CNS Anesthetics(1)

Iii surgical procedure performed during stage this

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Unformatted text preview: ng Stage this stage---anesthesia deepens. this Stage IV--- Medullary Paralysis---respirations are --lost and circulatory collapse occurs and ventilatory assistance is necessary. assistance 16 Inhaled Anesthetics Inhaled Halothane----prototype Florane---high safety profile. Suprane---rapid induction at low doses rapid and maintenance. and Nitrous Oxide---(gas) low potency and --(gas) limited to minor surgical procedures or in combination with IV anesthetic agents. combination Ultane---maintain sedation. 17 Characteristics of Inhalation Anesthetics Anesthetics 1. 2. 3. 4. 5. 6. Classified as gases or volatile liquids. Rapidly absorbed from alveoli into general Rapidly circulation. circulation. Are complete anesthetics and thus can abolish Are superficial and deep reflexes. superficial Provide controllable anesthesia because the Provide depth of anesthesia is easily varied by changing the inhaled concentration. the Allergic reactions are uncommon. Rapid recovery can occur as soon as Rapid administration ceases because the anesthetic is 18 excreted in expired air. excreted Inhaled Anesthetics Inhaled Mechanism of Action---enhancing transmission at inhibitory synapses & depressing transmission of excitatory synapses--depressing interacts with multiple receptors in the brain---iinhibits nhibits receptors neurotransmitters that activate the RAS---easily cross the BBB. neurotransmitters Pharmacokinetics---effective concentrations depend on effective pressure of the gas sufficient to suppress neuronal excitability. pressure Uses---anesthesia to produce unconsciousness, skeletal anesthesia muscle relaxation, visceral smooth muscle relaxation for surgical procedures. surgical Adverse Reactions---(dose dependent) hypotension, (dose circulatory depression, respiratory depression, shivering, nausea & vomiting, larynospasm. nausea 19 Nursing Interventions for a Client Receiving Inhalation Anesthetics Anesthetics Assess for pain and administer pain medication as Assess needed (remember that any sedative or analgesic used must be decreased to one half to one fourth of usual dose for first dose after surgery). usual Administer oxygen. Avoid heat loss by using heated blankets, covering Avoid the client’s head with a blanket, and using a hyperthermic blanket. hyperthermic Monitor vital signs & LOC closely. Monitor N&V. 20 Intravenous Anesthetics Intravenous 1. 2. 3. 4. Used for the induction or maintenance of general Used anesthesia, and to promote amnesia anesthesia, Supplements to general surgery that help patients Supplements rapidly progress through Stages 1& 2 rapidly May be used alone. Allows the dose of the inhaled anesthetic to be Allows reduced. Barbiturates---Pentothal, Brevital Barbiturates---Pentothal, Benzodiazepines---Valium, Versed Benzodiazepines---Valium, Opioids---Sublimaze, Sufenta, Fentanyl Opioids---Sublimaze, Other Agents---Ketalar, Diprivan Other 21 Intravenous Anesthetics Intravenous Mechanism of Action---ultra-short acting dr...
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