PST 04211: Basic pharmacology
Session 40:Description of General
and Local Anaesthetics
Indications of General and Local Anaesthetics
• General anaesthetics include;
• halothane,
• ketamine,
• isoflurane and
• thiopental
• while local anaesthetic include
• lignocaine
• bupivacaine
Indication of General anaesthetics include:
• Halothane is occasionally used for inhalation
induction of anaesthesia with careful monitoring for
cardiorespiratory depression and arrhythmias
• Ketamine is useful in induction and maintenance of
anaesthesia it is used during surgery and intubation
• Isoflurane is a volatile liquid anaesthetic It is used in
induction and maintenance of anaesthesia. It is useful
during surgery and intubation
• Thiopental is used in induction of general anaesthesia,
in surgery and intubation
Indication of Local anaesthetics include:
• Bupivacaine labour, and surgery.
• Lignocaine is used for minor surgical and
dental procedures.
Contraindication of General anaesthetics;.
• Halothane is contraindicated in the presence of a
tumour in the pharynx or larynx and in patients
with acute circulatory failure.
• Ketamine is contraindicated in raised intracranial
pressure, head trauma and porphyria.
• Isoflurane is contraindicated in breast feeding
• Thiopental is contraindicated in the presence of a
tumours in the pharynx or larynx). Also in acute
porphyria, myotonic dystrophy and breast-feeding
Contraindication of Local anaesthetics;
• Bupivacaine is contraindicated in hypovolemia,
complete heart blockade should not be used in
solutions containing adrenaline for anaesthesia in
appendages.
• Lignocaine like bupivacaine, it is contraindicated
in hypovolaemia, complete heart blockade
should not be used in solutions containing
adrenaline for anaesthesia in appendages
Side effects and adverse effects of general anaesthesia
• Halothane: severe hepatotoxic
• Ketamine: hallucinations, nightmares tachycardia,
hypertension, arrhythmias, hypotension, bradycardia increased
salivation, laryngospasm, anxiety, insomnia, raised intra-
ocular pressure and rashes at injection-site
• Isoflurane: irritation of mucous membranes causing cough,
and laryngospasm
• Thiopental; hypotension, arrhythmias, myocardial depression,
laryngeal spasm, cough, sneezing, hypersensitivity reactions,
Side effects and adverse effects of local
anaesthesia
• light-headedness
• sedation.
• convulsions can occur in severe reactions.
• respiratory depression, hypotension and
bradycardia
Interaction and precaution of general and local anaesthesia
• General anaesthetics which include Halothane,
Ketamine, Isoflurane and Thiopental have the
following interaction:
• Their hypotensive effect is enhanced when
given with adrenergic blocker, angiotensin ii
receptor antagonists, monoamine oxidase
inhibitors, tricyclic antidepressants, beta
blocker, and calcium channel blockers
• increased chances of convulsion when given
with theophyllin especially Ketamine
• increased chance of arrhythmias when given
with ocytocin and theophyllin
POINT TO NOTE
• Local agents provides effects on localized area
only while general exits its effects on the whole
body
• General agents cause loss of consciousness
while local doesnt cause it
• Main side effects are respiratory depression,
sedation
• Vital organs should be assed first before
adminstrations
QUESTIONS
• What do you understand about local and
general anaesthetics?
• Outline 3 general anaesthetic agents
• What things to consider before administration
of anaesthetic agents?
• Outline the interactions of local anaesthetics
Refference
• Katzung, Bertram G, Masters, Susan B, & Trevor, Anthony J. (2006).
Basic & clinical pharmacology (10th Ed).
• Ministry Of Health and Social Welfare. (2013). Standard Treatment
Guidelines &National Essential Medicines List Tanzania Mainland (4th
ed.). Dar es salaam, Tanzania government printers
• Rang, H. P., Ritter, J. M., Flower, R. J., & Henderson, G. (2014). Rang &
Dale's Pharmacology: Elsevier Health Sciences.
• Sally, S.R, Jeanne C.S. 2000. Introductory Clinical Pharmacology (6th
ed) New York, Lippincott, W., Wilkins R. & M (year) Title,
Journal/Book; Publisher.
