34 r

Anesthesio

3eie:c

i;:rc:on .

35

Toble 4-2. Gommonly Used Conduclion Aneslhelics*

(Continued)
Method ol Adminis-

Concen-

lrolion
Topicol

Agenl

lrolion/
Dosa

Commenls
High potency; ropid

Cocoine
Tetrocoine
(Pontocoine)

2-10././
200 mg

obsorption through mucous membrones OphtholmiC usej ropid onset

Topicol

O,solo/drops

amounts -::er drugs administered -:picol Aneslhesio

igrnis mq1_be requir.ed such as haloxone/Na;;;;';; :umazenil/Jlazicon. The. circulato, ."tpfetes the anesrhetie record including ao."-""ti"g.-the "i." times :he beginning and the term"ination of1fr""p"o""Or"", of ,rlblogd nressure at appropriare intervats, .:fr"''fl::,i11

-.::,n drugs to re\-er.se. the effects of the aforementioned

i:o

rne trmes and

of anesthetic agents or any

.All conduction onesthetic ogents, when odministered in greoier thon recommended dosoges or if occidentolly given- iniro_ (or by idiosyncro.iic reoctjon), moy couse eitreme venously ogitotion, convulsions, cordioc orrest, ond deoth, Resusciiotive equipment ond drugs must be immediotely ovoiloble whenever
This

:hetic agent as a liquid .of"tio",'Jv"arti., of an anes_ nent, arid/or spray to.the site of the .".g;;;;leilv, oirrtsee Table J-2. f,ocal or general anesthesia to
The preceding chart lists only several of the more :omrnonly employed agents for adult putierris. Numer_ :us oth-er agents can be utilized i;.I;J;; t[ose re_ servedfor pediatric patients. In addition,-u-*la. u""uy :,t ancillary
supplement these anesthetics.,

Topical anesthesia is the direct application

-uti;;;q"ired

lhese ogents ore employed, chort lists only severol of the most commonly used onesthetjc ogents primorily for odult potients. Additionoi ogents ore em?Plgq_qgligrlorty for pedjorric surgeries, Num6rous oncjlory orugs tnctuding muscle reloxonis, tronquilizers, norcotics, onil omnestic ogents likewjse hove not been listed os use of these ogents vories widely between onesthetists ond institutions.

Locol Anesthesio Local anesthesia is frequently used for lesser proce_ dures and many plastic surgeries, ophthalmic proce_

patient and administer supplementai sedation or even

general anesthesia as required.

ministers the anesthetic. With few exceptions an intravenous line is inserted. When ,,anesthesia standby" is requested, the anesthetist will monitor the

dures, anorectal procedures, and.o orr. The surgeon

ad_

When an anesthetist is not present, the circulator will insert an intravenous line (in accordance with hos_ pital policy), place ECG electrodes and pulse oximeter, and monitor the patient,s vital signs, Llood pressure, and ECG. At the direction of the surgeon, the circula_ tor may administer various drugs paienterally includr^ng,narcoticr (g C:, morphine, keperidine, fentanyl/ Sublrmaze, or Sufentanil), sedatives (e.g., diazepam/ Valium, ortrydroxyzineA/istaril), urd agii. that have an amnestic effect (e.g., midazolam/Ve-rsed). On occa_

tained.by the surgeon to.complete operabive orders. or dictation. rmmediately available, the

-"flipi" ciai medications. The chart.may

agents, including muscle ."iu"urrt., t"ur. narcotics. and amn"esti. ug""t., ni not l;,i-r1i?"f lsreo oecause therr use varies widely among been anes_ thetists and institutions. completion of the surgical procedure, placement -On ,:f dressings, and so on, the iir."futo"-u..o-ianies the recovery. room. White tn" p"li"i,t is repo:,i::"^1,,,:^,h: necessary) for.movemenr onto :i:r:::i l?:bed or frame).. i.ntravascular the surney ,or spectal lines. urinary catheter, splinted extremities, u"a,o o" a"e'i"ote.tuO. The security of the airway. is the ,".p"".iliiity of the anesthetist. Wherr rhe paiient h", b;;;;"aitlou.ly rransported to the recovery room, the anesihesia and records, special appliun.e., ;;";; on are 1p-_"-*ti"" recovery room ill:",ro,rnurecovery room nurse. The circulator renurse any significant intra_ ryl::9 the rperauve events as a severe fluctuation in cardiovas_ rular or pulmonary functions, drugs, and/or the need fo" ""y ""t"."rd r"eaction to t*;;;;;. or

il;;;;"r"ily re_ opl""ii""'*t"s, postif th" .h;;t is not *iff "i*c"iaio" "iii." the re_

spe-