Anaesthesia

Anaesthesia
 Types –
 General
 Regional- 1. Topical.
2. Infiltration.
3. Nerve Block.
4. Spinal.
5. Epidural.
 General anesthesia -
 Reversible loss of all sensations &
consciousness with muscle relaxation &
abolition of all reflexes.
 Types –
 Spontaneous.
 Controlled.
 Stages-
 Induction.
 Maintenance.
 Reversal.
 Anaesthesia
 General Anaesthesia-
 Anesthetic Agents- Ether, Nitrous
Oxide, Ketamine.
 Muscle Relaxants- Scoline, Vecuronium,
Atracurium.
 Reversal Agents- Neostigmin with
Atropine.
 General anesthesia -
 Advantages –
 Pt. not aware of surroundings.
 Complete analgesia.

 Respiration can be controlled.

 All protective reflexes abolished.

 Un co-operative patients.
 Anaesthesia
 Complications-
1. Myocardial depression & Cardiac
arrest.
2. Hypertension.
3. Laryngeal & Bronchial Spasm.
4. Cardiac Arrhythmias.
5. Respiratory Failure.
6. ARDS.
7. Hypoxia.
 Anaesthesia
 Complications-
8. Pneumothorax.
9. Anaphylaxis.
10. Hypothermia.
11. Mendel son's Syndrome-
Bronchospasm, Pulmonary oedema
& circulatory failure.
 Regional Anaesthesia-
 Reversible depression of nerve
conduction leading to temporary loss
of sensation & relief of pain because
of interruption of nerve conductivity,
behind the point of application in a
restricted area.
 Regional Anaesthesia-
 Drugs Used-
 Lignocaine
 Xylocaine.
 Regional Anaesthesia-
 Topical Anaesthesia-
 Used in surgeries of eye, laryngoscopy,
endoscopy.
 4% solution used.
 Regional Anaesthesia-
 Infiltration block-
 I&D
 Excisions.
 Regional Anaesthesia-
 Nerve Block-
 Finger block.
 Ankle block

 Intercostal block.
 Regional Anaesthesia-
 Spinal Anaesthesia-
 Injection into subarachnoid space.
 Causes loss of sympathetic tone,
sensation & motor function.
 Spinal Anaesthesia-
 Advantages-
1. Economical.
2. Hypotension reduces bleeding.
3. Muscle relaxation achieved.
4. Less respiratory complications.
 Spinal Anaesthesia-
 Complications-
1. CSF leak.
2. Aseptic inflammation of meninges
causing head ache
3. Infection.
 Regional Anaesthesia-
 Epidural Anaesthesia-
 Space between dura anteriorly &
ligmentum flavum posteriorly.
 Has negative pressure inside.
 Epidural Anaesthesia-
 Advantages-
1. Used for continuous repeated
prolonged anaesthesia.
2. Used for post-op analgesia.
3. Can be kept for several days.
 Incisions-
 General principals.
 Abdominal incisions.
 Suture materials-
 Absorbable-
 Catgut.
 Chromic catgut.
 Vicryl.
 Monocryl.

 Uses-
 Bowel anastamosis.
 muscle., peritoneum, mucosa.
 Ligation of pedicles.
 Suture materials-
 Non-absorbable-
 Silk.
 Prolene.

 Ethylene.

 Linen.

 Cotton.

 Clips.
 Suture materials-
 Numbering.
 Biopsy-
 Procedure involving removal of cells
or tissues, partly or completely for
histopathological examination.
 Biopsy-
 Types-
1. FNAC.
2. Core needle biopsy.
3. Vacuum assisted biopsy.
4. Punch biopsy.
5. Open surgical biopsy.
 Open surgical biopsies-
1. Incisional biopsy.
2. Shave biopsy.
3. Edge biopsy.
4. Excision biopsy.
 Drains-
 Tubing/material kept in a cavity to
remove or prevent any fluid
collection in the cavity.
 Drains-
 Uses-
 Prophylactic-
 To abolish dead space.
 To remove anticipated discharge.

 Therapeutic-
 When there is an established collection of
fluid/air.
 eg:- Pneumothorax, Abscess,
 Drains-
 Types-
1. Closed drains.
2. Open drains.
 Closed drains-
1. Suction drains.
2. Non suction drains.
 Open drains-
1. Gauze drain.
2. Rubber drains-
1. Glove drains.
2. Corrugated rubber drains.
3. Tube drains-
 Eg.- malecot’s, ADK, T-tubes.
 Endoscopy-
 Looking inside the body & organs for
medical reasons an instrument
called endoscope.
 Endoscopy-
 Types-
1. Upper GI endoscopy.
2. Colonoscopy.
3. Bronchoscopy.
4. Cystoscopy.
 Endoscopy-
 Uses-
 Diagnostic.
 Therapeutic.
 Radiological Diagnostic
Procedures-
1. Projection radiography.
2. Fluoroscopy.
3. Ultrasound scanning.
4. C.T scanning.
 Projection radiography-
 Electromagnetic radiations are
passed through body.
 Radiation tends to pass through less
dense materials like muscle, air , fat.
 Radiations are absorbed or scattered
by denser materials like bones, some
tumors.
 Fluoroscopy-
 Special X-ray technique.
 A fluorescent screen or image
intensifier tube is connected to a
closed-circuit television system.
 Ultrasonography-
 Uses ultrasound (high-frequency
sound waves) to visualize soft tissue
structures in the body in real time.
 No ionizing radiations used.
 CT scan-
 In CT, an X-ray generating tube
opposite an X-ray detector (or
detectors) in a ring shaped
apparatus rotate around a patient
producing a computer generated
cross-sectional image (tomogram). 
 MRI scan-
 Uses strong magnetic fields to align 
atomic nuclei (usually hydrogen protons)
within body tissues, then uses a radio
signal to disturb the axis of rotation of
these nuclei and observes the radio
frequency signal generated as the nuclei
return to their baseline states plus all
surrounding areas. The radio signals are
collected by small antennae, called coils,
placed near the area of interest.