Friday, August 23, 2013

Anesthesia 5 General


GENERAL ANESTHESIA

General anesthesia is a reversible, drug-induced state of non-responsiveness to outside stimuli.

      With the use of agents such as the muscle relaxants, modern general anesthesia aims at a balance between ‘relaxation’, ‘analgesia’ and lack of awareness.

      General anesthesia is achieved by using intravenous or inhalational agents (gases or vapours)

     Patient receives a premedication one hour before the anesthetic procedure

     The next step to anesthesia is induction which can be achieved by administration of intravenous drugs or inhalation agents

     On induction, muscle relaxation is necessary to facilitate tracheal intubation. Relaxation during maintenance of anesthesia is also required.

Intravenous Inducting Agents

Intravenous anesthetic agents are used commonly in anesthesia as induction agent. Induction is more rapid and smoother than that associated with inhalational agents. Sometime for maintenance also, these agents can be used.

 

             The intravenous agents (IVA) can be classified as:

      A.  Rapidly acting agents:

             1.   Thiopentone (Barbiturate).

             2.   Etomidate (Imidazole compound).

             3.   Propofol (Phenol group).

             4.   Propanidid (Eugenol derivative).

      B.  Slower acting:

             1.   Ketamine (Phenocyclidine derivative).

             2.   Diazepam and other benezodiazepine derivative.

             3.   Morphine, fentanyl, alfentanyl, sufentanil (Narcotics).

             4.   Haloperidol, droperidol with opioids.
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