1. Introduction to anaesthesia

2. Terms
Anaesthesia
Anesthesiologist
Anesthetist

3. modern general anesthesia is based on the ability to provide adequate analgesia and amnesia during surgical procedures.
Muscle relaxant may be used to facilitate surgical exposure
Normal physiological function

4. The challenge in anaesthesia is:
To maintain a balance between the stress of the surgical procedure and the cardio- respiratory depressant effects of deepening levels of anaesthesia

5. Anaesthesia
Surgery
Physiological stability
End organ homeostasis
-Cardiovascular
-respiratory
-neural
-renal
-endocrine
Stress
-psychological
-physiological
-blood loss
-fluid shift
-cardiovascular stress
-respiratory stress
-temperature changes
-organ insult

6. The anesthetic surgical balance
Surgical insult
Physiological stress
Amnesia
Analgesia
Muscle relaxant

7. General anaesthesia A state of general anaesthesia may be
induced with the injection of anaesthetic
drugs, or by the inhalation of a mixture
of anaesthetic vapour
With general anaesthesia, muscle relaxants
may be used to facilitate both tracheal intubation and muscle relaxation

8. As muscle relaxants have no effect on the state of consciousness, additional anaesthetic medications must be given to ensure both amnesia and analgesia. The use of muscle relaxants avoids the need for excessive amounts of other anaesthetic agents that would otherwise be required to achieve the same degree of muscle relaxation

9. When muscle relaxant use positive pressure ventilation is frequently use
When muscle relaxants are not use the patient may be allowed to spontaneously inhale anaesthetic vapors to maintain the anesthetic state

11. Anaesthetic Options
-eg. iv Propofol, midazolam, fentanyl -e.g. droperidol + opioid (such as fentanyl) -e.g. Spinal Anaesthesia Epidural Anaesthesia Brachial Plexus Block Intravenous 'Bier' Block Peripheral Nerve Blocks
1-Local Anaesthesia alone 2-Local Anaesthesia with intravenous conscious sedation 3-Neurolept-analgesia 4-Regional Anaesthesia, with or without sedation

12. Anaesthetic Options 5-General Anaesthesia 6-others
May be combined with regional anaesthesia, peripheral nerve blocks or local anaesthesia -Acupuncture Inhalational agents im, po, iv sedatives, narcotics, neuroleptics, or antiemetics

13. Modem general anaesthesia uses combinations of medications in an attempt to minimize each drug's side effects, and maximize individual benefits.