I have many things to be posted here, but the time seems to be unkind, I need to steal time in order for me to write freely here, without interruptions.
** I've got to beat the time!
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General anesthesia
General anesthesia (GA) causes total loss of sensation, and complete loss of consciousness in the patient. They are administered by inhalation of certain gases or vapourized liquids, intravenous infusion, or rectal induction.
Example of inhalant anesthetics: Isoflurane, Nitrous oxide, desflurane, halothane, thiopental
The induction of inhalant anesthesia is divided into 4 stages.
Stage 1
Refers as stage of analgesia (reduce pain sensation) and induction (conscious to unconciousness). During this period, patient experiences dizziness, sense of unreality, and less sensitivity of pain. Patients sense of hearing is increased and and response to noises are intensified.
Stage 2
Stage of excitement. During this period, there is a variety of reactions involving muscular activity and delirium. Patient may become very aggressive. All the reflexes still present and may appear exaggerated. Patient may exhibit involuntary excitement in the firm of rapid movement of the limbs, vocalisation and struggling.
Stage 3
Surgical and operative stage. It is subdivided into 4 planes (Plane 1- plane 4)
Plane i
- Respiratoty pattern becomes regular
- Involuntary movement cease
- Eyeball rotates ventrally
- Pupils may be partially constricted
- Depressed swallowing reflexes (to insert endotracheal tube)
Plane ii
- Increased heart rate and respiration rate
- Patients unconscious and immobile
- Eyeball central or ventral
- Skeletal muscle become relax
- Protective reflexes lost
Plane iii
- Patient deeply anesthetised
- Pulse strength reduce due to reduce blood pressure
- Increase capillary refill time
- Eyeball become central
- Pupils moderately dilated
- Absent reflex activity
- Skeletal muscle relaxation
Plane iv
- Rocking ventilation
- Decrease ventilation
- Fully dilated pupils
- Absence of pupillary reflex
- Eyes become dry due to absence of lacrimal secretion
- Muscle tome flaccid
- Depression of CVS (drop heart rate and blood pressure)
- Pale mucous membrane
- Prolonged CRT
This stage is in danger in respiratory and cardiac arrest.
Stage 4
**Due to increase past stage 3!!
- Cessation or respiration (skeletal muscle too relax)
- Circulatory collapse
- DEATH!
**Immediate resuscitation is necessary to save patient's life
Recovery (not include in the stage of anesthesia)
Begins when the concentration anesthetics agent in brain decrease (varies in anesthetic agents).
Summary of stages of anesthesia
Sources; Veterinary anesthesia and analgesia 3rd edition, Mosby publication, General anethesia www.tpub.com
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