This document summarizes the equipment, supplies, and procedures for lymph node biopsy under general anesthesia. It outlines the machines, instruments, drugs, and consumables needed, as well as how equipment is sterilized between uses. The key points are: 1) General anesthesia is used and requires equipment like an anesthesia machine, ventilator, cardiac monitor, and surgical tools. 2) Instruments and equipment are washed, soaked in disinfectant, sterilized in an autoclave or other method, packaged, and stored for use in biopsy procedures. 3) Consumables like gloves, gowns, drapes, sutures, and medications are also prepared and available for the procedure.

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How to prepare ot for
Lymph node biopsy
-RIYA SANJAY BAGHELE
-NAGPUR.

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Anesthesia point of view
 General anesthesia technic used
1. Anesthesia machine with ventilator circuit
2. Cardiac Monitor with all cables
3. Body Warmer
4. Suction Machine

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Equipments on general anesthesia
trolley
1. Laryngoscope Blade 4 are arranged on trolley according to size 1,2,3,4
2. Laryngoscope Handle They are of two types long and stoutVideo Laryngoscope with two blades
type C and D.
3. LMA Laryngeal Mask Airway1, 1.5, 2, 2.5, 3, 4, 5
4. I-Gel
5. Face mask For Pediatrics- 1,2.For Adults-3,4,5.
6. Bougie
7. Stillet
8. Magill’s forcep
9. Stethoscope

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Sterilization
All the equipments except video laryngoscope are initially washed
under running water and then send to CSSD where it is kept dipped in
2% disinfectant solution for 20 mins, then rinsed, then kept in ultrasound
machine having 0.25% enzymatic solution, again they are washed
under running water then dried , packed, metal instruments are
autoclaved whereas nonmetal instruments are sterilized in EO or
PLASMA and supplied back to OT.

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Consumables On anasthesia trolley
 Oral Airways 4 are arranged on trolley according to size 1,2,3,4
 Stickings
 ET EndoTracheal tube For Pediatrics- 3,3.5,4,4.5
 For Adults-5, 5.5 , 6, 6.5, 7, 7.5, 8, 8.5
 Lignocan hydrochloride jelly
 Eye ointment
 Closed circuitPediatric /adult depending on patient age
 Face maskFor Pediatrics- 1,2.For Adults-3,4,5.
 Face mask disposable
 Nasal cannula
 Syringes 2cc, 5cc, 10cc
 Suction Catheter12
 ECG Leads

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Drugs-:
Propofol -Decreases level of consciousness and a lack of memory for events.
Midazolam- Induces sleepiness, decreases anxiety,causes a loss of ability to create new
memory.
Atracurium- Non-depolarizing muscle relaxant.Fentanyl It is an opioid used as a pain
medication.
Scoline- It is skeletal muscle relaxant.
Neostigmine –Reverse the effect of non-depolarizing muscle relaxants.
Glycopyrolate- To reduce airway and gastric secretions.

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Machines used on surgical side
 Electrosurgical-it is used to achive haemostasis and tissue
destruction by passing alternating and direct current
through a resistant metal wire. The heat conduction from
metal probe stops blood vessels from bleeding.
 2D Echo machine-Ultrasound allows visualization of the
anatomy of the region of interest.
 Suction machine- It is needed to draw the blood flowing
out.

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Electrosurgical
Suction machine

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Instrument set and equipments -:
 Excision set
Particulars Quantity
Allis forceps 6” 4
Aretry forcep curved 5” 4
Aretry forcep curved 6” 4
B.P handle no. 3 1
B.P handle no. 4 1
B.P handle no. 7 1
Babcock forcep 6” 2
Catspow retractor
(kilners retractor)
2
D.F adison plain 1
D.F adison tooth 1
Particular Quantity
D.F plain forcep 6” 1
Kidney tray 6” 1
Mixture clamp 6” 1
Needle holder 6” 2
Right angel
retractor(8×20)
2
S.S bowls 8cm 3
Sponge holder 8” 1
Suction tip no.4 1
Towel clip 5” 4

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Sterilization
All the instruments are prewashed in O.T. then send to CSSD.In decontamination
room they are decontaminated either manually or automatically. In manual
process the instruments are washed under R.O. water, then they are kept soaking
in disinfectant like corslex, after a certain contact time of disinfectant instruments
are again washed under R.O. water and then transferred to ultrasonic machine
which contains enzymatic solution for eg. Plurazyme and then send for drying in
dryer for around 10 to 20 mins. Where as in automatic process the instruments
are washed and transferred to washer disinfector, in it enzymatic solution like
liquizyme is used. The machine runs washing, disinfecting and drying process
itself.In packing and assembling room dried instruments are packed accordingly-
Single pouches items are packed in peel pouch, it is packed in double layers to
maintain sterility. The linen and instrument sets are packed in SMS sheets (Spun
Bond, Melt Blown, Spun Bond), similarly like pouch instruments they are also
packed in double layers to maintain sterility.Then these instruments and linen are
autoclaved at 134°C for 60 mins and stored in clean restricted area. Whenever
needed for surgery they are passed through pass box, maintaining the sterility
strictly.

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Manual cleaning Autoclave Machine

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Consumables-
Material Quantity
Sterile surgical Gloves According to no. of sterile
team members .
Sterile desposable gown According to no. of sterile
team members .
Plain sheet 2
Vaccum Suction 1
Cautery pencil 1
Cautery pad 1
Povidone iodine scrub
7.5%
1
Povidone iodine solution
10%
1
Bactorub sterline 1
Surgical blades no.15 and
no.22
2
Normal saline 500ml 1
Material Quantity
Abdominal mops 3
Vicryl 2.0 and 3.0 1 each
Ethilon 2.0 and 3.0 1 each
Mupirocin ointment 1
Gamzee pad 4
Gauze pieces 5
Elastic adhesive bandage 1
Camera cover 1

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Thank
You