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Uses of Anesthesia
- Endotracheal intubation
- Mechanical ventilation
- Muscle relaxation during surgery
- Electroconvulsive therapy
- Procedural sedation (formerly known as conscious sedation)
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Anesthetics work by ....
- Enhancing transmission at inhibitory synapse; GABA
- Depressing transmission at excitatory synapse
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Balanced Anesthesia
- Combination of drugs to ensure that induction is smooth and rapid and that anagesia and muscle relaxation are adequate.
- Short acting barbituate
- Neruomuscular blocking agents
- Opioids and/or nitrous oxide
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Stage I Anesthesia
Analgesia - patient experiences analgesia, but is conscious
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Stage II Anesthesia
Excitement - systolic pressure rises, excitation/restlessness, increased respirations - often circumvented by a short-acting IV barbituate
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Stage III Anesthesia
Surgical anesthesia
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Stage IV Anesthesia
Medullary Depression - respirations cease; EMERGENCY!
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Pre-anesthetic Medications
- Sedatives: Thiopental (Pentothal)
- Anxiolytics: Diazepam (Valium), Midazolam (Versed)
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Nursing Responsibilities in Preoperative Environment
- Preanestheic medication
- Patient safety
- Quiet environment
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Local Anesthetic Agents
- Reversibly block all nerve impulses by disrupting permeability to sodium during action potential
- Two major groups: Esters: Procaine (Novacain); Amides: Lidocaine (Xylocaine)
- * Esters - more likely to cause an allergic reaction. If allergiv to one, it is assumed the persin will be allergic to all
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Nueromuscular Blocking Agents (NMB)
- Directly interfere with neurotransmission at the end plate (site of communication between a nerve and a muscle)
- Clinical use: Facilitate endotracheal intubation, mechanical ventillation and surgery
- Do not block muscle constriction, they cause total muscular paralysis
- DO NOT PROVIDE ANALGESIA OR SEDATION
- Opioid analgesics and benzodiazepines are administered to manage pain, anxiety, and
fear
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Chronic accidental exposure to isoflurane may increase the incidence of:
- SAB
- Birth defects
- Still births
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Gluteraldehyde, a disinfectant agent for heat sensitive medical devices may cause:
- Asthma-like symptoms
- Rash
- HA
- Buring eyes
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