ANESTHESIA

NCM 106: PHARMACOLOGY TRANSCRIBED BY: MIKEE
ANESTHESIA STAGE IV: MEDULLARY DEPRESSION

Anesthesia is the use of medicines to prevent pain − Medullary paralysis
during surgery and other procedures. − This stage can be reached if too much anesthesia has been
Classification: administered
• General (Inhalation/Intravenous) − RR: shallow
• Spinal/Regional − PR: weak and thready
• Local − Dilated pupils not reactive to light
− Cyanosis develops and death rapidly follows
BALANCED ANESTHESIA − Management:
• Pre-operative medications: anti-cholinergic − - Respiratory and Circulatory support
• Sedative-hypnotics: decreases sympathetic stimulation
• Anti-emetics: to decrease N/V from decreased GI motility GENERAL ANESTHESIA
• Anti-histamines • state of narcosis (severe CNS depression produced by
• Narcotics pharmacologic agents), analgesia, relaxation and reflex
loss.
• patients under general anesthesia are not arousable, not
STAGES OF GENERAL ANESTHESIA
even to painful stimuli.
• Stage I – Beginning Anesthesia • patients lose the ability to maintain ventilatory function
• Stage II – Excitement and require assistance in maintaining patent airway.
• Stage III – Surgical Anesthesia
• Stage IV – Medullary Depression INHALATION ANESTHETICS
Volatile Liquids:
STAGE I: BEGINNING ANESTHESIA
- halothane (Fluothane)
− As the patient inhales the anesthesia, warmth, dizziness,
- enflurane (Ethrane)
and a feeling of detachment maybe experienced.
- isoflurane (Forane)
− Noises are exaggerated, low voices or minor sounds seem - sevoflurane (Ultrane)
loud and unreal - desflurane (Suprane)
− Patient is still conscious and able to communicate - Gases: nitrous oxide
STAGE II: EXCITEMENT • volatile liquids and gases act on the cerebral centers to
produce loss of consciousness and sensation
− Sympathetic stimulation
− characterized by struggling, shouting, talking, singing,
laughing, or crying (Can be avoided if the anesthetic agent INTRAVENOUS ADMINISTRATION
is administered smoothly and quickly OPIOID ANALGESIC AGENTS:
− Pupillary dilation - alfentanil (Alfenta)
− Increased PR, irregular respirations - fentanyl (Sublimate)
- morphine SO4 (MS)
− Have someone available to restrain the patient from
uncontrolled movements
INTRAVENOUS ANESTHETIC AGENTS
STAGE III: SURGICAL ANESTHESIA - methohexital (Brevital)
− Relaxation of skeletal muscles - diazepam (Valium)
− It is reached by continued administration of anesthetic - ketamine (Ketalar)
vapor or gas - thiopental sodium (Penthotal)
− Patient is unconscious and lies quietly on the table
SPINAL ANESTHESIA
− Pupils are small but contract when exposed to light
- Lidocaine (Xylocaine)
− Regular RR, normal PR
- Bupivacaine(Sensoricaine)
- Procaine (Novocaine)
Page | 1
NCM 106: PHARMACOLOGY TRANSCRIBED BY: MIKEE
• Introduced at subarachnoid space between L4 and L5 MANAGEMENT

• It produces anesthesia of the lower extremities, perineum 1. Decrease metabolic demand
and lower abdomen 2. Reverse metabolic and respiratory acidosis
• Few minutes after induction of SA, anesthesia and 3. Correct dysrhythmias
paralysis affect the toes and perineum and gradually the 4. Decrease Body Temp
legs and abdomen 5. Provide oxygen, nutrition
• S/E: N/V, H/A, hypotension, respiratory arrest 6. Correct electrolyte imbalances
LOCAL ANESTHESIA
• Injection of the solution containing the anesthetic agent
into the tissues at the planned incision site
• Local anesthetic work by causing a temporary interruption
in the production and conduction of nerve impulses.
• Prevents depolarization of the nerve by blocking sodium
ions.
NURSING INTERVENTIONS WITH ANESTHESIA

• Monitor VS
• Maintain hydration
• Keep patient lie down for up to 12 hours after the anesthesia
to minimize H/A
POTENTIAL INTRA-OPERATIVE COMPLICATIONS

• Nausea and Vomiting • Anaphylaxis
• Hypoxia •Hypothermia
Hypothermia
Secondary to:
- low temperatures in the OR
- Infusion of cold fluids
- Inhalation of cold gases
- Open body wounds or cavities
- decreased muscle activity
- advanced age
- general anesthesia
Malignant Hyperthermia
• From inhalation agents
• Results from hypermetabolic
condition that involves
altered mechanisms of
calcium function in skeletal
muscle cells.
Page | 2

ANESTHESIA

Uploaded by

Copyright:

Available Formats

ANESTHESIA

Uploaded by

Document Information

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

ANESTHESIA

Uploaded by

Copyright:

Available Formats

NCM 106: PHARMACOLOGY TRANSCRIBED BY: MIKEE

ANESTHESIA STAGE IV: MEDULLARY DEPRESSION

• Introduced at subarachnoid space between L4 and L5 MANAGEMENT

NURSING INTERVENTIONS WITH ANESTHESIA

POTENTIAL INTRA-OPERATIVE COMPLICATIONS

You might also like