ANAESTHESI

A
ITS TYPES ,
USES AND
EFFECTS ON

HUMAN
BODY.
CERTIFICATE
CLASS : XII
YEAR : 2014 -2015
This is to certify that work
entered in this project named,
ANAESTHESIA ITS TYPES USES AND
EFFECT ON HUMAN BODY.

Done by Miss ADITI BHALCHANDRA

CHURI
Of Std : 12th Division : B Roll no :
Has satisfactory completed the
Biology project.

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ANAESTHESIA

Anaesthesia, or anaesthesia is a temporary

state consisting of unconsciousness, loss of
memory, lack of pain, and muscle relaxation.
Anaesthesia is a unique medical intervention which
does not itself offer any particular medical benefit
and instead enables the performance of other
medical interventions. The best anesthetic is
therefore one with the lowest risk to the patient
that still achieves the end points required to
complete the other intervention. There are many
different needs and goals of anaesthesia. The goals
(end points) are traditionally described as
unconsciousness and amnesia, analgesia, and
muscle relaxation.
The types of anaesthesia are broadly classified into
general anaesthesia, sedation and regional
anaesthesia. General anaesthesia refers to the
suppression of activity in the central nervous
system, resulting in unconsciousness and total lack
of sensation. Regional anaesthesia renders a larger
area of the body insensate by blocking
transmission of nerve impulses between a part of
the body and the spinal cord. It is divided into
peripheral and central blockades. Peripheral
blockade inhibits sensory perception within a

specific location on the body, such as when a tooth

is "numbed" or when a nerve block is given to stop
sensation from an entire limb.

History of General
Anaesthesia
During the Middle Ages, which correspond roughly
to what is sometimes referred to as the Islamic
Golden Age, scientists and other scholars made
significant advances in science and medicine in the
Muslim world and Eastern world, while their
European counterparts also made important
advances.
Although there has been a great deal of debate as
to who deserves the most credit for the discovery
of general anaesthesia, it is generally agreed that
certain scientific discoveries in the late 18th and
early 19th centuries were critical to the eventual
introduction and development of modern
anesthetic techniques.

General
Anaesthesia

TYPES OF ANAESTHESIA
1. General Anaesthesia

General anaesthesia (GA) is appropriate for most

complex surgical procedures. A general anesthetic
can be divided into three distinct phases:
Induction, Maintenance, and Emergence.

Induction
Induction of general anaesthesia for adults is
usually achieved
with the injection of intravenous medications. The
most commonly used induction agent in the United
States is propofol because of its favorable recovery
profile and short elimination half-life. A study of
over 4000 patients found an 18 percent reduction
in postoperative nausea and vomiting with propofol
compared propofol to sodium pentothal
Other less common induction agents include
etomidate and ketamine. These agents have lower
rates of hemodynamic instability than propofol and
may be used in specific situations.

Maintenance

Maintenance of anaesthesia can be achieved with

volatile or
intravenous (IV) anesthetics. Volatile agents remain
a popular choice among anesthesiologists because
of their ease of delivery, reliable recovery,
excellent safety profile, and modest cost.
The most severe adverse effect of all the volatile
anesthetics is fulminant hepatic necrosis caused by
halothane. The incidence of this rare event was 1
in 35,000 patients.
Maintenance of the anesthetized state with
intravenous anesthetics is rapidly becoming a
popular alternative to volatile gas anaesthesia for
certain procedures ( eg, breast biopsy) and a
necessity for procedures like bronchoscopy.

 Emergence
Emergence or "waking up" from general
anaesthesia is a
crucial time in which the anesthesiologist
welcomes the patient back to a restored state of
consciousness. With this return of consciousness
there is a short period of time in which the
patient's body is aware of the emergence without a
full return to consciousness.

2.

Neuraxial anaesthesia

Spinal or epidural anaesthesia may be used as a

primary anesthetic for patients undergoing surgery
of the lower extremities or abdomen.
The benefits of neuraxial anaesthesia are
associated with
some risks, which are uncommon but can be
serious. The most common adverse event
associated with neuraxial blockade is post-dural
puncture headache.

3. Spinal anaesthesia
Spinal anaesthesia is most popular for lower
extremity orthopedic procedures in appropriate
patients. A comparison of general anaesthesia and
spinal anaesthesia for total hip arthroplasty
demonstrated a decrease in surgical time by 12
percent, blood loss by 25 percent and
intraoperative transfusion requirement by 50
percent when using spinal anaesthesia.
The use of spinal anaesthesia may decrease the
incidence of thrombotic phenomena such as deep
venous thrombosis (DVT) or pulmonary
embolus(PE), which are a major cause of
postoperative morbidity in lower extremity surgery.

Spinal anaesthesia

4. Epidural anaesthesia and

analgesia
Epidural anaesthesia is achieved with the
placement of a small gauge flexible catheter into
the epidural space via a needle using either a loss
of resistance (more commonly used) or hanging
drop technique.
Repeat dosing of local anesthetic and adjunctive
medications for prolonged intraoperative
management is possible by leaving a catheter in
the central neuraxial space for infusion.
Epidural analgesia has been shown to be beneficial
in several situations. In patient undergoing major
aortic surgery, patients receiving combined of
general and epidural analgesia had a significantly
lower incidence of death and major perioperative
complications.

