Anaesthesiology

Dr. Pradeep Singh
Senior Consultant
MBBS D.A
Dr. Bobbin
Senior Consultant
MBBS MD
       
     
       

In medicine anaesthesia is useful in undergoing any procedure without pain. There are different types of anaesthesia for different procedures.

GENERAL ANAESTHESIA

In general anaesthesia person is made unconcious completely.For this an anaesthetic is given intravenously and then a combination of analgesic and muscle relaxant is given to paralise all the skeletal muscle,for the complete immobility.In this condition person can not breath because of muscle paralysis.A tracheal tube is inserted in trachea (Wind Pipe) and then connected to ventilator through tubes to give artificial ventilation and oxygen.After this, person can be kept paralized for any no.of hours with maintenanace doses of analgesic,relaxant and anaesthetic.During all these procedures person’s vitals are monitored.At the end of procedure anaesthetic is stopped and muscle relaxant is reversed with other medicine.Person starts breathing spontaneously and wakes up from unconciousness.Tracheal tube is removed and the person is shifted to recovery for observation.

REGIONAL ANAESTHESIA - SPINAL, EPIDURAL, BLOCKS

In Regional anaesthesia only a part (region) of body is anaesthetized,so that any procedure can be done in that part without pain.In this type of anaesthesia person is concious but can be sedated to keep him calm in operation theatre.There are different types of Regional anaesthesia.

SPINAL ANESTHESIA
This type of anaesthesia is used for procedures in abdomen and lower limbs,below belly button (umbilicus).This is useful for procedures lasting for 2-3 hours only.

For this a drug is injected with very fine needle (25-27G)in a particular space (dural) of spinal cord.This is done either in lateral or sitting position.

EPIDURAL ANAESTHESIA (LUMBER)
This type of anaesthesia is used for procedures in abdomen and lower limbs lasting more than 2-3 hrs.For this a very fine tube(20-22G) called catheter is inserted through a wide bore needle(16-18G) into a particular space (epidura) of spinal cord.In lateral or sitting position after cleaning the area first wide bore needle is inserted into epidural space,then a catheter is passed through this needle into the space.After this wide bore needle is removed and catheter is secured by adhesive tapes.The other end of catheter is taped at a place convenient for injecting drugs.

REGIONAL BLOCKS
Regional Blocks are used to block a particular nerve or a group of nerves so that any procedure can be done in the area supplied by that nerve or group of nerves.These Blocks are very useful for upper limp procedures.These are also very useful in cases where we can not give General or Spinal anaesthesia.Most commonly used Blocks for upper limbs are Brachial and Scalene Block

LOCAL ANAESTHESIA

This type of anaesthesia is for small area and small procedures.In this drug is injected in the area where any procedure is to be done.

PAINLESS DELIVERY

There are different ways to conduct painless delivery. But most effective and commonly it is done through Epidural analgesia.

A fine bore tube (catheter) is placed in epidural space of spinal cord.This catheter is placed in lateral or sitting position. First a wide bore needle is inserted in the back after making the area numb with local anaesthesia.Then the catheter is inserted through this and the needle is removed.Catheter is then taped on the back and fixed in a convenient place for drug delivery.

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