General Anesthetics

GENERAL ANESTHESIA
Presented by;
Muhammad Usman
2021-dvme-055
ANESTHESIA
• Anesthesia is the reversible loss of sensation in the patient to perform

different surgical procedures smoothly and is produced by different
drugs in different ways.
PURPOSES OF ANESTHESIA
1. Analgesia (loss of pain)

2. Amnesia (temporary loss of memory)
3. Immobility (loss of motor reflexes)
4. Hypnosis (trance)
5. Paralysis (relaxation of skeletal muscles)
GENERAL ANESTHESIA
• It is a state of unconsciousness combined with loss of sensitivity and

reduced motor response to stimuli produced in a controlled manner by
a process of reversible intoxication of CNS.
STAGES OF ANESTHESIA
• Stage 1 (induction phase):

• The period of administration of anesthetic agent to unconsciousness.
• It progresses from analgesia without amnesia to analgesia with
amnesia.
• The patient experiences sedation, analgesia (but still feels a bit of pain)
and amnesia.
• It is a phase of loss of consciousness to onset of automatic breathing.
• Stage 2 (stage of excitement):

• The patient experiences involuntary movements and irregular breathing.
• There is also visible dilation of pupils.
• Eyelid reflexes disappear but other reflexes still remain intact.
• Stage 3(stage of surgical anesthesia):

• In this stage, the patient is ready for surgery. Skeletal muscles relax
and respiratory depression occurs.
• It starts with the onset of automatic respiration to respiratory paralysis.
• Stage 4(medullary paralysis):

• Occurs due to overdose of anesthetic agent.
• Results in cessation of respiration and cardiovascular collapse.
• Leads to coma and death.
MOA OF GENERAL ANESTHETICS
• General anesthetics work by enhancing inhibitory neurotransmission and reducing

excitatory neurotransmission in the central nervous system.
• General anesthetics are thought to act on specific ion channels within neuronal cell
membranes. These include:
• G-amino butyric acid type A (GABAA) receptors: These receptors are activated
by general anesthetics.
• N-methyl-D-aspartate (NMDA) receptors: These receptors are blocked by general
anesthetics.
• Two-pore potassium channels (K2Ps): These channels are affected by general
anesthetics, especially halogenated inhalation anesthetics.
INTRAVENOUS ANESTHETICS
• Propofol
• Chloral hydrate
• Diazepam
• Thiopental sodium
• Ketamine
• Xylazine
• Medetomidine
PROPOFOL
• Onset is smooth and rapid.

• Decrease blood pressure without depressing the myocardium. Also
reduces intracranial pressure.
• Poor analgesia.
• It has replaced thiopental as first choice for anesthesia induction and
sedation, does not cause nausea and vomiting.
KETAMINE
• Ketamine induces a trance-like state where the animal appears awake

but is unresponsive to pain or surroundings.
• It prevents memory formation during the procedure.
• It provides significant pain relief and is usually combined with other
agents.
• Ketamine may cause muscle rigidity, which is often managed with
muscle relaxants or sedatives.
• It stimulates the cardiovascular system, increasing heart rate and
blood pressure, which can be beneficial in cases of low blood pressure
but risky for animals with heart conditions
BRAND NAMES AND DOSE RATES OF GENERAL ANAESTHETICS
Xylazine
Brand name: Xylaz, Xylaject
Dose in large animals : 0.02-0.05mg/kg sedation(IV) 0.25-0.5mg/kg (IV) preanesthetic
Dose in small animals: 0.1-0.2 mg/kg sedation (IV) 0.2-05mg/kg (IV) preanesthetic
Ketamine
Brand name: ketaset, ketadex
Dose in large animals: 2- 2.2 mg/kg (IV)
Dose in small animals: 2-5mg/kg (IV)
• Ketamine is more effective when we use it with xylazine
COMBINATIONS
• Ketamine + Diazepam (1:1)

• Ketamine + Xylazine (10:1 or 5:1)
• Propofol + Fentanyl (variable, titrated doses)
INHALANT ANESTHETICS
• Inhalant anesthetics used in veterinary anesthesia include nitrous oxide, halothane,

isoflurane, sevoflurane etc.
• These agents requires an anesthesia machine that provides oxygen, a breathing circuit, and
a facemask or endotracheal tube, as well as a way to remove accumulations of carbon
dioxide.
• The two more common inhalation agents used in veterinary medicine today are halothane
and Isoflurane.
• Isoflurane is generally used at concentrations of 2–4% for induction and 0.5–2.0% for
maintenance of general anesthesia.
• The concentration of halothane in small animals is 2-3% for induction anesthesia, and 1-
1.5% for maintenance anesthesia.
• Inhalant anesthetic equipment includes an anesthetic machine and a
breathing circuit.
• Components of anesthetic machine : □Flow meter □Regulator
□Vaporizer □Gas supply □Scavenger system
MONITORING OF ANESTHETIZED PATIENT
• Respiratory Rate
• Heart rate and rhythm
• Mucous membrane color and capillary refill time
• Body temperature
• Pupillary reflexes
RISK AND COMPLICATIONS OF ANESTHESIA
• Anesthesia is never without risk. The pre-anesthetic examination and

diagnosis help to reduce the risk of anesthesia by uncovering potential
problems. Complications that occur under general anesthesia are
apnea (not breathing), bradycardia (slow heart rate), hypotension (low
blood pressure), blood loss and sometimes cardiac arrest. To prevent
these complications from occurring, the patient is monitored
continuously. There are few complications associated with local
anesthetic.
THANKS

General Anesthetics

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GENERAL ANESTHESIA

• Anesthesia is the reversible loss of sensation in the patient to perform

1. Analgesia (loss of pain)

• It is a state of unconsciousness combined with loss of sensitivity and

• Stage 1 (induction phase):

• Stage 2 (stage of excitement):

• Stage 3(stage of surgical anesthesia):

• Stage 4(medullary paralysis):

• General anesthetics work by enhancing inhibitory neurotransmission and reducing

• Onset is smooth and rapid.

• Ketamine induces a trance-like state where the animal appears awake

• Ketamine + Diazepam (1:1)

• Inhalant anesthetics used in veterinary anesthesia include nitrous oxide, halothane,

• Anesthesia is never without risk. The pre-anesthetic examination and

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