Epidural anaesthesia and

analgesia

Mini set for epidural anaesthesia

ANAESTHESIA PROCEDURES AND

COMPLICATIONS
Endotracheal intubation

The placement of an endotracheal tube for airway

and ventilatory maintenance is probably the most
common procedure performed by
anesthesiologists..
The incidence of difficult intubation, requiring more
than one attempt at laryngoscopy, is cited at less
than 1 percent
There are many factors which predispose patients
to difficulty with airway management including
obesity, limited mento-hyoid distance, limited
mouth opening, limited mandibular flexibility and
limited extension of the cervical spine.
Post operative sore throat is the most common
adverse event related to endotracheal intubation
with an incidence of approximately 40 percent

Endotracheal intubation

 Laryngeal mask airway placement

The laryngeal mask airway (LMA) is a popular tool

for maintaining airway patency during general
anaesthesia.
The airway is inserted into the oropharynx after
induction of
general anaesthesia. Complications associated with
LMA placement include sore throat and
oropharyngeal trauma. It should also be noted that
the LMA is a supraglottic airway that does not
protect the patient against the risk of aspiration
pneumonitis.
An incidence of aspiration of 2 in 10,000 patients
receiving
anaesthesia with an LMA has been cited, although
the authors do note that these devices should be
used with caution in patients with increased risk
factors for aspiration.

Laryngeal mask airway

placement

 Peripheral intravenous catheter

placement

The vast majority of patients undergoing

anaesthesia have a peripheral venous cannula
placed for administration of medications,
intravenous fluids, and blood products.
Viens of the upper limbs and hand are the most
common cannulation sites used by the
anesthesiologist. It has become common practice
to administer a local anesthetic to reduce the pain
of cannulation.
The most frequent early complications are
thrombophlebitis and extravasation. Catheter
infection is a complication that is most likely to
occur after more than three to four days.

Peripheral intravenous catheter

placement

 Central venous catheter insertion

Placement of a catheter into a central vein
(subclavian, internal jugular) is helpful for both
monitoring volume status and infusion of
vasoactive or medications too irritating for
peripheral administration.

Arterial catheter insertion

Arterial catheters may be placed by

anesthesiologists for continuous blood pressure
monitoring or frequent blood gas analysis
(evaluating respiratory and metabolic function).
Arterial catheters are typically placed in the radial
artery at the level of the wrist using the Seldinger
techniques.

Pulmonary artery catheterization

Pulmonary artery catheterization involves the

placement of a catheter under hemodynamic
and/or fluoroscopic guidance through the central
venous circulation, the right atrium, right ventricle,
and into the pulmonary artery.
Under ideal circumstances this catheter provides
significant hemodynamic information to the
practitioner including cardiac output, pulmonary
artery pressure, pulmonary vascular resistance,
and pulmonary artery occlusion pressure.
Current evidence does not support the routine use
of pulmonary artery catheterization for high risk
patients undergoing major non-cardiac surgery
Intraoperative transesophageal echocardiography
is replacing the use of pulmonary artery catheters
in many high risk patients.

 Pulmonary artery catheterization

Drugs for treatment of General

Anaesthesia
Atracurium
Atracurium is a neuromuscular-blocking agent,
used as an adjuvant in anaesthesia. This
medication provides relaxation of skeletal muscles
during surgery.
Cisatracurium Besylate
Cisatracurium Besylate is a neuromuscular
blocking agent, used as an adjunct to general
anaesthesia.
Desflurane
Desflurane is a general anesthetic, prescribed for
induction of anaesthesia during surgery.
Enflurane
Enflurane is a structural isomer of isoflurane,
prescribed for induction and maintenance of
general anaesthesia.
Halothane
Halothane is an inhalational general anesthetic,
prescribed for the induction and maintenance of
general anaesthesia

Hyoscyamine
Hyoscyamine is an anticholinergic agent, used as
pain killer (Belladonna alkaloid). It blocks cardiac
vagal inhibitory reflexes during anaesthesia
induction and intubation, used to relax muscles.

Isoflurane
Isoflurane is halogenated ether, used for
maintenance of general anaesthesia.
Ketamine
Ketamine is a hydrochloride salt, used as an
anesthetic.
Methohexital
Methohexital is a barbiturate anesthetic, prescribed
for inducing anaesthesia before surgery.
Propofol
Propofol is a general anesthetic, prescribed for
induction and maintenance of general anaesthesia.
Rapacuronium
Rapacuronium is a neuromuscular blocker,
prescribed as an adjunct to general anaesthesia to
facilitate tracheal intubations.
Rocuronium
Rocuronium is a neuromuscular blocker, prescribed
as an adjunct to general anaesthesia for muscle
relaxation and to provide skeletal muscle
relaxation during surgery or external breathing.

DIFFERENT TYPES OF NEEDLES USED

IN ANAESTHESIA

STATISTICS OF ANAESTHESIA IN INDIA

Side effects of Anaesthesia.

Nausea and vomiting are more likely with
general anaesthesia and lengthy procedures. In
most cases, nausea does not last long and can
be treated with anti-emetic medicines.

Hypothermia (low body temperature) may

cause you to feel cold and shiver when you are
waking up due to a mild drop in body
temperature that is common during general
anaesthesia. Special measures are taken
during surgery to keep your body temperature
from dropping too much.

Impaired coordination or judgment can

result due to the effect general anesthetics can
have on the central nervous system. You may
feel drowsy, weak or tired for several days and
have blurred vision and fuzzy thinking. You
should not drive, operate machinery, or
perform other activities that could endanger
yourself or others for 24 hours or longer.