Operational Medicine Medical Education and Training

Introduction to Anesthesia

ANESTHESIA

ANESTHESIA - Partial or complete loss of sensation with or with out loss of consciousness as result of disease, injury, or administration of an anesthetic agent, usually by injection or inhalation.

HISTORY OF ANESTHESIA
PRIMITIVE TECHNIQUES

Club

Strangulation

Alcohol

Mesmerism

Plants

HISTORY OF ANESTHESIA
INHALATION AGENTS

Nitrous Oxide

  • 1799 Davy

  • 1824 Hickman

  • 1844 Wells

  • Ether

  • 1842 Long

  • 1847 Snow

  • Introduction to Anesthesia

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    Operating Room Team

    HISTORY OF ANESTHESIA
    LOCAL/REGIONAL

    1836 needle trochar

    1844 hollow needle

    1851 syringe

    1884 Koller opthalmic anesthesia

    1885 Hallstead/Hall local/regional blocks

    1898 Bier spinal

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 1 (Amnesia): From induction of anesthesia to loss of conciousness (loss of eyelid reflex). Pain perception threshold is not lowered.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 2 (Delirium/Excitement): Characterized by uninhibited excitation. Pupils are dilated and eyes divergent. Agitation, delirium, irregular respiration, and breatholding are commonly seen. Potentially dangerous responses can occur during this stage including vomiting, laryngospasm, HTN, tachycardia, and uncontrolled movement.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 3 (Surgical Anesthesia): Central gaze,constricted pupils, and regular respirations. Target depth of anesthesia is sufficient when painful stimulation does not elicit somatic reflexes or deleterious autonomic reflexes.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 3

    Plane 1 From the return of regular respirations to the cessation of REM.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 3

    Plane 2 The Surgical Plane

    From the cessation of REM to the onset of paresis of the intercostal muscles.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 3

    Plane 3 From the onset to the complete paralysis of the intercostal muscles.

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 3

    Plane 4

    From the paralysis of the intercostal of this plane the patient will be apneic. muscles to the paralysis of the diaphragm - at the end

    ANESTHESIA OVERVIEW
    STAGES OF GENERAL ANESTHESIA

    STAGE 4 (Impending Death/Overdose): Onset of apnea, dilated and nonreactive pupils, and hypotension to complete circulatory failure.

    ANESTHESIA OVERVIEW
    COMPONENTS OF GENERAL ANESTHESIA

    1. Unconsciousness (Hypnosis)

    2. Analgesia (Areflexia)

    3. Muscle relaxation

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    From

    SFC Hill

    Joint Special Operations Medical Training Center

    In

    Operational Medicine 2001

    Bureau of Medicine and Surgery

    Department of the Navy

     

     

     

     

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