Anesthesia 2020.pdf

Anesthesia Introduction  Role of the anesthetist the central role of the nevertheless the greater part anesthetist are to protect the of the anesthetist's time is still patient from the pain and spent in the operating room, stress of surgical intervention con...

Anesthesia Introduction  Role of the anesthetist the central role of the nevertheless the greater part anesthetist are to protect the of the anesthetist's time is still patient from the pain and spent in the operating room, stress of surgical intervention controlling the physiology and and to preserve physiological the pharmacology of the homoeostasis during the surgical patient. It is this work perioperative period. The skills that the anesthetists alone developed in this field have possess the necessary skills. opened the doors to extension of practice into intensive care, resuscitation and the control of pain problems unrelated to surgery.  The meaning of anesthesia The word anesthesia is derived from the Greek, meaning insensible or without feeling. Its use in the present context is usually ascribed to the American poet Oliver Wendell Holmes who, following the first successful demonstration of surgical anesthesia in 1846.  Cont… Insensible or without feeling The term analgesia should does not necessarily imply be restricted to loss or loss of consciousness. The reduction of the sensation word analgesia derived from of pain, with relative Greek, means a state of preservation of other painlessness or insensibility modalities of sensation. to pain. Spinal and nerve block will normally produce more than analgesia, and anesthesia seems to be an entirely appropriate term.  General anesthesia Definition 4. Minimal autonomic response to A condition induced by surgical stimulation, although this pharmacological or other means cannot be totally abolished. which results in all of the following 5. The process should be reversible. effects. 1. Loss of awareness. 2. No recall of events at the conscious level. 3. Lack of overt muscular response to surgical stimulation, an exception is the respiratory musculature, which usually responds to surgical stimulation by an increase in pulmonary minute volume, even in deep anesthesia.  Regional anesthesia In many circumstances With correct dosage, the regional or conduction block drugs used for conduction offers great patient safety. block have minimal effects Regional anesthesia also has on cardiovascular, evident advantages when no respiratory, renal, hepatic or anesthetist is available. central nervous systems. Regional anesthesia can be used for almost any operation but has special value in surgery on the limbs, in urology and in obstetrics.  The evolution of anesthesia advances in the discipline over the past five decades have been great. The net effect has been greater safety for the patient. Mortality has been reduced dramatically in spite of the greatly increased complexity of surgical procedures and the acceptance of seriously ill patients who would not in the past have been considered fit for any type of surgical intervention. Anesthetic practice change little during its first hundred years.  Cont… Diethyl ether, with All of this changed spontaneous breathing, dramatically after Word War dominated the scene in II, partly because of 1946 as it had in 1846. recognition of the major anesthesia, once the contribution of the wonder of its age, had anesthetist in the care of become a lack- lustre branch severely injured patients, of medicine. and partly because of developments in clinical pharmacology, particularly drugs which blocked the neuromuscular junction. William Thomas Green Morton (August 9, 1819 – July 15, 1868) was an American dentist who first publicly demonstrated the use of inhaled ether as a surgical anaesthetic in 1846.