Anaesthesia Grp 6 2010.ppt
- 1. THEATRE NURSING REGIONAL ANAESTHESIA PREPARED BY GROUP SIX -YEAR 4 (2010) GROUP MEMBERS: MKANDAWIRE OMEGA MKWAILA FAITH MPAZO BRENDA MPHEPO ELLEN MSISKA TAMARA MSHALI KONDWANI MTANTHIKO KHUMBO MTAPAONGA PRISCA MTEGHA THANDIE MNYANGA RUTH
- 2. ANAESTHESIA
- 3. Definition The term anaesthesia is derived from a Greek word anaesthesis meaning no sensation. Anaesthesia is the limited loss of feeling without loss of consciousness. The anaesthesiologist determine the method of administering the anaesthesia and the decision is influenced by the patient preference, age, physical status, emotional status, co-existing disease, type, length of the surgical procedure, post-operative recovery from specific anaesthetic agent and any requirement of the surgeon.
- 4. REGIONAL ANAESTHESIA This is a type of anaesthesia that causes a temporary loss of sensation in a particular portion of the body(dermatone). Usually it is used in patients whom general anaesthesia is contraindicated. The choice of regional agent depends on the type and anticipated length of the procedure, patient position during the procedure, and patient physical and psychological status.
- 5. ADVANTAGES It is simple It is done at a reasonable cost Easily induced Minimal equipment required Reduced post operative care Fewer systemic body effects on body function Decreased nausea and vomiting Useful for a variety of patient in circumstances where general anaesthesia is contraindicated
- 6. DISADVANTAGES Lack of patient acceptance and fear of being awake during the surgical procedure. Impracticality of anaesthetizing certain areas of the body Insufficient duration of anaesthesia. Patient fear anaesthesia will wear off prematurely Rapid absorption leading to cardiac arrest
- 7. TYPES OF REGIONAL ANAESTHESIA (1)Spinal anaesthesia Usually administered for surgical procedures performed on the lower abdomen, inguinal region, perineum and lower extremities. POSITION The patient lies on one side curled into fetal position or sitting position and physician inject local anaesthesia into cerebral spinal fluid through subarachnoid space.
- 8. Cont……. There is an immediate effect of anaesthesia on the site of injection. The duration and level of spinal anaesthesia are determined by: -body weight -site -speed of injection -specific gravity of anaesthetic agent -position of patient immediately prior to injection
- 9. COMPLICATIONS Headache-this result from cerebral spinal fluid leak from the dual needle puncture leading to decreased pressure within spinal cord and causes headache. Backache Hypotension Paresthesias Paralysis Tinnitus Arachnoiditis Meningitis Auditory and ocular disturbance
- 10. (2)Epidural anaesthesia This is achieved by injecting local anaesthesia agent through intervetebral space into the surrounding of the dura matter in spinal column. Anaesthesia may be delivered at the thoracic, lumbar or caudal level. It can be administered either in a single dose or intermittently through an epidural catheter and it diffuses slowly into cerebral spinal fluid .Epinephrine may be added to slow absorption.
- 11. INDICATIONS Procedures on abdomen Procedures on lower extremities Treatment of chronic pain Genital-urinary procedures. In contrast to spinal anaesthesia, epidural anesthesia requires high doses of local anaesthetic, has slower onset and not dependent on patient position for level of anaesthesia
- 12. COMPLICATIONS Infection High potential for failure than with spinal.
- 13. (3)NERVE BLOCK This is achieved by the use of local anesthesia into or around the nerve or a group of nerves that innervates the operative site. Either continuous or intermittent infusion may be used. For example, intercoastal, auxiliary, digital blocks. Nerve blocks interfere with sensory, motor or sympathetic transmission. Onset and length of the block depend on amount and concentration of the anaesthetic agent. Also used in chronic pain
- 15. (4)BIER BLOCK It is achieved by administering local anesthetic agent into the venous system of an exsanguinated extremity. A tourniquet is used to prevent the agent from entering systemic circulation.
- 16. ADVANTAGES • Short recovery time • Onset is quick
- 17. DISADVANTAGES Limited to procedures less than 2 hours only Tissue damage if tourniquet is left for more than 2 hours
- 18. (5)FIELD BLOCK This involves injecting anaesthetic solution around the area to be anaesthetized. For example, administering lignocaine when inserting Norplant.
- 19. TOPICAL/SURFACE ANAESTHESIA This involves applying local anaesthetic to skin as mucous membranes. Such application makes sensory receptors unresponsive to pain, itching and other stimuli. They are usually ingredients of various ointment solutions or lotions designed for use at particular sites. For example, preparations available for use on eyes, ears, nose, oral mucosa, perineum, hemorrhoid and skin.