Anesthesia Flashcards
Define Anesthesia.
‘sedation of a patient for the purposes of a medical procedure/intervention’
4 Types of Anesthesia.
- Local Anesthesia
- Regional Anesthesia
- General Anesthesia
- Monitored Anesthesia Care
Local Anesthesia
Localized loss of sensation in a specific area of the body. Used for minor procedures.
Regional Anesthesia.
Loss of sensation in a region of the body (ex. arm)
General Anesthesia.
Systemic Effect (giving via IV or inhalation) Complete loss of consciousness. Used for major, invasive procedures.
Monitored Anesthesia Care.
Also known as conscious sedation. A type of low dose sedation that is administered through an IV to make the patient sleepy and calm during a procedure. The patient is awake, but groggy, and is able to follow instructions as needed. CNS depressant!
What Drug Class are Local Anesthetics?
Sodium Channel Blockers
-The sodium influx into the neurons is blocked, inhibiting action potential. Therefore there is no cellular depolarization resulting in no communication of sensory information to the cerebral cortex.
Which nervous system pathway is affected?
Efferent and Afferent!
Kinetics of Local Anesthetics.
- Lipophilic
- Cleared via circulation and hepatic metabolism
- Does not cross the blood-brain barrier
- Onset of less than 2 minutes
- The duration must match the duration of the procedure
Local Anesthetic Medications.
Prilocaine, Lidocaine, Bupivicaine, Ropivicaine
Routes for Administrations for Local Anesthesia.
- Topical: on the surface of the location
- Infiltration: SC injection into the tissue
- Nerve block: SC injection near a large nerve bundle
- Epidural: Injection of an anesthetic into the epidural space
- Spinal: Drug delivered directly into CSF (intrathecal space/subarachnoid space)
Adjunct Medications paired with Local Anesthesia.
- Epinephrine (adrenalin): localized vasoconstriction, increases the duration of anesthetic
- Sodium Bicarbonate: Alkalinization of the tissue in case of bacterial infection
- Opioids: Analgesia
Epidural Route: Local Anesthesia.
Injection of an anesthetic into the epidural space. Causes loss of sensation to the spinal nerves. Any level of the spinal column can be blocked (cervical, thoracic, lumbar).
- Onset: 20-30 minutes
- Continuous infusion via an indwelling catheter.
- DOSE IS HIGHER THAN FOR SPINAL ROUTE
Spinal Route: Local Anesthesia.
Drug delivered directly into CSF (subarachnoid space). Spinal anesthesia is performed by placing a needle between the lumbar vertebrae and through the dura to inject the anesthetic medication.
- Quick Onset
- Most Common Procedures: Abdominal, Pelvic
Nursing Considerations for Local Anesthesia.
- Monitor VS
- Test sensation and motor function
- Monitor for signs of hematoma
- Monitor for signs of infections
- Monitor Catheter Migration (epidural)
- Backache
- Monitor Signs of spinal cord injury.
