Anesthesia

Purposes/Objectives of
Pre-Op
Meds
To allay fear

To produce some amnesia

To decrease secretion in the respiratory
tract
To raise the pain threshold (tolerance to
pain. that maybe influenced by factors
such as anxiety)
To lower the body metabolism so that
less anesthetic drug is needed

Drugs Used

Barbiturates
- eg Secunal, Nembutal
- usually given in the evening or
morning before surgery to
promote rest full sleep.
Narcotic Analgesic
- eg. Morphine, Demerol
- used as sedatives to release anxiety

Tranquillizers
- eg. Phenergan, Thorazine,
Compazine
- to decrease anxiety, decrease
motor activity
- has a antihistamine and antiemetic
effect
Anticholinergic Agents
- eg. Atropine Sulfate
- depresses salivary and bronchial
secretions.

Nursing Responsibilities
Instruct the patient about the side
effects of the pre-op meds.
After administering, keep client in
the bed with side rails up.
Instruct patient not to get out of
bed.

Factors that determine the

choice of drugs
1.

2.
3.
4.

Physical and mental condition of

patient
Age and weight of the patient
Operative procedure
Preference of the surgeon and
patient

Types of Anesthesia
1.

General Anesthesia Loss of

consciousness, sensation
- produces amnesia
- given thru ETT, IV, Inhalation
- eg.inhalation
Halothane(Fluothane),
Isoflurane(Forane).

- eg.IV

Ketamine HCl (Ketalar)

Fentanyl (Sublimaze)
Diazepam (Valium)

Local or regional block

Pain is controlled without loss of

consciousness. The sensory nerves in
one area or region of body are
anesthetized.
Local Anesthesia administered
topically, or thru local infiltration eg.
Xylocaine.
Regional - anesthesia drug is injected
around specific nerve or region to
prevent pain.

Spinal and Epidural Anesthesia

- sensation of pain is blocked at a
level below diaphragm without loss of
consciousness.
Spinal eg. Sensorcaine (Bupivacaine)
5% 4ml heavy.
Epidural - eg. Sensorcaine (Bupivacaine)
5% 10ml

Stages of Anesthesia
Stage 1 Induction Stage
- Starts from the induction
period and ends with the loss of
consciousness.
Patients Status: he may appear drowsy,
dizzy.

The Nurse should:

1. Close the operating room doors.
2. Keep room quiet (with general
anesthesia, hearing is the last
sense loss).
3. Stand by the patient to assist, if
necessary.

Stage 2 - Delirium Stage

- last from the loss of
consciousness to the loss of certain
reflexes (swallowing, vomiting and
eyelid reflex).
Patients Status: he may appear
excited, may breathe irregularly, may
move arms and legs and body. He is
very susceptible to external stimuli
(noise, being touched suddenly).

The nurse should:

1. Be ready to restrain the patient
if needed.
2. Remain at the patients side

Stage 3 - Stage of Surgical Anesthesia

- the period from loss of certain
reflexes respiratory paralysis
occurs.
Patient Status:
1. Regular respiration, contracted
pupils, jaw relaxed, auditory sensation
lost.
2. The patient is quiet, insensible
and unable to move by himself.

The nurse should:

1. Begin preparation only when
the anesthesiologist indicates that
stage III has been reached and the
patient is under good control.

The Nurse should:

1. React immediately to assist in
establishing the airway, if arrest occurs.
2. Provide cardiac arrest tray,
emergency drugs.
3. Assist the surgeon with closed or
open cardiac message.

Stage 4 - Stage of Danger

- reached when too much
anesthesia has been given and the
patient has not been ob served carefully.
Death may result from respiratory and
or cardiac arrest, unless the patient can
be resuscitated promptly.
Patient Status: not breathing, little or
no heartbeat or pulse.