesthetic technique where a mild dose of sedation is applied
to induce
– Anxiolysis (anxiety relief),
– Hypnosis
– Anterograde amnesia (inability to form new memories).
• The patient is not unconscious, but sedated. During "twilight state",
patient is relaxed and "sleepy", able to follow simple directions by the
doctor, and responsive.
• Twilight anesthesia is designed to help a patient feel more
comfortable and to minimize pain associated with the procedure
being performed.
• Generally, twilight anesthesia causes the patient to forget the surgery
.