AKLAN STATE UNIVERSITY

School of Arts and Sciences

Bachelor of Science in Nursing
Banga, Aklan

In Partial Fulfillment of the Requirements in

Related Learning Experience

A Report about

Different Types of Anesthesia and

Types of Sutures / CS (instruments)

Submitted by:
Juana A. Nabalde BSN 3-2A

Submitted to:
LUCELLE ANN MACAHILIG, RN
Clinical Instructor

2021
TYPES OF ANESTHESIA

General Anesthesia
General anesthesia is most commonly used to keep you safe and pain-free
during major operations that require you to be unconscious. During General Anesthesia,
medications are given so patients are unconscious (“asleep”) and unable to feel any pain
during the surgical procedure. Some of these medications are given through an IV and
others are gases administered through a breathing mask or tube with oxygen. Some of
the side effects of general anesthesia include nausea, vomiting, sore throat, muscle
aches, shivering and confusion. General anesthesia is the most common type of
anesthetic administered.

IV/Monitored Sedation
Sedation is used to make you more comfortable and relaxed during minimally
invasive procedures, such as biopsies. Monitored Anesthesia Care involves the injection
of medications through an IV catheter to help you relax, as well as to block pain.
Your anesthesia team may use sedation when general anesthesia isn’t
necessary but a local anesthetic isn’t enough. Your anesthesiologist may use an
analgesic medication to relieve pain in combination with sedation, particularly for
outpatient surgeries.
Your anesthesiologist will provide sedation and, in some cases, analgesia,
through an IV placed in your vein. Depending on your procedure, age, and medical
condition, your sedation level may range from:
 Minimal – You will be drowsy but able to talk
 Moderate – You may fall asleep and be unaware of your surroundings for
some of the procedure
 Deep (“Twilight”) – You won’t be unconscious but you will have very
little memory of the procedure
Your anesthesiologist will stop the medication once the procedure is over, to
continue managing any pain, your doctor may give you additional analgesic medication,
or regional anesthesia to numb a specific area of your body. You will experience fewer
side effects than general anesthesia as you wake up, and you will likely recover more
quickly and go home sooner.
Regional Anesthesia
Regional anesthesia is used to numb a large part of the body to keep you
comfortable during procedures such as childbirth or orthopedic surgery. Regional
Anesthesiology entails injecting a local anesthetic near nerves to numb a portion of the
body. There are several types of regional anesthetics including spinal anesthesia,
epidural anesthesia and various specific nerve blocks. When Regional Anesthesia is
used, patients may be awake, sedated or put to sleep for their surgical procedure.
 Peripheral Nerve Block – Your anesthesia provider will use a small needle to
give you a single injection of medicine near a group of nerves. Depending on the
medication, you may experience 12 to 24 hours of pain relief.
 Epidural – Similar to a peripheral nerve block, an epidural requires your
anesthesia provider to place a thin tube, called a catheter, in your back. The tube
remains there throughout the procedure so your care team can deliver medicine
as you need it. You will start to feel numb within 10 to 20 minutes of the initial
injection and will experience no pain throughout the entire surgery. Following
surgery, you’ll continue to receive pain relief medication through the catheter.
 Spinal Block – Your anesthesiology doctor or nurse anesthetist will use a thin
needle to give you a single injection of medicine. You will feel immediate relief
that lasts 2 to 4 hours, depending on the medication used.

Regional anesthesia complications are rare but may include:

 Decreased blood pressure

 Mild itching
 Headache
 Allergic reaction to the local anesthetic

Local Anesthesia
Local anesthetics are one-time injections given to numb a small area of the body
for procedures such as receiving stitches or a skin biopsy. Local anesthesia medication
will be injected into the affected area using a small needle prior to your procedure. You
may feel slight soreness where the medication was injected, but side effects will be
minimal and recovery is often quicker than other types of anesthesia.
 Local anesthesia can also be used in combination with general or regional
anesthesia to numb areas where a needle or IV will be placed.

