SLIDE ANAESTHESIA.pptx this slide share abut anesthesia

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1. Anaesthesia Madam Rozila Binti Ibrahim May Session 2024 27/7/2024 1

2. Learning outcome At the end of the session, learner’s should be able to; Explain the information that should be included in the pre-anaesthesia instruction. Describe the effect of anaesthesia medications on the patient. Discuss the role of the perioperative nurse during the administration of anaesthesia. Describe assessment factors related to the selection of anaesthesia agents and techniques. Describe techniques of general anaesthesia, regional anasethesia , and moderate sedation/analgesia. Discuss the role of the perioperative nurse regarding medication administration and safety. 27/7/2024 2

3. Introduction of anesthesia Greek philosopher Dioscorides first used the term “ anaesthesia ” in first century A.D. to describe narcotic like effects of the plant mandragora. Later different dictionaries defined the term as “a defect of sensation”, “privation of senses”, “absence of sensation”, “diminished or lost sense of feeling”. 27/7/2024 3

4. Definition Anesthesia is the use of medicines to prevent pain during surgery and other procedures. These medicines are called anesthetics. Given by injection, inhalation, topical lotion, spray, eye drops, or skin patch. cause you to have a loss of feeling or awareness. Anesthesia keeps patients from feeling pain during surgery or other procedures. 27/7/2024 4

5. Stage of anaesthesia Induction - initial stage anesthesia is first administered. Involves transition from the patient being fully conscious to a state of unconsciousness. Induction is achieved using intravenous (IV) agents or inhaled anesthetics. During this stage, the patient becomes relaxed and loses consciousness. Maintenance - Once the patient is unconscious, the anesthesia is maintained throughout the duration of the surgical procedure. Involves continuous administration of anesthetic agents to keep the patient in a stable, unconscious state. The goal is to ensure that the patient remains unaware of the surgery and does not experience pain. 27/7/2024 5

6. Stage of anaesthesia Emergence - After the surgical procedure is completed, the anesthetic agents are gradually reduced or discontinued. This stage involves the patient regaining consciousness and returning to a normal state of awareness. The emergence phase requires careful monitoring to ensure the patient wakes up safely and without complications. Recovery - occurs after the patient has emerged from anesthesia. Involves monitoring and supporting the patient as they recover from the effects of anesthesia. Patient’s vital signs, consciousness, and overall condition are closely observed until they are fully awake and able to function normally. 27/7/2024 6

7. Types of anaesthesia General Anesthesia- Fully unconsciousness Local Anesthesia. Local anesthesia is an anesthetic agent given to temporarily stop the sense of pain in a particular area of the body. Regional Anesthesia . Regional anesthesia is used to numb only the portion of the body that will undergo the surgery - including epidural, spinal and nerve block anesthesia S edation : monitored anesthesia care with conscious sedation. 27/7/2024 7

8. General Anaesthesia A combination of medications that put you in a sleep-like state before a surgery or other medical procedure. Under general anesthesia, patient don't feel pain because of completely unconscious. General anesthesia usually uses a combination of intravenous drugs and inhaled gasses (anesthetics). 27/7/2024 8

9. Local anesthesia Local anesthesia , also called local anesthetic, is usually a one-time injection of medicine that numbs a small area of the body. It is used for procedures such as performing a skin biopsy or breast biopsy, repairing a broken bone, or stitching a deep cut. The safest type of anesthesia is local anesthesia, an injection of medication that numbs a small area of the body where the procedure is being performed. Rarely, a patient will experience pain or itching where the medication was injected 27/7/2024 9

10. Regional anaesthesia With regional anesthesia, medication was injects near a cluster of nerves to numb only the area of your body that requires surgery. Patient may remain awake or may be given a sedative. Spinal and epidural blocks involve interrupting sensation from the legs or abdomen by injecting local anesthetic medication in or near the spinal canal. 27/7/2024 10

