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General/Local/Regional Anaesthesia types.pptx
- 1. PRINCIPLES OF GENERAL, REGIONALAND LOCAL ANAESTHESIA DR. MAITRI TALEKAR
- 2. ANAESTHESIA DEFINITION • insensitivityto pain, especially as artificially induced by the administration of gases or the injection of drugs before surgical operations
- 4. HISTORY OF ANESTHESIA •General anesthesia was absent until the mid- 1800s. • Ether used as anesthetic in 1842 by Dr. Crawford W.long • Ether publicized as anesthetic in 1846 by Dr. William Morton. • Ether is no longer used in modern practice, yet considered to be the first ideal' anesthetic • Chloroform used as anesthetic in 1853 by Dr. John Snow • Endotracheal tube discovered in 1878 • Thiopental first used in 1934
- 6. General anesthesia -for surgical procedure to render the patient unaware/unresponsive to the painful stimuli. Drugs producing General Anesthesia - are called GENERAL ANAESTHETICS Regional and Local anesthesia - reversible inhibition of impulse generation and propagation in nerves. Drugs producing local anaesthesia - are called LOCAL ANAESTHETICS
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- 10. • General anaesthetics(GAs) are drugs which produce reversible loss of all sensations and consciousness. It usually involves a loss of memory and awareness with insensitivity to painful stimuli, during a surgical procedure
- 12. Classic Stages ofAnesthesia Stage 1: Analgesia decreased awareness of pain, amnesia ,without loss of consciousness Stage 2:excitation delirium & excitation, enhanced reflexes,retching, incontinence, irregular respiration Stage 3: Surgical Anaesthesia Unconscious, no pain reflexes, regular respiration Stage 4: Medullary Depression Respiratory and CV depression requiring ventilation ad pharmacological support
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- 25. • A localanaesthetic is injected to block or anaesthetise a nerve or nerve fibers • Implies a major nerve block administered by an anesthesiologist (such as spinal, epidural, caudal, or major peripheral block)
- 27. POSITION FOR SPINAL/ EPIDURAL ANAESTHESIA
- 28. Mechanism of Action •Principle site of action - Nerve Root • LA bathes the nerve root in subarachnoid or epidural space • Spinal Anaesthesia- direct injection of LA into CSF, with lesser volume of drugs • Epidural Anaesthesia- LA injected in epidural space at nerve roots, with higher volume of drugs
- 29. • Local anestheticsolutions block sensory, autonomic and motor impulses as the anterior and posterior nerve roots pass through the CSF. It is NOT the spinal cord! • The site of action includes the spinal nerve roots and the dorsal root ganglion.
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- 31. • Spinal needleis inserted with the stylet through the introducer • Needle should be inserted in the midline and directed cranially at an angle of less than 50 degrees to the longitudinal axis of the vertebral column • Bevel of the spinal needle should be kept parallel to the longitudinal axis of the spine • Loss of resistances can be felt after puncturing ligamentum flavum and the duramater
- 33. PERIPHERAL NERVE BLOCKS •Surgery limited to one extremity (ideally one nerve distribution) • Moderate to severe postoperative pain anticipated • Facilitate same-day discharge and avoid hospitalization for pain management • Improve vascular supply • Early physical therapy and rehabilitations
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- 37. • Employed forminor procedures in which the surgical site is infiltrated with a local anesthetic • May inject drugs such as lidocaine or bupivacaine • Can be done on OPD basis or daycare surgery
- 38. MECHANISM OF ACTION •Local anaesthetics reversibly block impulse conduction along axons and other excitable membranes that utilize sodium channels as the primary means of action potential generation. • This action can be used clinically to block pain sensation.
- 39. INDICATIONS • Incision anddrainage of incised abscess. • Removal of cysts, residual infection areas, neoplastic growths, ranula and salivary calculi. • Most dental procedures. • Suturing of open wound.
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