More Related Content Similar to Types of anesthesia (20) More from MEEQAT HOSPITAL (20) Types of anesthesia1. Types of Anaesthesia
Prof. med. Nabil H. Mohyeddin
Anesthesiologist & Intensivist
Board certified
University Rostock, Germany
nhm1955@hotmail.com
2. Objectives
Short History
Definition/types of anaesthesia
General anaesthesia/drugs
Phases of GA
Regional anaesthesia
4. History
1845- Horace Wells- N2O
1846- William Morton- Ether
1847- Simpson- Chloroform
1853-John Snow
1878- ETT
1884- Cocaine
1895-98- Spinal analgesia/anaesthesia
5. History
1921- Epidurals
1934- Thiopentone, cyclopropane
1942- Curare
1946- Lignocaine
1951- Suxamethonium
1952- IPPV
1956-Halothane
8. Hypnosis
Death
Coma
Hypnosis
sedation
Amnesia
Awake
11. Analgesia
Good analgesia= good anaesthesia
Hypnotic sparing effect
Opiates
Local anaesthetics
NSAIDS
Paracetamol
12. Analgesia-Opiates
Gold standard – morphine
Derivatives- diamorphine, codeine
Synthetic agents
- Pethidine
- Fentanyl/Alfentanil-short acting
- Remifentanil-ultra short acting
14. Muscle relaxation
Aids intubation
Helps surgeon/surgery
Surgery of long duration
Reduces maintenance dose of
anaesthetics agents
15. Muscle relaxants
Two types
Depolarising-short acting
eg;suxmethonium
Non-depolarising- medium/long acting
- Tracurium
- Vecuronium
- Rocuronium
16. Prerequisites
Oxygen
Suction
Tilting trolley
Resuscitation drugs
Monitoring
Anaesthetist
Skilled assistance
Drugs and machine
17. Phases of
general anaesthesia
Induction
Maintenance
Recovery
18. Induction
Intravenous- majority
Inhalational- children, needle phobics
Monitoring
Preoxygenation
Hypnotic/analgesic and or relaxant
Mask/LMA/ET tube
19. Stages of anaesthesia
Alcohol General Anaesthesia
1.Dizzy, delightful 1.Amnesia, analgesia
2.Drunk, disorderly 2.Uninhibited
3.Dead drunk response to stimuli
4.Dangerously deep 3.Surgical anaesthesia
4.Vital centre
depression
20. Maintenance
Intravenous or inhalational
Oxygen –40%-100%
Nitrous oxide
Muscle relaxant
Analgesia
21. Recovery
Turn off agent
Reverse relaxation
Cough reflex
Extubate when awake
Recovery position
Monitor until discharge
22. Advantages
No absolute contraindications
Quick to establish
Never fails to work
23. Disadvantages
Polypharmacy
Effects on various systems
Allergic reactions
Recovery profile
Post operative Nausia &Vomiting
Awareness
24. Regional anaesthesia
Spinal/epidural
- surgery below umbilicus
- Provides analgesia/muscle relaxation
Plexus blocks eg brachial plexus
Intravenous- Bier’s block
27. Local anaesthetics
Lignocaine- quick/short acting
Bupivacaine/levobupicvacaine- slow
and long action
Ropivacaine- as above
Amethocaine- topical
Prilocaine- intravenous
28. Advantages
Effective alternative to GA
Avoids polypharmacy
Allergic reactions
Extended analgesia
Patient can remain awake
Early drink/feed
29. Disadvantages
Limited scope
Higher failure rate
Time constraints
Anticoagulants/Bleeding diathesis
Risk of neural injury