INTRO TO ANESTHESIA

SFC HILL

Joint Special Operations Medical Training Center

ANESTHESIA
ANESTHESIA - Partial or complete loss of sensation with or with out loss of consciousness as result of disease, injury, or administration of an anesthetic agent, usually by injection or inhalation.

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HISTORY OF ANESTHESIA PRIMITIVE TECHNIQUES

Club Strangulation Alcohol Mesmerism Plants

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HISTORY OF ANESTHESIA INHALATION AGENTS

Nitrous Oxide
1799 Davy 1824 Hickman 1844 Wells

Modern Agents
Halothane 1956 Enflurane 1972 Isoflurane 1981 Sevoflurane and Desflurane

Ether
1842 Long 1847 Snow

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HISTORY OF ANESTHESIA LOCAL/REGIONAL

1836 needle trochar 1844 hollow needle 1851 syringe 1884 Koller opthalmic anesthesia 1885 Hallstead/Hall local/regional blocks 1898 Bier spinal

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ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 1 (Amnesia): From induction of anesthesia to loss of conciousness (loss of eyelid reflex). Pain perception threshold is not lowered.

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ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 2 (Delirium/Excitement): Characterized by uninhibited excitation. Pupils are dilated and eyes divergent. Agitation, delirium, irregular respiration, and breatholding are commonly seen. Potentially dangerous responses can occur during this stage including vomiting, laryngospasm, HTN, tachycardia, and uncontrolled movement.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 3 (Surgical Anesthesia): Central gaze,constricted pupils, and regular respirations. Target depth of anesthesia is sufficient when painful stimulation does not elicit somatic reflexes or deleterious autonomic reflexes.

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ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 3 Plane 1 From the return of regular respirations to the cessation of REM.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 3 Plane 2 The Surgical Plane From the cessation of REM to the onset of paresis of the intercostal muscles.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 3 Plane 3 From the onset to the complete paralysis of the intercostal muscles.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 3 Plane 4 From the paralysis of the intercostal of this plane the patient will be apneic. muscles to the paralysis of the diaphragm - at the end

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ANESTHESIA OVERVIEW STAGES OF GENERAL ANESTHESIA

STAGE 4 (Impending Death/Overdose): Onset of apnea, dilated and nonreactive pupils, and hypotension to complete circulatory failure.

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ANESTHESIA OVERVIEW COMPONENTS OF GENERAL ANESTHESIA

1. Unconsciousness (Hypnosis) 2. Analgesia (Areflexia) 3. Muscle relaxation

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