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mardi 25 juin 2013

How General Anesthetics Are Used For Surgery

By Lila Barry


General anesthetics are often administered to patients prior to surgery in order to induce a complete loss of sensation and consciousness. While it is not totally understood how these medications work, there are a few speculations. The common thread found in each of these theories is that the drugs disrupt the function of the receptor cells in the nervous system, thus preventing the sensation of pain.

There are two possible ways to administer a general anesthetic, intravenously or though inhalation. In most cases a combination of the two methods is used. A doctor called an anesthetist will administer the anesthetic and monitor it closely during the surgery, afterwards it will be reversed and the patient will become conscious.

Inhaled anesthetics are delivered using an anesthesia machine, which mixes gases or vaporized liquids with oxygen, air, and in some cases nitrous oxide and releases these through a breathing mask which goes over the patient's nose and mouth. This apparatus monitors the patient's response and also manages the levels being administered. The compounds most often used are Isoflurane, Desflurane, and Sevoflurane.

The injectable form of anesthetics generally work faster and are effective for inducing unconsciousness and maintaining it through a constant intravenous drip. Drugs such as Propofol and Etomidate are some of the most common ones used in IV drips for general anesthesia. Sometimes benzodiazepines are given at the same time to bring about a sedative effect.

Surgeries which are more complex procedures that typically take a longer time to complete are usually best suited to using a general anesthetic as opposed to a local. This will be decided by the patient and his or her anesthetist. Some operations which normally always use a general include gallbladder removal, hysterectomy, hernia repair, and appendectomy.

Prior to administering this medication the anesthetist will ask the patient several questions to assess the risk. While highly uncommon, there are possible risks associated with undergoing anesthesia. Those who are obese, heavy drinkers or smokers, or have rare allergic reactions are usually affected more than others. Sometimes complications arise if the patient has not followed the doctor's instructions prior to the surgery, it is important to not eat anything for several hours before the operation as regurgitation and aspiration may occur.

There are four stage to anesthesia. The first is the initiation of unconsciousness. The second is referred to as the REM stage. The third is called "surgical anesthesia" and is marked by the relaxation of the muscles, constriction of pupils, and a regular breathing pattern. This is the optimal time for the surgery to be done. Stage four is an overdose of the anesthetic compounds and can be deadly if it isn't reversed.

During the procedure the patient's vital signs will be closely watched to ensure they are not in jeopardy. There are also some side effects which may be experienced after the use of general anesthetics. The patient may feel nauseous, have chills, be dizzy, or have a sore throat due to the insertion of a breathing tube. These feelings typically abate in a few hours and a full recovery will take place. The benefits of this type of anesthesia normally outweigh the minor discomforts which can accompany it.




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