GENERAL ANESTHESIA
General anesthesia is the abolition of pain or sedation by a temporary reversible loss of consciousness.
Premedication
• Anxiolytics - decreases anxiety
Midazolam, Benzodiazepine, Diazepam
• Anti-emetics – to reduce nausea or vomiting
Ondansetron, Metoclopramide
�...
It is done to reserve oxygen saturation so
that the patient doesn’t go into hypoxia
during the intubation. The intubation takes
time where the patient’s airway is blocked
and saturation might drop. Pre-oxygenation
is done for 3 minutes where FiO2 = 100%.
,Induction
IV agents
 Propofol – mostly used
 Thiopentone sodium – for an epileptic patient exclusively
 Ketamine – pediatrics
Inhalational agents
 Isoflurane – mostly used
ï‚· Sevoflurane - pediatrics
Muscle relaxants
 Succinyl choline – depolarizing agent given before intubation (or for
short time procedures)
 Atracurium, Vecuronium – non depolarizing agents (mostly used) –
maintenance relaxants
Intubation
ï‚· Oral or nasal intubation
ï‚· Direct laryngoscopy, video
laryngoscopy or fibreoptic
bronchoscopy can be done to
aid intubation.
ï‚· The patient end of the
infraglottic airways reach the carina of the trachea
ï‚· The patient end of the supraglottic airways reach the larynx.
ï‚· Cuffs of the tubes are inflated with cuff syringe
, ï‚· Auscultate for lung sounds to confirm the airway position.
ï‚· The tube is then secured with tapes.
Glycopyrolate is given to reduce secretions caused due to neostigmine
Extubation
ï‚· Suction the airway
ï‚· Deflate the cuff
ï‚· Remove the intubated
airway
ï‚· Oxygenate the patient
through face mask
ï‚· Disconnect the monitors
ï‚· Monitor the vitals
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