4. Anesthesia
From Greek anaisthesis means
not sensation
Listed in Bailey´s English
Dictionary 1721.
When the effect of ether was
discovered anesthesia” used as a
name for the new phenomenon.
7. HISTORY OF ANESTHESIA
• General anesthesia was absent until the mid-
1800s.
• Ether synthesized in 1540 by Cordus
• 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
8. Pre 1846 - The Foundations of
Anaesthesia
……..so the Lord God caused him to fall
into a deep sleep. While the man
was sleeping, the Lord God took out
one of his ribs. He closed up the
opening that was in his side……...
Genesis 2:21 NIrV
9. Primitive Anesthesia
Ancient civilizations- opium poppy,
coca leaves, mandrake root,
alcohol
Regional anesthesia in ancient
times- compression of nerve
trunks or the application of cold
(cryoanalgesia)
10. World Anaesthesia Day
On 16 October 1846,
John Collins Warren
removed a tumor from
the neck of a local
printer,Edward Gilbert
Abbott. Warren
reportedly quipped,
"Gentlemen, this is no
humbug.
MGH Boston
12. Birth of modern Anaesthesia
1913,Chevalier Jackson-use of direct
laryngoscopy as a means to intubate
the trachea
Sodium Pentathal - first used in humans
on 8 March 1934 by Ralph M. Waters
19. INTRODUCTION
• 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
General anesthesia
need for
unconsciousness
‘Amnesia-hypnosis’
need for analgesia
‘Loss of sensory and
autonomic reflexes’
need for muscle
relaxation
42. Local anaesthetics
Lignocaine- quick/short acting
Bupivacaine/levobupicvacaine
- slow and long action
Ropivacaine- as above
Amethocaine- topical
Prilocaine- intravenous
43. Advantages
Effective alternative to GA
Avoids polypharmacy
Allergic reactions
Extended analgesia
Patient can remain awake
Early drink/feed
44. Disadvantages
Limited scope
Higher failure rate
Time constraints
Anticoagulants/Bleeding
diathesis
Risk of neural injury
45. Patient is more important
than our ego; call for help,
whenever patient is in
danger
Your Text here
47. Choice of anesthesia
The patient´s understanding and wishes regarding the type of
anesthesia that could be used
The type and duration of the surgical procedure
The patients´s physiologic status and stability
The presence and severity of coexisting disease
The patient´s mental and psychologic status
The postoperative recovery from various kinds of anesthesia
Options for management of postoperative pain
Any particular requiremets of the surgeon
There is major and minor surgery but only major
anesthesia
48. Types of anesthesia care
General Anesthesia
Reversible, unconscious state is
characterised by amnesia (sleep,
hypnosis or basal narcosis),
analgesia (freedom from pain)
depression of reflexes, muscle
relaxation
Put to sleep
49. Types of anesthesia care
Regional Anesthesia
A local anethetic is injected to
block or ansthetize a nerve or
nerve fibers
Implies a major nerve block
administered by an
anesthesiologist (such as spinal,
epidural, caudal, or major
peripheral block)
50. Types of anesthesia care
Monitored anesthesia care
Infiltration of the surgical site with a local
anesthesia is performed by the surgeon
The anasthesiologist may supplement the
local anesthesia with intravenous drugs
that provide systemic analgesia and
sedation and depress the response of the
patient´s autonomic nervous system
51. Types of anesthesia care
local anesthesia
Employed for minor procedures in which the
surgical site is infiltrated with a local anesthetic
vital signs
May injsuch as lidocaine or bupivacaine
A perioperative nurse usually monitors the
patient´s ect intravenous sedatives or analgesic
drugs
52.
53. Thank
you
Macintosh noted: “for the
surgeon the spinal ends
with the injection of the
agent; for the anesthetist it
begins with the injection of
the agent.”