Seminar about:_

Anethesia and Surgical Instrument

Prepared by:
Hamid Saddam Ahmad
Noora Hashem Muhammad
Zahra Muhammad Ayoub
Raghad Abdel Karim Abdul latef

Under supervision:

Faisal sameen

2022-2021
 Anesthesia

When thousands of scientists and doctors were asked

about the greatest medical discovery that benefited
humanity in the last thousand years, their answers were
the same. It is "anesthesia". Anesthesia has
revolutionized medicine and therapy, making what was
impossible yesterday, possible today. The American
physician and poet Oliver U. Hotune was the first to
give anesthesia the name (anesthesia), which is a well-
known Greek word, meaning: loss of sensation.

Definition:

Anesthesia is defined as giving drugs that numb the

body, with the aim of performing major surgeries such
as: open-heart surgeries, or small procedures such as:
tooth extraction without feeling pain.

The type of anesthesia used in each procedure often

depends on each of the following:
- Type of surgery.
- The patient's health condition.
- The duration of the surgical procedure.
- The opinion of the anesthesiologist and the surgeon
responsible for the procedure.

Anesthesia is generally divided into three sections

1-General anesthesia.
2- Local anesthesia
3- Spinal anesthesia
1-General anesthesia
Purpose of :
It depresses the activity of the central nervous system, which
leads to loss of consciousness and a general loss of sensation
throughout the body. Sedation: Depresses the central nervous
system to a minimum degree, suppressing anxiety and creating
long-term memory of events, but without loss of consciousness.

Cause of the use :

The reason for using general anesthesia is because there are operations
that take long hours.
It will affect breathing.
It is performed on a wide area of the body.
It includes an essential organ in the body, such as the heart and brain.
It will cause severe bleeding in the body.
Very painful.
It causes severe stress to the patient.

Medicines used:

1-Nitrous oxide. 2-Propofol. 3-Fentanyl

 2-Local anesthesia:
Purpose of :
_To reduce the stress associated with surgery and to relieve
Pain after surger
_More commonly, it is used for pain caused by hemorrhoids,
Cracks, insect bites, and minor surgry
_It is also indicated for vaginal and rectal examinations, ear,
Cystoscopy,،and catheter
_Extraction or filling of the tooth and the removal of moles and
The removal of cataract in the eye and biopsy

Cause of the use :

This type is used to numb a small Part, which can be given as an
injection, spray, or ointment, And the .person is conscious
Medicines used:
1-Lidocaine 2-Tetracaine, or methocaine,
3-Cocaine is a local anesthetic

3-regional Anesthesia:
Purpose of :
1_Peripheral nerve block. A regional anesthetic is Injected near a
specific nerve or bundle of nerves to Block the sensation of pain from
the area of the body that Is nourished by the nerve. It is most commonly
used in Surgery of the arms, hands, legs, feet, thigh, and Face
2_Epidural and spinal anesthesia. A regional anesthetic is Injected near
the spinal cord and the major nerves that enter The spinal cord to prevent
pain from an entire area of the Body, Such as the lower abdomen, hips,
or leg

Cause of the use :

The use of regional
Anesthesia to prevent pain in a large area of the body, such as
An arm, leg, or abdomen. Regional anesthesia allows an
Operation on an area of the body without you being
Unconscious. The anesthetic is injected near a nerve, group of
Nerves, or the spinal cord
Medicines used:
1-bupivacaine 2-Chloroprocaine. 3-Mepivacaine
Nursing care Before Anesthesia :_

1_Taking a health history

2_ measuring blood sugar, and fasting for 8 hours( only
drinking Water)
3_ don't smoking for a week,
4_ don't take antiplatelet medications such as (aspirin),
5_ preoxygenate with 100%for 3min or deep breath over for 1
Min.
6_medicines are given intravenously in the arm 7_ cover
eyelides.

Nursing care Before Anesthesia :_

1-Anesthesia awareness can cause adverse psychological

symptoms in patients after surgery. Although rare,
posttraumatic stress disorder (PTSD) has been documented in
surgical patients who have a history of previous trauma or
maladaptive coping patterns.
2-Plastic surgical nurses should assess all patients for
anesthesia awareness postoperatively, recognize the diagnostic
criteria of PTSD, and offer support of psychiatric referrals if
indicated.
 *Classification of surgical instruments*
*A- Retracting and Exposing instruments*
Used to hold back or retract organs or tissue to gain
exposure tothe operative site
1- A Deaver : used to retract deep abdominal or chest
incisions. Used in Cholecystectomy (removal of
gallbladder) for retraction of right lobe of liver.

