INTRODUCTION TO

ANESTHESIA
dr. Carla O. Pandrya. SpAn
Universitas Pelita Harapan
Faculty of Medicine
WORKING AREA
Operating room
Emergency department
Intensive care unit
Ancillary unit (MRI, endoscopic procedure, gamma knife, etc)
Pain clinic

OPERATING ROOM

GENERAL ANESTHESIA
DEFINITION:
drug-induced loss of consciousness during which patients
are not arousable, even by painful stimulation
CONSIST OF:
amnesia, analgesia, muscle paralysis
ADMINISTERED THROUGH:
Intravenous
Inhalational or
Combined



NEURAXIAL BLOCK
Produces sensory, motor and autonomic blockade for lower
abdomen, perineum, and lower extremity surgery
Spinal anesthesia:
the local anesthetic is instilled into LCS
Epidural anesthesia
instilled outside the duramater (epidural space)
TRACHEAL INTUBATION
INDICATIONS:
Airway protection
Needs for mechanical ventilation
Operation procedure

FOR AIRWAY PROTECTION:
Loss of gag reflex eg severe head injury
Airway obstruction eg acute laryngeal edema (inhalational burn,
epiglotitis, etc)
Anticipated loss control of the airway eg anticipated laryngeal
edema (neck trauma)
INDICATIONS FOR MECHANICAL VENTILATION:
Ventilation failure
Loss of ventilatory drive: stroke, brain injury
Spinal cord injury
Myastenia gravis
Flail chest, obesity
Acute lung injury

Oxygenation failure
Ventilation perfusion mismatch (pulmonary embolism, emphysema)

Inability to extract at cellular level (severe sepsis, cyanide or CO
poisoning)
EQUIPMENT


ANATOMY

HOW TO INTUBATE
Laryngoscope held with left hand
Open patients mouth insert blade to right side of oropharynx
The tongue swept to the left and up into the floor of pharynx by the
blade
The tip of curved blade is usually inserted to vallecula, while straight
blade to cover epiglottis
The handle of the blade then raised up and away from the patient in
a plane that perpendicular to patients mandibule

HOW TO INTUBATE
MALLAMPATI
CLASSIFICATION
is used to predict the ease
of intubation

REFERENCES
Clinical anesthesiology : Edward Morgan Jr. (Lange)
Clinical anesthesiology : Barrash