TYPES OF SUTURES

ABSORBABLE SUTURES
 Catgut Sutures
A catgut suture is a natural, monofilament absorbable suture which has
good tensile strength. The suture retains optimal strength in order to hold tissues
together. Catgut is a smooth and flexible suture with good knotting, and based on
its size, it completely disappears between 60 to 120 days. The eventual
disintegration of this suture makes it good to use in healing tissues rapidly.
 Polydioxanone Sutures
A type of synthetic monofilament suture, the polydioxanone suture or is
used to repair various kinds of soft-tissue wounds, abdominal closures. Surgeons
also use this suture during paediatric cardiac procedures.
 Poliglecaprone Sutures
The Poliglecaprone suture is a synthetic monofilament suture, generally
used to repair soft tissues. It is commonly used for the purpose of subcuticular
dermis closures on a patient’s face, and as a ligature. These sutures promote
scar-free, aesthetic healing. The suture material is used in case of vascular
anastomosis procedures that connect blood vessels.
 Polyglactin Sutures
The Polyglactin Suture comprises a synthetic braid, which is good to
repair lacerations on the face and hands and is the most preferred option for
general soft tissue approximation. Like the Poliglecaprone suture, this suture too
is used in of vascular anastomosis procedures. Polyglactin sutures typically have
a mild tissue reaction, for the duration of the absorption process but are a better
alternative to catgut sutures as the absorption level of this suture is more
predictable. Also, this suture exhibits little to no tissue reaction.

NON-ABSORBABLE SUTURES
 Some examples of non-absorbable sutures can be found below. These types of
sutures can all be used generally for soft tissue repair, including for both
cardiovascular and neurological procedures.
 Nylon. A natural monofilament suture.
 Polypropylene (Prolene). A synthetic monofilament suture.
 Silk. A braided natural suture.
 Polyester (Ethibond). A braided synthetic suture.

CS INSTRUMENTS

Allis clamp: Used to perform a “pinch” skin test to determine numbness prior to start of
surgery, used for AROM once bag is seen through incision, used to hold intestinal;
delicate structures.
Knife handle: (separate scalpel blade is attached) .Used to make incision in skin, uterus
Curved Kelly: aka hemostats, tags, snaps. Used for hemostasis, esp. vessels in
subcutaneous tissue, holds heavier abdominal tissue.
Straight Kelly: aka hemostats, tags, snaps. Used for hemostasis-esp. vessels in
subcutaneous tissue, holds heavier abdominal tissue
Richardson retractor aka “Rich”- Large, Medium, and Small: used to hold tissue (e.g.
skin, adipose, fasciia) out of the way, keeps abdomen open.
Forceps, aka “pick ups”: used to grasp tissue.
Kocher: clamps used to hold fascia (to retract)-note the tooth and notch on the tips.
Pean: used to clamp umbilical cord
Bandage Scissor: used to extend the uterine incision, cut the umbilical cord
Bladder blade: used to protect the bladder and retract the lower part of the abdominal
incision.
Goulet : a retractor
Long Ring Forcep: used with gauze e,g, 4x4 to absorb blood from site, or to clamp
such as membranes with placenta removal.
Penningtons: a rarely used clamp for heavy tissue-distinctive triangle shaped tips.
Babcocks: a clamp in a special shape for holding fallopian tubes.
Metzenbaum scissors: for snipping delicate tissue such as the peritoneum.
Russian: a special type of tissue pick-up, note the shape and pattern of the “teeth”.
 Needle Driver: holds needle for suturing.
Curved Mayo Scissor: used to cut heavy/ tough tissue (fascia).
Straight Mayo Scissor: used to cut suture
Addisons: a narrow tipped tissue pick-up used to pull the edges of the incision together
for closure.
Bovie Electro Cautery tip: for cauterizing bleeding tissues. Note: fire risk with
proximity of Chlorhexadine prep, this is why prep must dry for 3 minutes prior to draping.
Scratch Pad: used with Cautery tip for removing burnt matter buildup.
Yankauer suction tip: To remove fluids including amniotic fluid, irrigation fluid, blood.
Poole suction tip: used over incision to remove fluid when irrigated.

References:

https://www.medstarhealth.org/mhs/our-services/anesthesiology/for-patients/types-of-
anesthesia/

https://www.healthline.com/health/sutures#types

https://www.merillife.com/blog/medtech/types-of-surgical-sutures-and-their-uses

http://www.ashnha.com/wp-content/uploads/2016/09/Facilitator-Guide-to-Surgical-
Instrument-Pictures-for-Cesarean-Surgical-Procedure.pdf