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    Anesthesia

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    This document discusses the history and principles of anaesthesia. It describes how anaesthesia was first used with nitrous oxide in 1844 by Horace Wells and ether in 1846 by Dr. William Morton. It explains the stages of anaesthesia and the need for unconsciousness, analgesia and muscle relaxation during surgery. Characteristics of an ideal anaesthetic are listed. Common inhalation anaesthetics like ether, nitrous oxide and halothane are described. New trends in anaesthesia include balanced and multimodal approaches.

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    Anesthesia

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    jaanabhenchod
    315 views17 pages
    This document discusses the history and principles of anaesthesia. It describes how anaesthesia was first used with nitrous oxide in 1844 by Horace Wells and ether in 1846 by Dr. William Morton. It explains the stages of anaesthesia and the need for unconsciousness, analgesia and muscle relaxation during surgery. Characteristics of an ideal anaesthetic are listed. Common inhalation anaesthetics like ether, nitrous oxide and halothane are described. New trends in anaesthesia include balanced and multimodal approaches.

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    This document discusses the history and principles of anaesthesia. It describes how anaesthesia was first used with nitrous oxide in 1844 by Horace Wells and ether in 1846 by Dr. William Morton. It explains the stages of anaesthesia and the need for unconsciousness, analgesia and muscle relaxation during surgery. Characteristics of an ideal anaesthetic are listed. Common inhalation anaesthetics like ether, nitrous oxide and halothane are described. New trends in anaesthesia include balanced and multimodal approaches.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    315 views17 pages

    Anesthesia

    Uploaded by

    jaanabhenchod
    This document discusses the history and principles of anaesthesia. It describes how anaesthesia was first used with nitrous oxide in 1844 by Horace Wells and ether in 1846 by Dr. William Morton. It explains the stages of anaesthesia and the need for unconsciousness, analgesia and muscle relaxation during surgery. Characteristics of an ideal anaesthetic are listed. Common inhalation anaesthetics like ether, nitrous oxide and halothane are described. New trends in anaesthesia include balanced and multimodal approaches.

    Copyright:

    Attribution Non-Commercial (BY-NC)
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    of 17

    ANAESTHESIA

    INTRODUCTION

    The word anaesthesia is derived from the Greek: meaning insensible or without feeling.

    Insensible does not necessary imply loss of consciousness.

    Why do we need anesthesia ?

    Horace Wells
    Williams Mortons Dr. John Snow

    Nitrous oxide Used as anaesthetic in 1844 by Horace Wells

    HISTORY

    ETHER Used as anaesthetic in 1846 by Dr. William Morton.


    CHLOROFORM Used as anesthetic in 1853 by Dr. John Snow

    GENERAL ANAESTHESIA

    General anaesthetics (GAs) are drugs which produce reversible loss of all sensations and consciousness. It usually involves a loss of memory and awareness with insensitivity to painful stimuli, during a surgical procedure
    General anesthesia

    need for unconsciousness

    need for analgesia

    need for muscle relaxation

    Characteristic of ideal anaesthesia


    Rapid and pleasant induction of surgical anesthesia Rapid and pleasant withdrawal from anesthesia Nontoxic Non-flammable/ non-explosive Inexpensive

    STAGES OF ANAESTHESIA
    Starts from beginning of anaesthetic inhalation and lasts upto the loss of

    Stage of Analges ia

    consciousness Pain is progressively abolished Reflexes and respiration remain normal Use is limited to short procedures From loss of consciousness to beginning of regular respiration Patient may shout, struggle and hold his breath; muscle tone increases, jaws are tightly closed, breathing is jerky; vomiting, involuntary micturition or defecation may occur Heart rate and BP may rise and pupils dilate due to sympathetic stimulation No operative procedure carried out Can be cut short by rapid induction, premedication

    Stage of Delirium

    Surgical anaesthesia

    Extends from onset of regular respiration to cessation of spontaneous breathing. This has been divided into 4 planes which may be distinguished as: Plane 1 roving eye balls. This plane ends when eyes become fixed. Plane 2 loss of corneal and laryngeal reflexes. Plane 3 pupil starts dilating and light reflex is lost. Plane 4 Intercostal paralysis, shallow abdominal respiration, dilated pupil.

    Medullary paralysis

    Cessation of breathing to failure of circulation and death. Pupil is widely dilated, muscles are totally flabby, pulse is thready or imperceptible and BP is very low

    GABA, endogenous compound, causes GABA to open Receptor capable of binding 2 GABA molecules, between an alpha and beta subunit Binding of GABA causes a conformational change in receptor Opens central pore, chloride ions pass down electrochemical gradient ,net inhibitory effect, reducing activity of the neuron

    Anesthetics bind to specific sites on the receptor protein.

    They do not compete with GABA for its binding on the receptor. They inhibit the response to painful stimuli by interacting with beta3 subunit of GABAA receptor.

    I. INHALATION ANESTHETICS
    Ether (diethyl ether)
    H3C O CH3

    Spontaneously explosive Irritant to respiratory tract High incidence of nausea and vomiting during induction and post-surgical emergence

    I. INHALATION ANESTHETICS
    O Nitrous Oxide Rapid onset N N Good analgesia Used for short procedures and in combination with other anesthetics Supplied in blue cylinders

    I. INHALATION ANESTHETICS
    Halothane (Fluothane) F Volatile liquid F C Narrow margin of safety Less analgesia and muscle relaxation F Hepatotoxic Reduced cardiac output leads to decrease in mean arterial pressure Increased sensitization of myocardium to catecholamines
    Br CH Cl

    I. INHALATION ANESTHETICS
    Pharmacokinetics The concentration of a gas in a mixture of gases is proportional to the partial pressure Inverse relationship between blood and gas solubility and rate of induction
    Alveoli Nitrous oxide (low solubility) Blood Brain

    Halothane (high solubility)

    NEW TRENDS IN ANAESTHESIA


    1. Balanced anaesthesia:
    Use of different potent drugs for every

    component of anaesthesia :

    Unconsciousness by low inhalational Analgesia by narcotics or nitrous oxide Muscle relaxation by muscle relaxant.
    So we can get best results with less side effects

    and can be reversed.

    2. Multimodal anaesthesia: Use of combination Regional with light general Local analgesia with sedation IV induction and inhalational maintenance

    References

    The Pharmacological basis of therapeutics- Goodman & Gilman Clinical Pharmacology- Bennett & Brown Essentials of medical pharmacologyTripathi KD Basic & Clinical Pharmacology- Katzung

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