Types of Anesthesia
General
Regional
MAC: Monitored Anesthesia Care
Local
When used:
long surgeries
require skeletal muscle relaxation
require uncomfortable operating positions
require control of respiration
induced by IV or inhalation - maintained by either one or both
require deep breathing/coughing post-op
may cause lung irritation / sore throat
Drugs
IV administration
pleasant sleep - rapid onset
used as induction agents prior to inhalation agents
Barbiturates
Nonbarbiturates Hypotonics
induce sleep
may cause nausea
Inhalation administration
via volatile liquids or gases by mask or artificial airway
always administer with oxygen as a carrier gas
enters body via alveoli
may irritate respiratory tract
Volatile liquids (isoflurane, desflurane) cause
respiratory depression
hypotension
myocardial depression
Nursing Considerations
patients with heart/respiratory problems
medications patient is taking
Gaseous Agents
weak anesthesia
rarely used alone
administered with oxygen to prevent hypoxia
Adjuncts to General Anesthetic
drugs added an inhalation anesthetic
added to achieve unconscious, analgesia, muscle relaxation, or autonomic nervous system control
Example: Opioids
Phases of General Anesthesia
Induction
Pre-induction
Maintenance
Emergence
pre-op meds
initiation of IV access
application of monitoring devices
initiation of meds that render pt. unconscious
airway secured
surgical procedure performed
surgical procedure completed
patient prepared to return to consciousness
removal of artificial airway
Lidocaine or EMLA cream
interrupts generation of nerve impulses by altering low of Na through cell membrane
loss of sedation to refine of the body
no loss of consciousness
blocks specific nerves with local anesthetic
spinal block
Epidural
have on hand
airway equipment
emergency drugs
cardiac monitor/defibrillator
injection into cerebrospinal fluid (CSF)
autonomic, sensory, and motor blockage
causes
vasodilation
hypotension
inability to move
cannot feel pain
injection of local anesthetic into epidural space
less autonomic blockage
both may be administered via indwelling catheter
monitor closely for S&S of ANS blockade
side effects
headache
back pain
isolated nerve injury
previously called "conscious sedation"
similar to general anesthesia
sedative s& opioids used at lower dosages
no inhalation agents
relieves anxiety
provides analgesia & amnesia
patient remains responsive
patient breathes without assistance
used in minor surgical procedures
moderate sedation
keep near by
crash cart
oxygen
suction