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optimal surgery room atmostphere
between 68 and 73 degrees F with low humidity (20%-60%)
injecting gas or air into the cavity before surgery to separate organs and improve visualization
purpose of anesthesia
block nerve impulse transmission, suppress reflexes, promote muscle relaxation, achieve a controlled level of unconciousness.
- reversible loss of consciousness induced by inhibiting nueronal impulses in several areas of the CNS.
- Can be achieved with a single agent or a combination of agents.
- **used most often in surgery of the head, neck, upper torso, and abdomen**
3 types of general anesthesia
Inhalation (most controllable), Intravenous, and Balanced
Begins in the skeletal muscle exposed to a specific agents, causing increased calcium levels in muscle cells and increased muscle metabolism. Serum calcium and potassium levels are increased, as is metabolic rate, leading to acidosis, dysrythmias, and high body temperature.
indications of MH
tachycardia, dysrythmia, muscle rigidity, hypotension, tachypnea, skin mottling, cyanosis, myoglobinuria, unexpected rise in the end tidal carbon dioxide level with a decrease in O2 saturation.
4 stages of general anesthesia
- Stage 1- analgesia and sedation, relaxation
- stage 2- excitement, delerium
- stage 3- operative anesthesia, surgical anesthesia
- stage 4- danger
stage 1 of G.A.
patient feels drowsy and dizzy, has reduced sensation to pain, hearing is exaggerated. BEGINS WITH INDUCTION AND ENDS WITH UNCONSCIOUSNESS.
stage 2 of G.A.
BEGINS WITH LOSS OF CONSCIOUSNESS AND ENDS WITH RELAXATION, REGULAR BREATHING, AND LOSS OF EYELID REFLEX. Laryngospasm or vommiting may occur.
stage 3 of G.A.
BEGINS WITH GENERALIZED MUSCLE RELAXATION AND ENDS WITH LOSS OF REFLEXES AND DEPRESSION OF VITAL FUNCTIONS. jaw is relaxed, breathing is quiet and regular. Patient cannot hear, sensations are lost.
stage 4 of G.A.
BEGINS WITH DEPRESSION OF VITAL FUNCTIONS AND ENDS WITH RESPIRATORY FAILURE, CARDIAC ARREST, AND POSSIBLE DEATH. Resp. muscles are paralyzed, apnea occurs. pupils are fixed and dilated.
Local or regional anesthesia
briefly disrupts sensory nerve impulse transmission from a specific body area or region. Pt. remains conscious. It is often supplemented with sedatives, opioids, or hypnotics.
delivered topically (applied to the skin or mucous membranes of the area to be anesthetized) and by local infiltration.
regional anesthesia (4 types)
- type of local anesthesia that blocks multiple peripheral nerves in a specific body region.
- Field Block
- Nerve Block
- Spinal anesthesia
- epidural anesthesia
- a series of injections around the operative field
- used most commonly for chest procedures, hernia repair, dental surgery, some plastic surgeries
- injection of the local anesthetic agent into or around one nerve or group of nerves in the involved area.
- most commonly used for limb surgery or to relieve chronic pain
- Injection of an anesthetic agent into the cerebrospinal fluid in the subarachnoid space.
- most commonly used for lower abdominal, pelvic, hip, and knee surgery
- injection of an agent into the epidural space.
- most commonly used for vaginal, perineal, hip, and lower extremity surgeries
- conscious sedation.
- reduces the level of consciousness but allows the pt. to maintain a patent airway and to response to verbal commands
- used for endoscopy, cardia catheterization, closed fracture reduction, cardioversion