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general anesthesia
- IV: induction/induced
- Inhalation: maintains the sedation
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Local anesthesia
- infiltration: stitches/sutures; dentist
- regional blocks: spinal, epidural
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benzodiazepines
midazolam (Versed)-causes amnesia so pt can't recall what happened
-
general drugs
- opiates, barbituates, hypnotics (to get tubes down),
- Anesthetic :propofol (Diprivan) <--needs to be aseptic technique; short half life to "bring pt up"
-
inhaled anesthetics
- for maintenance
- usually given neuromuscular blocker (Dantrium) to achieve muscle relaxation & paralysis since inhaled doesn't turn motor function
- "ane" family
- SE: Malignant hyperthermia
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Malignant hyperthermia
- genetic disorder
- s/sx: ^ temp., muscle pain/breakdown, dark brown urine d/t myoglobinuria from muscle breakdown, bleeding. Dantrum works on muscles to relax them
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Conscious sedation
- "twilight sleep"
- primary goal: reduce pts anxiety & discomfort
- used for diagnostic & endoscopic procedures (colonoscopy, etc. )
- Ramsay level 2-4
- light sedation
- 30-90 min waking (recovery)
-
dissociative anesthesia
- "dissociated from self"
- don't loose motor function
- uses for burn dressing change
- SE: hallucinations
- ketamine (Ketalar) used at vets for animals
-
Local anesthetics
- affect autonomic, sensory, motor fibers IN THAT ORDER
- with recover IN REVERSE ORDER
-
local anesthetic drugs
- "caine" family
- lidocaine (Xylocaine)-most commonly used
- cocaine-used in ENT as topical. causes intense vasoconstricitoin
- benzocain-used for sunburns
-
Biggest SE of anesthetics
- sick to stomach
- antiemetics usually given
-
neuromuscular blocking agents
- depolarizing: succinylcholine (used to get tube down)
- non-depolarizing: curonium. ANTIDOTE: anticholinesterase such as neostigmine
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