Types of anesthesia : A. General anesthesia - total loss of consciousness, and sensation , produces amnesi: iv inhalation and rectal. B.

Regional anesthesia reduces all painful sensation in one region of the body without inducing unconsciousness. Stages of anesthesia : 1. ONSET / INDUCTION extends from the administration of anesthesia to the time of loss of consciousness. 2. EXCITEMENT / DELIRIUM extends from the time of loss of consciousness to the time of lid reflex. It may be characterized by shouting, struggling of the patient. 3. SURGICAL extends from the loss of the lid reflex to the lost of most of the reflexes, surgical procedure is started. 4. MEDULLARY /STAGE OF DANGER respiratory/ cardiac depression or arrest. It is due to anesthesia overdose. CPR must be done. Positions during Surgery: 1. Dorsal recumbent (Supine) (Abdominal surgery ex. Colostomy & herniorrhaphy,Thorocic surgery (open heart surgery) Extremitites.) Ensure that knees are not flexed- to avoid compressing of blood vessels & sluggish circulation. Use trochanter rolls or other padding to avoid internal or external rotation of the hips and shoulders. 2. Semisitting position- Thyroid and neck areas. Assess hypotension; ensure that knees are not sharply flexed. Use soft padding to prevent nerve compression. 3. Prone position- spinal fusion and removal of hemorrhoids. To promote optimum respiratory function, raise the clients chest and abdomen and support and padding. 4. Lithotomy position- gynecologic, perineal, or rectal surgeries. Monitor respirations and assess for hypoxia and dyspnea. To avoid injury- ensure adequate padding and manipulate both legs into the stirrups simultaneously. 5. Jacknife position proctologic surgery (removal of hemorrhoids), Spinal surgery. Cause 12% decrease in vital capacity of the lungs. Monitor RR, assess for hypoxia and dyspnea.

DORSAL RECUMBENT

JACKNIFE POSITION

LITHOTOMY POSITION

SUPINE POSITION

PRONE POSITION

Categories of Surgery According to Urgency

1.Emergent This is to save life and limb. Is done within 24-48. (I.E. Accidents, Gun Shot Wounds, Stab Wounds) 2.Urgent There is an urgency to perform the procedure. It has to be done immediately. (I.E. Bleeding) 3.Elective: a.Optional. In an optional surgery, it is not necessarily forced or needed. (I.E. Cosmetic Surgery) b.Planned/Required. A planned or required surgery is needed to be done but not immediately. (I.E. Non Bleeding Hemorrhoids) 4. On the Day Surgery Out Patient Department (OPD); it does not require admission.