What do we understand anesthesia to be
- No memory**
- Loss of consciousness
- Loss of senses
- Immobility
- Abolition of reflexes
Sympathectomy
Def
Website: the cutting of clamping off of the sympathetic nerve chain. Keeps signals from passing through it
Modern history of Anesthesia
Name some individuals credited with discovery of inhaled anesthetics
Joseph Priestley- NO Crawford Long- Ether Horace Wells- NO William Morton- Gaseous Ether James Simpson- Chloroform
What assisted in their credit for discovering these anesthetics?
Documentation publishing, talking, etc
Alice Magaw
Known as Mother of Anesthesia
- @ St Mary’s Clinic= later Mayo Clinic
- Specialty: Published her use of ether/chloroform with OPEN DROP TECHNIQUE
- No Complications
- Later Taught…MDs, etc
Agatha Hodgins
- Began 1st NA program and Founded AANA (NANA 1931- AANA 1939)
General Triad of Anesthesia
- Analgesia
- Hypnosis
- Muscle Relaxation
TRIANGLE
ED50 Dosing
Web: “median effective dose”= dose that produces quantal effect (all or nothing) in 50% of the population that takes it
-effective dose for 50% of people receiving drug
ED95
Web: dose required for desired effect in 95% of population exposed to it
Ex. Non- depolarizing agents= median dose required to achieve 95% reduction in maximal twitch response from baseline, in 50% of the population
Dyad of Regional Anesthesia
- Analgesia
- Muscle relaxation
TRIANGLE with both at bottom points
Ex. Spinal/ Epidural …conditions for no pain,movement (abolition somatic/ Autonomic reflexes etc.
Local Anesthesia
-Anesthetic drug usu injected into tissue to numb specific location required for surgery
Regional
Ex. Epidural, Spinal, and PNB (peripheral nerve block)
-provides numbness to much larger area
MAC
- Monitored anesthetic Care (MAC)
- Use sedatives, other agents but dosage low enough that pt remains responsive
- Breathes w/o assistance
- Use: Simple procedures; minor surgery
General Anesthesia
- Deep state of sleep= Pt loses consciousness and Sensation
- Usu requires assisted ventilation
Combination techniques
-MAC/sedation and Local/regional anesthesia, Regional. And general etc.
***MAC= Billing term
Anesthesia vs Sedation
- Minimal Sedation (Anxiolysis)
- Moderate Sedation (Consious Sedation)
- Deep Sedation (Analgesia)
- General Anesthesia
Minimal Sedation
- Anxiolysis
- Pt reponds to normal verbal commands
- Cog function/Coordination may be impaired
- Vent/ Cardio functions= unaffected!
Moderate Sedation
- Analgesia (Concious sedation)
- Pts respond purposefully to verbal cmds either alone or by light tactile stim
- No interventions needed to maintain patent airway
- Spontaneous vent adequate
- CV function usu maintained
Deep Sedation
- Analgesia
- Not easily arroused
- Responds purposefully following repeated/ painful stim
- Independent ability to maintain vent function/ patent airway MAY BE IMPAIRED
- CV function maintained
General Anesthesia
- Not arousable even by pain stim
- Independent vent function impaired
- Requires assistance maintaining Airway; PPV may be req
- CV function may be IMPAIRED
