Introduction to

Anesthesia
 Topics
• Introduction to anesthesia, anesthetics
• Uptake of inhalant anesthetics
• Pharmacology of inhalant anesthetics
• Inhalation apparatus
• Preanesthetics-1
• Preanesthetics-II (Narcotics)
• Injectable anesthetics
• Analeptic agents
Introduction to Anesthesia

Veterinary Pharmacology &

Therapeutics, 8th edition, 2001
Pages 153-171
 Objectives
Study:
• Important contributions of individuals
• Characteristics of anesthesia
• Purpose of anesthesia
• Ideal properties of inhalant anesthetics
• Selection of anesthetics
• Mechanism and sites of action of anesthetics
• Important theories of anesthesia
• Signs and stages of anesthesia
• Selected definitions
 History & Methods used
• History:
Egyptians:- Narcotics
Chinese:- Hashish
• Methods:
Asphyxiation by strangulation
Cerebral concussion
 History of Anesthesia
• 1776 Priestly discovered O2 and N2O
• 1799 Humphry Davy reported analgesic effect of N2O
• 1818 Faraday reported analgesic effect of Ether
• 1842 Long used Ether in his practice, did not publish
• 1844 Colton’s demonstration, Cooley inhaled, Wells
attended
• 1846 Morton’s demonstration in Ether dome (at MGH)
• 1887 Simpson introduced Chloroform, knighted by
Queen Victoria
 Purpose, Types, Routes
• Purpose: obtund (alleviate) pain,
Restraint
• Classification: General, Local, Regional
• Routes:
– inhalation
– intravenous
– intraperitoneal
– intramuscular
 Uses of Anesthetics
• Restraint: Radiographic procedures, cleaning,
grooming dental work, splinting, casting, capture
of wild animals, transportation
• Diagnostic Examination: Palpation, Endoscopy,
Radiology
• Manipulation: Catheterization, Fracture reduction,
wound care, obstetrics
• Surgery: Major surgery
• Control of Convulsions: Epilepsy treatment
• Euthanasia: Humane sacrifices
 General Anesthesia
Characteristics:
• reversible condition
• loss of consciousness
• amnesia
• analgesia
• muscle relaxation
• loss of reflexes
Ideal anesthetic: Properties
• non irritant
• rapid induction and recovery
• high therapeutic index
• no disagreeable odors
• non-explosive
• no residues
• satisfactory muscle relaxation.
 Anesthetic Selection
• Nature of surgery: duration (minor procedure), site
(capped elbow, deeply located abscesses, eye
surgery
• Anatomy and physiology (size, temperament, species) eg:
nerve block in horses, general anesthesia for pigs,
parenteral (injectable) for birds
• Species susceptibility: morphine for cats, barbiturates
for greyhounds, Procaine for parakeet
• Patient’s condition: starving, disease (liver & kidney)
• Drug & environment: organophosphate &
neuromuscular agents, ambient temperature.
• Age & Sex differences
• Legal aspects
Site of action of anesthetics
• 1. Macroscopic: RAS inhibition, suppression of
cerebral cortex, spinal cord inhibition, multisites,
(Peripheral nerve conduction is not affected).

• 2. Microscopic: Does not affect synthesis or storage

of mediators, causes impaired transmitter release,
postsynaptic membrane inhibition (antagonism with
transmitter), nonspecific stabilization of membrane

• 3. Molecular: presently unclear

 Mechanism of action
• Anesthetics combine with hydrophobic portion of
protein molecule of cell membrane. Induces
conformational change and unfolding of protein
molecules making it less active
• Interaction with Essential proteins such as rate-
limiting enzymes, ion-channel proteins, receptor
proteins and those needed for transmitter release
• Anesthetics reduce proteins charge and Ca binding to
vesicles thus reducing release
• Interact with membrane proteins that are essential for
consciousness (RAS).
 Theories of anesthesia
• Lipid theory (Mayer-Overton)Higher the lipid
solubility, the higher the anesthetic action (all lipids
are not anesthetics).
• Surface tension or adsorption theory: the higher the
ability to lower surface tension, the higher the potency
• Cell permeability: decrease membrane permeability,
interfere ion movements, disrupts depolarization
• Biochemical:
O2 uptake,
oxidative phosphorylation.
(Dinitrophenol, an uncoupler of oxidative
phophorylation does not cause anesthesia).
 Theories (contd.)
• Neurophysiological:
synaptic transmission,
but axon conduction is not affected, inhibits
RAS.

• Physical: occlude critical portion of cell

membrane,
permeability, forms hydrated
microcrystals, unfold protein structures
(Pauling & Miller). Hydrophobic portion as
receptors (Roth)
 Definitions
• Anesthesia: reversible condition characterized by
analgesia (loss of pain), unconsciousness, muscle
relaxation(loss of muscle tone), amnesia (memory loss),
and loss of reflexes.
• Neuroleptics (tranqulizers) produce decrease of
excitability, dulling of consciousness and reduction in
spontaneous motor activity
• Sedation is a mild degree of CNS depression, awake
but calm
• Hypnosis artificially inducing sleep or trance.
Depresses CNS
 Definitions
• Basal anesthesia: a light level of general
anesthesia produced by pre-anesthetic agents
• Balanced anesthesia: a general anesthesia
produced by a combination of complimentary
drugs to reduce dose of the anesthetic and
toxicity
• Neuroleptanalgesia: CNS depression produced
by a combination of drugs (neurolepts &
narcotic analgesics)
 Stages of Anesthesia
• There are four stages (Stage I, II, III, & IV)
• Stage III has four planes (Plane 1,2,3,& 4)

• Stage I: stage of analgesia, ataxia, CNS stimulated.

Consciousness is present.
• Stage II. Excitement or Delirium. Higher cerebral
centers depressed, inhibitory centers inhibited.
Increased muscle tone. Excitement. Dangerous stage,
avoid this. Pupil dilated (sympathetic Stimulation),
irregular respiration, analgesia and amnesia.
 Stages (cont)
Stage III:
Plane 1.
Resp.irregular, tidal volume increased, nystagmus, pupil
constricted, depression of reflexes begins, small muscle tone
being lost, swallowing retained in the beginning
Plane 2.
Resp. regular, shallower, eye fixed, pupil mid-dilatation,
large muscles relax
Plane 3.
Surgical anesthesia, diaphragmatic respiration, intercostals
lag behind, pupil moderately relaxed, general muscle tone is
lost.
Plane 4.
Res. Complete intercostal paralysis, breathing
diaphragmatic, inspiration short and gasping, pupillary
paralysis.
 Stages (contd.)
Stage IV
• Begins with resp. paralysis, and
then vasomotor paralysis and
circulatory failure.

• This stage is not reversible.

 Self Analysis
• Purpose & uses of anesthesia, properties of
ideal anesthetics, mechanism & sites of action,
possible effects of cell membranes
• Theories of anesthesia, important definitions
• Name and describe the planes and stages of
anesthesia
• Difference between tranquilization & sedation