A. Give examples of anesthesia administered to the client before surgery.

Anesthesia controls pain during surgery or other medical procedures. It includes using
medicines, and sometimes close monitoring, to keep you comfortable. It can also help control
breathing, blood pressure, blood flow, and heart rate and rhythm, when needed. Anesthetics are
divided into two classes:

1. Those that suspend sensation in the whole body General anesthesia

2. Those that suspend sensation in certain parts of the body local, regional, epidural or
spinal anesthesia

General Anesthesia

This type of anesthesia promotes total loss of consciousness and sensation. General anesthesia is
commonly achieved when the anesthetic is inhaled or administered intravenously. It affects the
brain as well as the entire body. Types of general anesthesia administration:

Volatile liquid anesthetics this type of anesthetic produces anesthesia when their vapors are
inhaled. Included in this group are the following:

1. Halothane (Fluothane)
2. Methoxyflurane (Penthrane)
3. Enflurane (Ethrane)
4. Isoflurane (Forane)

Gas Anesthetics anesthetics administered by inhalation and are ALWAYS combined with
oxygen. Included in this group are the following:

1. Nitrous Oxide
2. Cyclopropane

Stages

General anesthesia consists of four stages, each of which presents a definite group of signs and
symptoms.

Stage I: Onset or Induction or Beginning anesthesia.

This stage extends from the administration of anesthesia to the time of loss of consciousness. The
patient may have a ringing, roaring or buzzing in the ears and though still conscious, is aware of
being unable to move the extremities easily. Low voices or minor sounds appear distressingly
loud and unreal during this stage.

Stage II: Excitement or Delirium.

Stage II extends from the time of loss of consciousness to the time of loss of lid reflex. This stage
is characterized by struggling, shouting, talking, singing, laughing or even crying. However,
these things may be avoided if the anesthetic is administered smoothly and quickly. The pupils
become dilated but contract if exposed to light. Pulse rate is rapid and respirations are irregular.

Stage III: Surgical Anesthesia.

This stage extends from the loss of lid reflex to the loss of most reflexes. It is reached by
continued administration of the vapor or gas. The patient now is unconscious and is lying quietly
on the table. Respirations are regular and the pulse rate is normal.

Stage IV: Overdosage or Medullary or Stage of Danger.

This stage is reached when too much anesthesia has been administered. It is characterized by
respiratory or cardiac depression or arrest. Respirations become shallow, the pulse is weak and
thread and the pupils are widely dilated and no longer contract when exposed to light. Cyanosis
develops afterwards and death follows rapidly unless prompt action is taken. To prevent death,
immediate discontinuation of anesthetic should be done and respiratory and circulatory support is
necessary.

Local Anesthesia

Local anesthetics can be topical, or isolated just to the surface. These are usually in the form of
gels, creams or sprays. They may be applied to the skin before the injection of a local anesthetic
that works to numb the area more deeply, in order to avoid the pain of the needle or the drug
itself (penicillin, for example, causes pain upon injection).

Regional anesthesia

Regional anesthesia blocks pain to a larger part of the body. Anesthetic is injected around major
nerves or the spinal cord. Medications may be administered to help the patient relax or sleep.
Major types of regional anesthesia include:

1. Peripheral nerve blocks. A nerve block is a shot of anesthetic near a specific nerve or
group of nerves. It blocks pain in the part of the body supplied by the nerve. Nerve blocks
are most often used for procedures on the hands, arms, feet, legs, or face.
2. Epidural and spinal anesthesia. This is a shot of anesthetic near the spinal cord and the
nerves that connect to it. It blocks pain from an entire region of the body, such as the
belly, hips, or legs.

With regional anesthesia, an anesthetic agent is injected around the nerved so that the area
supplied by these nerves is anesthetized. The effect depends on the type of nerve involved. The
patient under a spinal or local anesthesia is awake and aware of his or her surroundings.

Regional anesthesia carries more risks than local anesthesia, such as seizures and heart attacks,
because of the increased involvement of the central nervous system. Sometimes regional
anesthesia fails to provide enough pain relief or paralysis, and switching to general anesthesia is
necessary.

Spinal Anesthesia

This is a type of conduction nerve block that occurs by introducing a local anesthetic into the
subarachnoid space at the lumbar level which is usually between L4 and L5. Sterile technique is
used as the spinal puncture is made and medication is injected through the needle. The spread of
the anesthetic agent and the level of anesthesia depend on:

1. the amount of fluid injected

2. the speed with which it is injected
3. positioning of the patient after injection
4. specific gravity of the agent

Nursing Assessment

The following are nursing assessment after anesthesia:

1. Monitoring vital signs.

2. Observe patient and record the time when motion and sensation of the legs and the toes
return.

Side Effects

1. Some numbness or reduced feeling in part of your body (local anesthesia)

2. Nausea and vomiting.
3. A mild drop in body temperature.

How do anesthesiologists determine the type of anesthesia to be used?

The type of anesthesia the anesthesiologist chooses depends on many factors. These include the
procedure the client is having and his or her current health.

B. Specify different types of surgical instruments.