PUTLA MO. ANEMIC KA NOH?!

IKAW NANGINGITIM KA NA! CYANOTIC KA! INTUBATE KITA!

 is the state of narcosis,

analgesia, relaxation and loss of reflex the client is not arousable even to painful stimuli

ANESTHESIOLOGIST- physician trained to deliver anesthesia and to monitor patient during surgery ANESTHETIST- health care professional, such as a nurse anesthetist, who is trained to deliver anesthesia and to monitor the patients condition during surgery ANESTHETIC- the substance such as a chemical gas, used to induced anesthesia

1. 2. 3. 4. 5.

To produce muscle relaxation Analgesia Loss of memory Artificial sleep (unconsciousness) Relieves fear and anxiety

 Physical condition Age Presence of co-existing disease Type, site, duration of surgery Anesthesiologists preference Patients preference

1.Beginning
2.Excitement 3.Surgical 4.Medullary

1.GENERAL

ANESTHESIA 2.REGIONAL ANESTHESIA

 General anesthesia

Loss of all sensation and

consciousness Regional or Local anesthesia Loss of sensation in ONE area with consciousness present

 Blocks the pain stimulus at the

cortex Total loss of consciousness and sensation Produces amnesia, analgesia, hypnosis and relaxation

WHAT are the ADVANTAGES:

DISADVANTAGE:

1. 2.

IV INFUSION INHALATION
Mask Nasal Oral tracheal

1.

TRANQUILIZERS AND SEDATIVE HYPNOTICS (Benzodiazepines) a. Midazolam (Dormicum) b. Diazepam (Valium) c. Chlordiazepoxide (Librium) d. Droperidol (Inapsine) e. Lorazepam (Ativan)

2.

OPIOIDS (Narcotics) a. Morphine b. Meperidine HCl (Demerol)

3.

4.

NEUROLEPANALGESICS a. Fentanyl (Sublimaze) b. Sufentanil DISSOCIATIVE AGENTS a. Ketamine (Ketaralac; Ketajact)

BARBITURATES a. Thiopental Na (Pentothal) b. Methohexital Na (Brevital) 6. NONBARBITURATES HYPNOTICS a. Etomidate (Amidate) b. Propofol (Diprivan)
5.

BARBITURATES a. Thiopental Na (Pentothal) b. Methohexital Na (Brevital) 6. NONBARBITURATES HYPNOTICS a. Etomidate (Amidate) b. Propofol (Diprivan)
5.

1. 2. 3. 4. 5.

Positioning IV line Monitoring Strap Rapid acting drugs

Thiopental (Pentothal) Propofol (Diprovan) Methohexital (Brevital) ADULT: Succiniylcholine chloride (Anectine) PEDIA:
Rocuronium (Zemuron) Atracurium (Tracrium) Vecuronium (Norcuron)

6. 7.

O2 and Gas via mask Muscle relaxant

8.

INTUBATION

KEY POINTS DURING INDUCTION! 1. Circulator should remain 2. Gentle and rapid approach 3. Avoid stimulation of the patient (mandatory) noise avoidance 4. Do not touch patient until anesthesiologist says it is safe to do so 5. Precaution: ECG, defib, chest stet, BP 6. Positioning: if obese elevate head to avoid pressure (protect diaphragm) 7. If hypotensive- flat 8. Children: circulator- to be less frightening stay close to the child

1.

VOLATILE LIQUIDS: a. Halothane (Fluothane) b. Methoxyflurane (Penthrane) c. Enflutane (Ethrane) d. Isoflurane (Forane) e. Sevoflurane (Ultrane) f. Desflurane (Suprane)

2.

GASES: a. Nitrous oxide

Produces loss of sensation in only one region of the body and does not cause loss of consciousness Blocks pain stimulus at its: 1. Origin 2. Along afferent neurons 3. Along the spinal cord

1.

2.

TOPICAL directly applied into the area to be desensitized with the use of a solution LOCAL INFILTRATION BLOCK blocks only peripheral nerves around the area of incision

1.

2.

FIELD BLOCK areas proximal to the incision site is injected and infiltrated a barrier (WALL IN) PERIPHERAL NERVE BLOCK anesthetizes individual nerves or nerve plexuses rather than all the nerves anesthetized by a field block

Blocks impulses along the

spinal cord and nerve roots and may occur either in the subarachnoid or epidural space

SPINAL produces a nerve block in the subarachnoid space 2. EPIDURAL injection of local anesthetic into the spinal canal in the space surrounding the dura mater 3. CAUDAL (TRANS-SACRAL) produces anesthesia of the perineum and occasionally, the lower abdomen
1.

TOPICAL INFILTRATION

Applied directly on the skin Injected into a specific area of skin nerve Low spinal anesthesia

NERVE BLOCK Injected around a

SPINAL Subarachnoid EPIDURAL

Epidural space is injected with anesthesia

Lidocaine (Xylocaine) and Mepivacaine (Carbocaine) 2. Bupivacaine (Marcaine) 3. Etidocaine (Duranest) 4. Procaine (Novocaine) 5. Tetracaine (Pontocaine)
1.

1. Procaine (Novocaine) 2. Tetracaine (Pontocaine) 3. Lidocaine (Xylocaine) 4. Bupivacaine (Marcaine)