General Anesthesia

Question 1

What is general anesthesia

Answer 1

Drug induced LOC
*hypnosis, amnesia, analgesia, relaxation, loss of control, loss of autonomic nervous system

Question 2

What happens to the patient when under general anesthesia and what is required of the operation team

Answer 2

1. Patient is not arousable even with painful stimuli
2. Cardiovascular function may be impaired
3. Require assistance to maintain airway, ventilation (positive pressure)

Question 3

What are the components of general anesthesia

Answer 3

1. IV and inhalant form (usually both given)
2. Three normal phases (also a fourth phase)
3. Includes skeletal muscle relaxation
   *facilitate intubation of trachea
   *provide optimal surgical exposure

Question 4

What is stage one of general anesthesia (Guedels classification)

Answer 4

Stage one / induction
1. Period between the initial adminsitration of the induction agents and LOC
2. Progresses from analgesia without amnesia to analgesia with anemia
3. Can carry on a conversation at this time

Question 5

What is stage two of general anesthesia (Guedels classification)

Answer 5

Stage two / excitement stage
1. The period following LOC and marked by delicious activity
2. Respiration and HR may become irregular
3. Could be uncontrolled movements, vomiting, breath-holding, pupillary dilation

Question 6

What is used to minimize stage 2 or excitement stage

Answer 6

Rapidly acting drugs
*want to reach stage 3 ASAP

Question 7

What is stage 3 of general anesthesia (Guedels classification)

Answer 7

Stage 3 / surgical anesthesia
1. Skeletal muscles relax, vomiting stops, respiratory depression occurs
2. Eye movements slow, then stop, the patient is unconscious and ready for surgery
3. Intercostal paralysis, shallow abdominal respiration

Question 8

What is stage four of general anesthesia (Guedels classification)

Answer 8

Stage four / overdose
1. Too much medication has been given
2. Patients has severe brain stem or medullary depression

Question 9

What does brain stem or medullary depression result in?

Answer 9

Cessation or respiration and potential cardiovascular collapse
*lethal without cardiovascular and respiratory support

Question 10

When is the anesthesia record made and kept?

Answer 10

Kept and recorded whether anesthesia is being given until cessation