2-Richardson Retractor is a 9-1/2" long retractor

that can be used during procedures, such as chest or
abdominal, to grasp soft tissue using the curved
blade.

3- Army-Navy is used in many cases, from small

wounds to abdominal operatio
 4- goulet : is used to retract shallow or superficial
incisions.

5- Malleable or ribbon : Used to retract deep

wounds. May be bent to various shapes to assist in
holding back tis

6-Weitlaner : Is a self-retaining retractor commonly used

in herniotomy, plastic surgery, bone and joint
procedures, and mastoid surgery. It is also useful with
small, deep incisions and soft tissue dissection at a
superficial level
7- retractor is often used in smaller surgical
procedures. Gelpi is self-retaining retractor with ratchets
and locking mechanism. It keeps the site open once
placed in position without any further assistance.

8- Balfour Retractors : Are widely used in laparotomy

practices to hold the incision or wound opening. It may
also be used for particular abdominal methods ..

*B- Cutting and Dissecting* : These instruments usually

have sharp edges or tips to cut through skin, tissue and
suture material. Surgeons need to cut and dissect tissue to
explore irregular growths and to remove dangerous or
damaged tissue. These instruments have single or double
razor-sharp edges or blades.
1- surgical scissors: Used during an operation in
order to cut tissues at the surface or inside the
human body. The blades can be either curved or
straight.

- Straight-bladed Mayo scissors are designed

for cutting body tissues near the surface of a
wound.
- The curved style of Mayo scissor is used to
cut thick tissues such as those found in the
uterus, muscles, breast, and foot.

2- Surgical Knives/Scalpels. A scalpel is a bladed

surgical instrument used to make cuts into the
body. This is a very sharp instrument and comes
in various sizes for different types of cuts and
surgeries.

♦ 3 handle with 10 blade (inside knife) – Used

to cut superficial tissue.

♦ 4 handle with 20 blade (skin knife) - Used to

cut skin.
 ♦ 7 handle with 15 blade (deep knife) - Used to
cut deep, delicate tissue.

*C-Clamping and Occluding Instruments*

are used to compress blood vessels or hollow organs
for hemostasis or to prevent spillage of
contents.

1-Hemostat forceps: available in curved and straight

varieties,are used to control bleeding by
clamping and holding blood vessels so cauterization
or ligation can be performed.
Hemostat forceps can also be used for fine tissue
dissection and to hold small sutures.
2-A mosquito is used to clamp small blood vessels Its
jaws may be straight or curved

3- A Kelly is used to clamp larger vessels and tissue.

Available in short and long sizes.
4-A burlisher is used to clamp deep blood vessels.
Burlishers have two closed finger rings. Burlishers with
an open finger ring are called tonsil hemostats.

5- A right angle is used to clamp hard-to-reach vessels

and to place sutures behind or around a vessel.

6- A hemoclip applier with hemoclips applies metal

clips onto blood vessels and ducts which will remain
occluded.
*D-Grasping and Holding Instruments*
are used to hold tissue, drapes or sponges.
1- An Allis : Is used to grasp tissue. Available in short
and long sizes.

2- A Babcock : Is used to grasp delicate tissue

(intestine, fallopian tube, ovary). Available in short
and long sizes

.
3- A Kocher is used to grasp heavy tissue. May also
be used as a clamp. The jaws may be straight or
curved.

4- A Foerster sponge stick is used to grasp sponges ,

Other names: sponge .

5- dissector Surgery: Are used to separate one tissue

or tissue plane from another
 6- The Backhaus towel clamp : Is a perforating
clamp used for grasping tissue, securing towels or
drapes, and holding or reducing small bone
fractures.

7- thumb forceps : are spring forceps used by

compression between your thumb and
forefinger and are used for grasping, holding or
manipulating body tissue.

8- Tissue Forceps: Non-toothed forceps used for

fine handling of tissue and traction during
dissection
9- Adson pick ups are either smooth: used to
grasp delicate tissue; or with teeth: used to grasp the
skin.

10- Long smooth pick-ups are called dressing

forceps. Short smooth pick-ups are used to grasp
delicate tissue.

11- DeBakey forceps are used to grasp delicate

tissue, particularly in cardiovascular surgery.
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