Professional Documents
Culture Documents
Pharmacology
Pharmacology
Pharmacology
Analgesia
Unconsciousness
Amnesia
Risk Factors:
• All body systems are affected because of wide effects,
patients must be evaluated for factors that may
increase their risk:
CNS Factors
Cardiovascular Factors
Respiratory Factors
Sedative- hypnotics
Antiemetics
Antihistamine
Narcotics
Administration of General Anesthesia:
• Delivered by a physician, nurse or nurse anesthetist along
with intubation, mechanical ventilation, and full life
support.
• Different Stages/ Depth: Different Phases:
Maintenance
• Period from stage 3 until surgical procedure is complete.
• Slower more predictable anesthetic may be used to maintain anesthesia in
stage 3, gas anesthetic
Recovery
• Period from discontinuation of the anesthetic until
regained consciousness, movement and ability to
communicate.
• Requires continues monitoring for adverse effects of
drug and the patient’s vital functions.
General Anesthetic Agents
• Barbiturate, nonbarbiturate anesthetics, gas anesthetics
and volatile liquids.
Barbiturate Anesthetic
• THERAPEUTIC ACTIONS AND INDICATIONS
Thiopental- most widely used IV anesthetics. No analgesic
properties. May need additional analgesics after surgery.
Methohexital- lacks analgesic property. May require
postoperative analgesics.
• PHARMACOKINETICS
Thiopental- very rapid onset usually within 10-30 secs.
Ultrashort recovery period of 5-8 mins.
Methohexital- rapid onset. Recovery period of 3-4 mins.
Lipophilic. Dissolved in water and diffuse to brain rapidly.
Barbiturate Anesthetic
• CONTRAINDICATIONS AND CAUSES
Methohexital cannot come into contact with silicone like rubber
stopper and disposable syringe.
Methohexital and Thiopental should not be used until medical
staffs are ready and equipped for intubation and respiratory
support.
Pregnancy and Lactating. Should not be used unless it clearly
outweighs the potential fetal risk.
• ADVERSE EFFECTS
Related to suppression of CNS with:
-decreased pulse
-hypotension
-suppressed respiration
-Decreased GI activity
-Nausea and vomiting: common after recovery
Barbiturate Anesthetic
• DRUG TO DRUG INTERACTIONS
Cannot be used with any other CNS suppressants.
Barbiturates can cause decreased effectiveness of theophylline, oral
anticoagulants, beta-blockers, corticosteroids, hormonal
contraceptives, phenylbutazones, metronidazole, quinidine,
carbamazepine.
Infiltration
Field Block
Nerve Block
Infiltration
• Involves injecting the anesthetic directly to the
tissues to be treated
Field Block
• Injecting the anesthetic all around the area that
will be affected by the procedure or surgery.
• More intense than infiltration anesthesia
• Often used for tooth extraction
Nerve Block
• Involves injecting anesthetic at some point along the nerve or
nerves that run to and from the region in which the loss of pain
sensation or muscle paralysis is desired.
• More potential for adverse effects
• Several types of nerve blocks:
Epidural Anesthesia
Caudal Block
Spinal Anesthesia
Intravenous Regional
Local Anesthesia
• Carefully draining all of the blood from patient’s
arm or leg
• Securing a tourniquet to prevent anesthetic from
entering the general circulation, injecting
anesthetic into the vein of the arm or leg.
• This technique is used for very specific surgical
procedures
Local Anesthetic Agents
• Used to prevent from feeling pain for varying periods of time.