By Zekariyas T.

(Generic Bsc
Anaesthetist.)

Introduction to anesthesia
Anesthesia:-

it is partial or complete loss of

sensation with or with out loss of
consciousness as a result of disease,
injury or administration of an
anesthetic agent, usually by injection
or inhalation.
By Zekariyas T. (Generic Bsc Anaesthetist.)

Types of anesthesia
There are mainly two types of anesthesia:1-General anesthesia
2- Regional (local anesthesia)

By Zekariyas T. (Generic Bsc Anaesthetist.)

1- General anesthesia (GA)

Anesthesia that complete and affecting the
entire body with loss of consciousness when
the anesthetics acts up on the brain.
This type of anesthesia is usually
accomplished following
administration of
inhalational or IV anesthetics commonly used
for surgical procedures.

By Zekariyas T. (Generic Bsc Anaesthetist.)

The cardinal features of GA

Sleep (unconsciousness)hypnosis and amnesia
loss of all sensation( analgesia)
muscle relaxation (abolition of reflexes)
Triad of General anaesthesia
Hypnosis

Analgesia

Muscle relaxation(Areflexia)

1- General anesthesia (GA)

In the modern practice of balanced anesthesia,
these modalities are achieved by using
combination of drugs, each drug for a specific
purpose.
Look at the following.

By Zekariyas T. (Generic Bsc Anaesthetist.)

1- Hypnosis
Death

Coma
Hypnosis

sedation
Amnesia
Awake
By Zekariyas T. (Generic Bsc Anaesthetist.)

Hypnotic drugs Intravenous

Gold standard- thiopentone
Propofol
Others
Etomidate
Benzodiazepines
Ketamine

Hypnotic drugs
Inhalational anaesthetics:
Nitrous oxide
Isoflurane
Sevoflurane
Desflurane
Halothane

2-Analgesia

Good analgesia= good anaesthesia

Hypnotic sparing effect
Local anesthetics
It includes:
Opiates
NSAIDs
work by blocking the production of prostaglandins,
chemical messengers that often are responsible for the pain
and swelling of inflammatory conditions.

Paracetamol

Analgesia.
NSAIDS

Gold standard- aspirin

Ibuprofen
Diclofenac
Cox-2 inhibitors

Analgesia
Opiates
Morphine
Derivatives- diamorphine, codeine

Synthetic agents
Pethidine
Fentanyl/Alfentanil-short acting
Remifentanil-ultra short acting

3- Muscle relaxation(Relaxation)

Aids intubation
Helps surgeon/surgery
Surgery of long duration
Reduces maintenance dose of anaesthetics
agents

Muscle relaxants
Two types
Depolarising- short acting. E.g; suxmethonium
Non-depolarising- medium/long acting

Tracurium
Vecuronium
Rocuronium
pancronium

Prerequisites

Oxygen
Suction
Tilting trolley
Resuscitation drugs
Monitoring
Anaesthetist
Skilled assistance
Drugs and machine

Regional anaesthesia(local anesthesia)

Local anesthetics
Drugs which upon topical application or local injection
cause reversible loss of sensory perception, especially
of pain in a restricted area of the body.
block generation and conduction of nerve impulse with
out causing any structural damage.
Sensory & motor impulses are interrupted when a local
anesthesia .

Regional anaesthesia
Spinal/epidural
Surgery below umbilicus
Provides analgesia/muscle relaxation

Plexus blocks e.g brachial plexus

Intravenous- Biers block

Regional anaesthesia
Triads of Regional Anesthesia

Analgesia

Muscle relaxation

Local Anaesthetics
Lignocaine- quick/short acting
Bupivacaine /levobupicvacaine- slow and long
action
Ropivacaine
Amethocaine
Prilocaine-

Comparative features of GA & LA

features

General anesthesia

Local anesthesia

Site of action

CNS

Peripheral nerves

Area of body involved

Whole body

Restricted area

Consciousness

Lost

unaltered

Care of vital functional

Essential

Usually not needed

Physiological

High

Low

Poor health patient

Risky

Safer

Use in
patient

Possible

Not possible

Major surgery

Preferred

Can not be used

Minor surgery

Not preferred

Preferred

effect

non-cooperative

The Scope of Anaesthesia

Providing general or regional anaesthesia

inside and outside the operating room
Intensive care units
Respiratory therapy departments (Anesthetist is
respiratory physiologist and experts at managing
ventilatory inadequacy.)
Recovery
room
management

The Scope of Anesthesia

Blood, Fluid and electrolyte replacement
during operation is supervised by anesthetist.
Anesthetist
arrange the schedule,
interview and instruct patients before the day of
opration,
admit and examine them,
anesthetize, supervise recovery, and discharge
them.
By Zekariyas T. (Generic Bsc Anaesthetist.)

The Scope of Anaesthesia

Participate in opportunities for researches in
anesthesia.
Anesthetist, ridges the gap between basic and
clinical sciences, participate in teaching of
basic science, anesthesia practice &skill.
Anesthetists are pharmachologists

By Zekariyas T. (Generic Bsc Anaesthetist.)

Definition of the practice of

anaesthesiology
1)Assessing,consulting, and preparing patients for
anaesthesia
2)Rendering patients insensible to pain during
surgical obstetric, therapeutic, and diagnostic
procedures

By Zekariyas T. (Generic Bsc Anaesthetist.)

13

Definition of the practice of anaesthesiology

3)Monitoring and restoring homeostasis in

perioperative and critically patients

4)Diagnosing and treating painful syndromes

By Zekariyas T. (Generic Bsc Anaesthetist.)

14

Definition of the practice of anaesthesiology

5)Managing and teaching of cardiac and pulmonary

resuscitation
6)Evaluating respiratory
respiratory therapy

function

and

applying

7)Teaching, supervising, and evaluating the performance

of medical and paramedical personnel involved in
anaesthesia,respiratory care, and critical care
By Zekariyas T. (Generic Bsc Anaesthetist.)

15

Definition of the practice of anaesthesiology

8)Conducting research at the basic and clinical science levels
to explain and improve the care of patients in terms of
physiologic function and drug response

9)Involvement in the administration of hospitals, medical

schools, and outpatient facilities as necessary to implement
these responsibilities

By Zekariyas T. (Generic Bsc Anaesthetist.)

16

So Take a Little break

By Zekariyas T. (Generic Bsc Anaesthetist.)