ANESTHESIA TECHNIQUES
GENERAL ANESTHESIA
General anesthesia is the abolition of pain or sedation by a temporary reversible
loss of consciousness.
Premedication
Anxiolytics - decreases anxiety
Midazolam, Benzodiazepine, Diazepam
Anti-emetics – to reduce nausea or vomiting
Ondansetron, Metoclopramide
Antacids –
Ranitidine
Anti-sialagogues – to decrease tracheo-bronchial secretions
Atropine, Glycopyrolate
Antibiotics – to decrease infections
Amoxicillin, Cephalosporin
Analgesics – opioids
Morphine, Fentanyl
Pre-oxygenation
It is done to reserve oxygen saturation so
that the patient doesn’t go into hypoxia
during the intubation. The intubation takes
time where the patient’s airway is blocked
and saturation might drop. Pre-oxygenation
is done for 3 minutes where FiO2 = 100%.
,Induction
IV agents
Propofol – mostly used
Thiopentone sodium – for an epileptic patient exclusively
Ketamine – pediatrics
Inhalational agents
Isoflurane – mostly used
Sevoflurane - pediatrics
Muscle relaxants
Succinyl choline – depolarizing agent given before intubation (or for
short time procedures)
Atracurium, Vecuronium – non depolarizing agents (mostly used) –
maintenance relaxants
Intubation
Oral or nasal intubation
Direct laryngoscopy, video
laryngoscopy or fibreoptic
bronchoscopy can be done to
aid intubation.
The patient end of the
infraglottic airways reach the carina of the trachea
The patient end of the supraglottic airways reach the larynx.
Cuffs of the tubes are inflated with cuff syringe
, Auscultate for lung sounds to confirm the airway position.
The tube is then secured with tapes.
Maintenance of anesthesia
Oxygen + inhalational agent + nitrous oxide + Atracurium or
Vecuronium
Maintenance is done until suturing is complete.
Reversal
Neostigmine + Glycopyrolate (myopyrolate inj)
Glycopyrolate is given to reduce secretions caused due to neostigmine
Extubation
Suction the airway
Deflate the cuff
Remove the intubated
airway
Oxygenate the patient
through face mask
Disconnect the monitors
Monitor the vitals
GENERAL ANESTHESIA
General anesthesia is the abolition of pain or sedation by a temporary reversible
loss of consciousness.
Premedication
Anxiolytics - decreases anxiety
Midazolam, Benzodiazepine, Diazepam
Anti-emetics – to reduce nausea or vomiting
Ondansetron, Metoclopramide
Antacids –
Ranitidine
Anti-sialagogues – to decrease tracheo-bronchial secretions
Atropine, Glycopyrolate
Antibiotics – to decrease infections
Amoxicillin, Cephalosporin
Analgesics – opioids
Morphine, Fentanyl
Pre-oxygenation
It is done to reserve oxygen saturation so
that the patient doesn’t go into hypoxia
during the intubation. The intubation takes
time where the patient’s airway is blocked
and saturation might drop. Pre-oxygenation
is done for 3 minutes where FiO2 = 100%.
,Induction
IV agents
Propofol – mostly used
Thiopentone sodium – for an epileptic patient exclusively
Ketamine – pediatrics
Inhalational agents
Isoflurane – mostly used
Sevoflurane - pediatrics
Muscle relaxants
Succinyl choline – depolarizing agent given before intubation (or for
short time procedures)
Atracurium, Vecuronium – non depolarizing agents (mostly used) –
maintenance relaxants
Intubation
Oral or nasal intubation
Direct laryngoscopy, video
laryngoscopy or fibreoptic
bronchoscopy can be done to
aid intubation.
The patient end of the
infraglottic airways reach the carina of the trachea
The patient end of the supraglottic airways reach the larynx.
Cuffs of the tubes are inflated with cuff syringe
, Auscultate for lung sounds to confirm the airway position.
The tube is then secured with tapes.
Maintenance of anesthesia
Oxygen + inhalational agent + nitrous oxide + Atracurium or
Vecuronium
Maintenance is done until suturing is complete.
Reversal
Neostigmine + Glycopyrolate (myopyrolate inj)
Glycopyrolate is given to reduce secretions caused due to neostigmine
Extubation
Suction the airway
Deflate the cuff
Remove the intubated
airway
Oxygenate the patient
through face mask
Disconnect the monitors
Monitor the vitals
