By; Rhyan G.

Tiopianco RN, MAN

Manuel S. Enverga University Foundation
College of Nursing and Allied Health Science
Introduction
 Anesthesia involves the administration of potentially
lethal drugs and gases in various methods.
 It depresses the nervous system.
 It induces the state of partial or total loss of sensation,
occuring with or without loss of consciousness, to
permit the performance of surgery or other painful
procedures.
 This condition is also concerned with controlling
motor, sensory, mental, and reflex functions.
Cont.
 The autonomic nervous system is equally important as
the central nervous system because of its role in the
physiology of the cardiovascular system.
Types of Administration of
Anesthesia
• General Anesthesia
 A state of unconsciousness is produced by anesthetic
agents, with the desired results of amnesia, analgesia, and
muscle relaxation. Sensation of pain all over the body is
controlled.

• Balanced Anesthesia
 Uses a combination of drugs, each in amount sufficient to
effect hypnosis, analgesia, and muscular relaxation to an
optimum degree and to keep undesirable effects to a
minimum. Referred to as Neuroleptanesthesia.
Cont.
• Local or Regional Block Anesthesia
 Produced in a limited area and does not affect the
consciousness of the client. The sensory nerves in one
area or region of the body are anesthetized. Referred to
as Conduction Anesthesia. One type of local
anesthesia is acupuncture.
Cont.
• Spinal or Epidural Anesthesia
 Produced by injecting an agent beneath the
membrane of the spinal cord. Sensation of pain is
blocked at a level below the diaphragm. Like local
anesthesia, there is no loss of consciousness in clients
which had been given spinal or epidural anesthesia.
Stages of Anesthesia
 Induction Stage
 Client begins to feel;
 Drowsy
 Dizzy
 Amnesic
 Loses consciousness
Cont.
 Excitement Stage
 Feels excited and has irregular breathing.
 He /She then shows movements of the extremities and
then feels relaxed, with slight hypnosis afterwards.

 Operative Stage
 Client experiences regular respiration.
 Contraction of the pupils.
 Loss of reflexes
 Muscle relaxation
 Loss of auditory sensation
 Depression of vital functions
Cont.
 Danger Stage
 Vital sign’s are too depressed.
 He /She exhibits no breathing
 Weak or absent pulse or heartbeat.
Techniques in Administering
General Anesthesia
 Inhalation – Nitrous oxide, Halothane (Fluothane),
Isoflurane (Forane), Sevoflurane (Sevorane)

 Intravenous injection – Propofol (Diprivan, Lipuro),

Ketamine Hydrochloride (Ketalar, Ketaject)
Adjunctive Drugs used in General
Anesthesia
• Narcotics – Fentanyl; Meperidine hydrochloride
(Demerol), Morphine Sulfate

• Narcotic reversal (Narcotic antagonists) – Naloxone

hydrochloride (Narcan)

• Muscle relaxant – Succinylcholine chloride (Quelicin)

• Muscle relaxant reversal agents (Cholinergics) –

Neostigmine methysulfate (Prostigmin), Adrophonium
chloride (Tensilon)
Adverse Effects of Administration
Techniques
 Mask Inhalation
 A significant amount of gas may leak into room air because of an
ill-fitting facemask.

 Endotracheal Administration
 May lead to the following complications:
 Trauma to teeth
 Pharynx
 Vocal cords
 Trachea
 Cardiac dysrhythmias
 Hypoxia and Hypoxemia
 Accidental esophageal or endobronchial intubation
Cont.
 Aspiration of gastrointestinal contents
 Tracheal collapse

Complications of General Anesthesia

 Aspiration – due to depression of pharyngeal and laryngeal
reflexes.
 MMR or Masseter Muscle Rigidity or Trismus – Jaw
tightness is brought about by malignant hyperthermia.
 Hypoxia – due to excitement, coughing, holding of breath,
vomiting, irregular respiratory patterns, or laryngospasm.
 Cardiac dysrhythmias – due to excessive suctioning
through the endotracheal tube.
Drugs used for Balanced
Anesthesia
 Intravenous drugs:
• Thiobarbiturate derivatives (Thiopental sodium
(Pentothal), Methohexital (Brevital))
• Diazepam (Valium)
• Midazolam (Dormicum)

 Inhalation drugs:
• Nitrous chloride
• Halothane (Fluothane)
• Isoflurane (Forane)
• Sevoflurane (Sevorane)
Adverse effects of Balanced
Anesthesia
It may produce a detached, apathetic state.
It may affect the behavior and attitude of the client
postoperatively. The client may manifest anger,
irritability and preoccupation with death.
Local and Regional Anesthesia
 Local Anesthesia
o Topical application
 Applied directly on the skin, mucous membranes, to a
serious surface, or into an open wound.
 Duration of anesthesia is from 20 to 30 minutes.

o Local infiltration
 Injected intracutaneously and subcutaneously into the
tissues at and around the incisional site to block
peripheral sensory nerve stimuli at their origin.
Cont.
 Regional Anesthesia
o Spinal and Epidural anesthesia
 Spinal and Epidural Anesthesia is injected between the
Lumbar 3 and Lumbar 4 levels.

• Spinal anesthesia (Intrathecal block)

 Prevents the transmission of impulses at the spinal ganglia
and motor roots.

• Epidural anesthesia (Peridural/ Extradural)

 The aesthetic diffuses toward the head (cephalad) and
toward coccyx (caudad).
Complications of Spinal and
Epidural Anesthesia
 Hypotension
 Transient or permanent neurologic complication from
cord trauma and loss of spinal fluid with decreased
intracranial pressure syndrome.
 True spinal headache
 Respiratory Paralysis
Complications of General
Anesthesia
 Aspiration
 Due to the depression of pharyngeal and laryngeal reflexes.

 Masseter Muscle Rigidity (MMR) or Trismus

 Jaw tightness is brought about by malignant hyperthermia.

 Sellick Maneuver – apply pressure on the cricoid cartilage

(the complete ring around the inferior wall of the larynx
below the thyroid cartilage prominence).

-prevents regurgitation and aspiration of

stomach contents.
END…
 Quiz
Answer the following question. No erasures and no
impositions.
11. __________involves the administration of potentially
lethal drugs and gases in various methods.
12. __________ uses a combination of drugs, each in
amount sufficient to effect hypnosis, analgesia, and
muscular relaxation to an optimum degree and to keep
undesirable effects to a minimum.
13. __________Sensation of pain all over the body is
controlled. What type of anesthesia is this?
Cont.
14. __________ The sensory nerves in one area or region of
the body are anesthetized. What type of anesthesia is this?
15. Give the four stages of anesthesia in order.
16.
17.
18.
19. Common complication of General Anesthesia to patient.
20. What type of Local Anesthesia that is injected
intracutaneously and subcutaneously into the tissues at
and around the incisional site to block peripheral sensory
nerve stimuli at their origin.