ANAESTHETICS

By Dr. Vijaya R, MD(Ay)

HOD, PKAMC&PGC
• A general anaesthetic is an agent used to
produce a reversible loss of consciousness and
sensation.
• The term surgical anaesthesia is defined as the
total unawareness of environment without
appreciation of pain or other sensory
perception and without the memory of
experience.
 The features of anaesthetics are –

• Reversible loss of consciousness

• Reversible loss of sensation
• Analgesia and amnesia
• Muscle relaxation and abolition of reflexes
 A single anaesthetic drug cannot produce all
the above effects, hence the protocol includes—
• Premedication
• Induction of anaesthesia
• Maintenance of anaesthesia
• Skeletal muscle relaxation
• Analgesia
• Uses of other drugs – to reverse neuromuscular blocade
and to reverse the residual effects of opioids and
benzodiazepines.
Types
• General anaesthetics
• Local anaesthetics
General anaesthetics : The main site of action is reticular
formation. Most of the drugs depress the reticular
formation by enhancing the activity of inhibitory
transmitters and blocking the activity of excitatory
transmitters.
Stages
1. Stage of analgesia - The patient is conscious but
drowsy.
2. Stage of excitement – Loss of consciousness, increase
of sympathetic activity, i.e., elevation of HR, BP,muscle
tone, dialated pupil and irregular breathing.
 3. Stage of surgical anaethesia – Regular respiration,
relaxation of muscles, loss of reflex and paralysis
of intercostal muscles.
4. Stage of medullary paralysis – Depressed
respiration and vasomotor centre, death occurs
within few minutes.
Classification of drugs

• Injections – Opioids (morphine/pethedine) and non-opioids

(barbiturates/benzodiazepines)
• Inhalers – Volatile liquids (halothane, ether, chloroform) and gases
(nitrous oxide)
Local anaethetics

• The agents that prevent the transmission of nerve impulse without

causing unconsciousness.
• Applied topically or injected locally.
Types
• Surface anaesthetics – Lignocaine, Cocaine, etc.
• Injectible anaesthetics
– Short acting with low potency; eg., Procaine
-- Intermediate acting with intermediate potency;
Eg. Lignocaine
-- Long acting with high potency; eg., Tetracaine
• Spinal anaesthesia – injected into sub-arachnoid space (L2-L3 or
L3-L4).
Actions influenced by -

• Site of injection
• Amount of fluid injected
• Force of injection
• Specific gravity of the drug solution
• Position of the patient
Advantages
No loss of consciousness, good analgesia, good
muscle relaxation, can tolerate the patient with
cardiac, pulmonary and renal complaints.
Epidural anaesthesia

• Injected to epidural space of thorasic, lumbar or sacral

regions.
• Act on spinal nerve routes.
• Mostly used in labor.
• Needs large quantity of drug.
Qualities of ideal anaesthetic drug
• For the patient - Non irritating, fast recovery, no side
effects.
• For the surgeon – Provide adequate anaesthesia
• For the anaesthetist – Controllable administration, easily
storable, cheap and stable.