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12. Sedation: monitored anesthesia care with conscious sedation(MAC) Monitored Anesthesia Care (MAC) with Conscious Sedation MAC is a state of consciousness somewhere between being totally awake and totally asleep (general anesthesia). During MAC, a combination of sedative and narcotic medications are used to help patient tolerate a procedure that otherwise would be uncomfortable. Deep sedation: The patient is nearly unconscious and only has purposeful response to repeated and painful stimulation. The patient may need assistance with breathing, but cardiovascular function is usually unimpaired. General anesthesia: The patient is completely unconscious and does not respond to any level of pain 27/7/2024 12

13. Sedation 27/7/2024 13

14. Stage 1: Induction. The earliest stage lasts from when you first take the medication until you go to sleep. You’re calm but able to talk for a while. Your breathing is slow but regular, and you lose the ability to feel pain. Inhalation anesthetics (nitrous oxide, halothane, isoflurane, desflurane, sevoflurane, most commonly used agents in practice today) are used for induction and maintenance of general anesthesia in the operating room. General overview of inhalation anesthetic agents. Patient is conscious and rational, with decreased perception of pain. Inhalation anesthetic agents are medications primarily used in the operating room to provide general anesthesia for surgery. 27/7/2024 14

15. Anaesthetic agent Induction agent Propofol, Thiopentone, Ketamine, Midazolam (at least one) Narcotics: Fentanyl, Morphine, Pethidine Neuromuscular blocking agents: Cisatracurium, rocuronium, Atracurium, Pancuronium Resuscitation drugs: atropine, calcium, adrenaline Other: antiemetics, antibiotic 27/7/2024 15

16. Induction drug :propofol, ketamin , thipontone Narcotic: fentanyl Neuromuscular blocking agent/muscle relaxion: Atracium 27/7/2024 16

17. Cont..induction Laughing gas and nitrous oxide are one in the same—a safe and effective anesthetic administered to dental patients through a mask in an oxygen mixture. Laughing gas won't put you to sleep like general anesthesia. Instead, inhaling this mixture will make you feel a light tingling sensation. Nitrous oxide (N2O) is called “laughing gas” because it has a euphoric effect when inhaled. It has a mildly sweet odor and taste. N2O was first synthesized by J. Priestley in 1772. 27/7/2024 17

18. Nurses role pre-anaesthesia 1. Preoperative preparation: Preoperative assessment/risk stratification Consent/explanation/reassurance Preparation – management of health problems - Premedication - special patient preparation 2. Planning/preparation for anaesthesia 3. Monitoring 4. Induction 5. Airway management 6. Positioning 7. Maintenance – aneasthesia/analgesic, muscle relaxants, iv fluids, ventilation, management of occurrences 8. Recovery (early) - cessation/ reversal, weaning /extubating 27/7/2024 18

19. Cont..phase aneasthesia “Post op care” airway/ ventilation Iv fluids Pain management Management of PONV (Post nausea and vomiting) Management of common postoperative problems Vital sign monitoring (ECG, Non invasive blood pressure, pulse oximetry) 27/7/2024 19

20. Anaesthesia Nurses/ Nurse’s role and responsibility The anesthetic nurse's role is to detect adverse events as soon as possible and intervene promptly and adequately, communicating with the anesthetist and other members of the team, assisting in interventions, delegating tasks when appropriate and keeping records. Nursing responsibilities during the intraoperative phase include continuing the assessment of the patient's physiologic and psychologic status, promoting safety and privacy, preventing wound infection, and promoting healing. 27/7/2024 20

21. Anesthesia Nurses/Nurse’s role and responsibility maintaining ventilation and circulation, monitoring oxygenation and level of consciousness, preventing shock, and managing pain. The nurse should assess and document respiratory, circulatory, and neurologic functions frequently. Airway patency. Respiratory status (rate and oxygen saturation) Cardiovascular status (blood pressure and pulse) Circulatory status (strict fluid balance and central venous pressure where available) Temperature. Haemorrhage/drainage volumes/ vomiting/fluid balance. Mental state. 27/7/2024 21

22. Anesthesia Nurses/nurse’s role and responsibility Assessing, observing, and speaking to patients. Recording details and symptoms of patient medical history and current health. Preparing patients for exams and treatment. Administering medications and treatments, then monitoring patients for side effects and reactions. 27/7/2024 22

23. Complications of General Anesthesia 27/7/2024 23

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