ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA STAGE 1 (Amnesia): From induction of anesthesia to loss of conciousness (loss of eyelid reflex).

Pain perception threshold is not lowered.

STAGE 2 (Delirium/Excitement): Characterized by uninhibited excitation. Pupils are dilated and eyes divergent. Agitation, delirium, irregular respiration, and breatholding are commonly seen. Potentially dangerous responses can occur during this stage including vomiting, laryngospasm, HTN, tachycardia, and uncontrolled movement.

STAGE 3 (Surgical Anesthesia): Central gaze,constricted pupils, and regular respirations. Target depth of anesthesia is sufficient when painful stimulation does not elicit somatic reflexes or deleterious autonomic reflexes.

Plane 1 From the return of regular respirations to the cessation of REM.

Plane 2 The Surgical Plane From the cessation of REM to the onset of paresis of the intercostal muscles.

Plane 3 From the onset to the complete paralysis of the intercostal muscles.

Plane 4 From the paralysis of the intercostal of this plane the patient will be apneic. muscles to the paralysis of the diaphragm - at the end

STAGE 4 (Impending Death/Overdose): Onset of apnea, dilated and nonreactive pupils, and hypotension to complete circulatory failure.

Types of Anesthesia

1. Local anesthesia involves injection of a local anesthetic (numbing agent) directly into the surgical area to block pain sensations. It is used only for minor procedures on a limited part of the body. You may remain awake, though you will likely receive medicine to help you relax or sleep during the surgery. Local anesthetics are usually given by injection into the body area that needs to be anesthetized. They are not injected into the bloodstream (intravenous, IV). Local anesthetics may be given with other medicines that make you relaxed or sleepy (sedatives). These other medicines are often given by IV. Local anesthesia is most often used when: You do not have a high level of anxiety and apprehension. If you have local anesthesia without sedation, you need to be able to lie still and remain calm during the surgery, although you may also be given medicine to help you relax. A surgery can be performed in a short time and you will go home soon after. A surgery does not require unconsciousness or extreme muscle relaxation. Less commonly, local anesthesia may be applied directly to the skin or mucous membranes as a cream or ointment. This is called topical anesthesia. Topical local anesthesia is used for very minor procedures on the surface of the skin.

1. Regional anesthesia involves injection of a local anesthetic (numbing agent) around major nerves or the spinal cord to block pain from a larger but still limited part of the body. You will likely receive medicine to help you relax or sleep during surgery. Major types of regional anesthesia include: Major types of regional anesthesia include:

Peripheral nerve blocks. A local anesthetic is injected near a specific nerve or bundle of nerves to block sensations of pain from the area of the body supplied by the nerve. Nerve blocks are most commonly used for surgery on the arms and hands, the legs and feet, the groin, or the face. Epidural and spinal anesthesia. A local anesthetic is injected near the spinal cord and major nerves that enter the spinal cord

to block sensations of pain from an entire region of the body, such as the lower abdomen, the hips, or the legs. For regional anesthesia, the anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord. Skill and experience are necessary for the anesthesia specialist to inject the anesthetic at the proper location, because the site of injection of the anesthetic has a significant impact on its effect. Careful technique is needed to reduce the risk of rare complications, such as infection or nerve damage.

1. Regional anesthesia may be given with other medications that make you relaxed or sleepy (sedatives) or relieve pain (analgesics). These additional medications are given through a vein (intravenously, IV).General anesthesia is given into a vein (intravenously) or is inhaled. It affects the brain as well as the entire body. You are completely unaware and do not feel pain during the surgery. Also, general anesthesia often causes forgetfulness (amnesia) right after surgery (postoperative period)

Surgical Positions:

UNIVERSITY OF BAGUIO SCHOOL OF NURSING

Submitted in Partial Fulfillment of the Requirements in NPRAC05

Submitted to: Juvy Carame, RN, MAN Clinical Instructor

Submitted by: Alan Roque NPH - 1