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    General Anesthetics

    Uploaded by

    Ayush

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    © All Rights Reserved
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    General Anesthetics

    Uploaded by

    Ayush
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    3 views20 pages

    General Anesthetics

    Uploaded by

    Ayush

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    Bachelor of Pharmacy

    Fourth Semester
    BP 404 T

    Pharmacology-I
    Dr Shvetank Bhatt
    Associate Professor, MIT WPU

    1
    General Anesthetics
    General Anesthetics

    3
    Anesthesia

    Anesthesia = without sensation

    an = without

    aestos = sensation

    A controllable and reversible condition in which sensory perception

    and motor responses are both markedly depressed


    General Anaesthetics
    • Loss of all modalities of sensation, particularly pain
    • Inhibition of autonomic reflexes
    • Relaxation of skeletal muscle
    • Amnesia and reversible loss of consciousness
    • 1776 – Nitrous oxide (1844 used)
    • 1846 – Ether general anaesthesia
    6
    Stages of Anesthesia
    • 4 stages
    • I - Stage of analgesia
    • II – Stage of delirium
    • III – stage of surgical anesthesia (Divided into 4
    planes)
    • IV – Respiratory paralysis
    Stage of Analgesia
    • Inhalation to loss of consciousness
    • Sense of remoteness, falling, suffocation, visual/
    auditory abberations
    • Analgesia comes before loss of consciousness
    • Minor surgical procedures
    • Later stage I amnesia
    Stage of delirium/ excitement

    • From loss of consciousness to begining of surgical


    anesthesia
    • Excitement, shouting, increased muscular activity,
    breathholding, tachyapnoea (abnormally rapid
    breathing), hyperventilation (rapid or deep breathing,
    usually caused by anxiety or panic
    • Cortical depression: release of lower centre
    • Pupil may dilate, marked hypertension, tachycardia
    • Struggling, increased tone of skeletal muscle,retching,
    vomitting - undesirable
    Stage of surgical anesthesia

    • Regular respiration, loss of relfexes, relaxation of skeletal muscle


    Plane 1
    • Pupil dilate progressively
    • Respiration full regular, deep, thoracoabdominal
    • BP, pulse rate normal
    • Skeletal muscle – incomplete relaxation
    • Corneal reflex present
    Plane 2
    • Respiration regulation, diminished amplitude
    • Adequate muscle relaxation, Laryngeal reflex abolished
    Stage of surgical anesthesia
    Plane 3
    • Beginning of asynchrony between the thoracic and
    abdominal and respiratory movements
    • BP falls, intercostal muscle paralysis
    • Respiration assumes – Abdominal character
    • Pupillary and light reflex lost
    • Muscle relaxation – essentially complete
    Plane 4
    • Paralysis complete
    • Pupil dilated
    • Secretion – completely abolished
    Stage of Respiratory Paralysis
    • Severe depression of vital medullary centres
    • Vasomotor collapse
    • Respiratory arrest
    • Balanced anesthesia: Rapid and smooth induction
    with IV anesthetics
    • Maintained with inhalational anesthetics
    Stage of Respiratory Paralysis

    • Inadequate anesthesia
    • ANS overactivity
    • grimacing or other muscle activity
    • Surgical anesthesia
    • loss of lid reflex
    • Development of rhythmic respiration
    • Deep
    • Depression of respiration
    • Hypotension
    • Asystole
    14
    Classification of General Anesthetics

    • Inhalational general anesthetics


    • Volatile liquids: Diethyl ether, ethyl chloride,
    trichloroethylene, halothane, enflurane, isoflurane,
    desflurane, sevoflurane
    • Gas: Nitrous oxide
    • IV general anesthetics
    • Ultrashort acting barbiturates: Thiopental sodium,
    methohexital
    • Propofol
    • BDZ: Midazolam, diazepam
    • Phencyclidine derivative: Ketamine
    • Opioid analgesic: Morphine, fentanyl, sufentanil
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