Anesthesia, General Health Article

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Table of Contents
Author Info: Lisette Hilton, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Nursing and Allied Health, 2002
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Definition

General anesthesia is the induction of a balanced state of unconsciousness, accompanied by the absence of pain sensation and the paralysis of skeletal muscle over the entire body. It is induced through the administration of anesthetic drugs and is used during major and other invasive surgical procedures.

Purpose

General anesthesia is intended to bring about five distinct states during surgery:

  • analgesia, or pain relief
  • amnesia, or loss of memory of the procedure
  • loss of consciousness
  • motionlessness
  • weakening of autonomic responses

Precautions

A complete medical history, including a history of allergies in family members, is an important precaution. Patients may have a potentially fatal allergic response to anesthesia known as malignant hyperthermia, even if there is no previous personal history of reaction.

General anesthetics should be administered only by board-certified medical professionals. Anesthesia providers consider many factors, including a patient's age, weight, allergies to medications, medical history, and general health when deciding which anesthetic or combination of anesthetics to use. The American Society of Anesthesiologists has compiled guidelines for classifying patients according to risk levels as follows:

  • I: healthy patient
  • II: patient with mild systemic disease without functional limitations
  • III: patient with severe systemic disease with definite functional limitations
  • IV: patient with severe systemic disease that is life-threatening
  • V: dying patient not expected to survive for 24 hours with or without an operation

ANESTHETICS: HOW THEY WORK
Type Name(s) Adminstered Affect
General Halothane, Enflurane Isoflurane, Ketamine, Nitrous Oxide, Thiopental Intravenously, Inhalation Produces total unconsciousness affecting the entire body
Regional Mepivacaine, Chloroprocaine, Lidocaine Intravenously Temporarily interrupts transmission of nerve impulses (temperature, touch, pain) and motor functions in a large area to be treated; does not produce unconsciousness
Local Procaine, Lidocaine, Tetracaine, Bupivacaine Intravenously Temporarily blocks transmission of nerve impulses and motor functions in a specific area; does not produce unconsciousness
Topical Benzocaine, Lidocaine Dibucaine, Pramoxine, Butamben, Tetracaine Dermal (Sprays, Drops, Ointments, Creams, Gels) Temporarily blocks nerve endings in skin and mucous membranes; does not produce unconsciousness

Equipment for general anesthesia should be thoroughly checked before the operation; all items that might be needed, such as extra tubes or laryngoscope blades, should be available. Staff members should be knowledgeable about the problems that might arise with the specific anesthetic being used, and be able to recognize them and respond appropriately. General anesthetics cause a lowering of the blood pressure (hypotension), a hemodynamic response that requires close monitoring and special drugs to reverse it in emergency situations.

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