Franzel Micaela D.

Agudo
BSN IIIA
GROUP 1

ANESTHESIA ADMINISTERED TO CLIENT BEFORE SURGERY

Preoperative medications are given to client prior to going to the operating room.
Commonly used preoperative medication includes:
Antiemetics
Anticholinergics
Sedatives
Antibiotics

Induction agents

Propofol, a nonbarbiturate intravenous anesthetic, has displaced barbiturates in many

anesthesia practices.

The use of propofol is associated with less postoperative nausea and vomiting and
a more rapid, clear-headed recovery.
In addition to being an excellent induction agent, propofol can be administered by
slow intravenous infusion instead of vapor to maintain the anesthesia.
Among its disadvantages are the facts that it often causes pain on injection and that
it is prepared in a lipid emulsion, which, if not handled using meticulous aseptic
precautions, can be a medium for rapid bacterial growth.

Anesthesia can also be induced by inhalation of a vapor. This is how all anesthetics were
once given and is a common and useful technique in uncooperative children. It is
reemerging as a choice in adults. Sevoflurane is most commonly used for this purpose.

Traditional opioid analgesics

Morphine, meperidine, and hydromorphone are widely used in anesthesia as well as

in emergency departments, surgical wards, and obstetric suites.
In addition, anesthesia providers have at their disposal a range of synthetic opioids,
which, in general, cause less fluctuation in blood pressure and are shorter acting. These
include fentanyl, sufentanil, and remifentanil.
Muscle relaxants
Succinylcholine, a rapid-onset, short-acting depolarizing muscle relaxant, has
traditionally been the drug of choice when rapid muscle relaxation is needed.
For decades, anesthesia providers have used it extensively despite numerous predictable
and unpredictable adverse effects associated with its use.
The search for a drug that replicates its onset and offset speed without its adverse effects
is the holy grail of muscle relaxant research.
Other relaxants have durations of action ranging from 15 minutes to more than 1 hour.

Electronic References: http://emedicine.medscape.com/article/1271543-overview#a4

Pre-Operative Anesthesia
 SURGICAL INSTRUMENTS

I. CUTTING AND DISSECTING

~ Cutting and dissecting instruments are sharp and are used to cut body tissue
or surgical supplies.
A. KNIFE HANDLES deep knife 7 handle with Used to cut
15 blade deep, delicate
tissue.

inside 3 handle with Used to cut

knife 10 blade superficial
tissue.

skin knife 4 handle with Used to cut

20 blade skin.

Instruments Functions
B. SCISSORS

Straight Mayo Scissors Used to cut suture and supplies.

Also known as: Suture scissors.

Curved Mayo Scissors

Used to cut heavy tissue (fascia, muscle,

uterus, breast).

Metzenbaum Scissors

Used to cut delicate tissue.

II. CLAMPING and OCCLUDING
~ Clamping and occluding instruments are used to compress blood vessels or
hollow organs for hemostasis or to prevent spillage of contents.
Instruments Functions
Hemostat
Other names: crile, snap or stat.
A hemostat is used to clamp blood vessels
or tag sutures. Its jaws may be straight or
curved.

Hemostat, Mosquito (left to right)

A mosquito is used to clamp small blood

vessels. Its jaws may be straight or curved.

Kelly, Hemostat, Mosquito (left to

right)
Other names: Rochester Pean A Kelly is used to clamp larger vessels and
tissue

Burlisher
Other names: Schnidt tonsil forcep, A burlisher is used to clamp deep blood
Adson forcep. vessels. Burlishers have two closed finger
rings. Burlishers with an open finger ring
are called tonsil hemostats.

Right Angle
Other names: Mixter.
A right angle is used to clamp hard-to-reach
vessels and to place sutures behind or
around a vessel. A right angle with a suture
attached is called a "tie on a passer."

Hemoclip applier with hemoclips

A hemoclip applier with hemoclips applies

metal clips onto blood vessels and ducts
which will remain occluded.

Carmalt Clamp

Larger than a kelly clamp and often confused

with the Peon Clamp of the same size; Carmalt
clamps have the characteristic jaw structure
pictured.

Debakey Vascular Clamp

The most standard of vascular clamps, the jaw of

the clamp is designed to clamp veins and arteries
without causing damage.
III. GRASPING and HOLDING
~ Grasping and holding instruments are used to hold tissue, drapes or sponges.
Instruments Functions
Allis

An Allis is used to grasp tissue. Available in

short and long sizes. A "Judd-Allis" holds
intestinal tissue; a "heavy allis" holds breast
tissue

Babcock

A Babcock is used to grasp delicate tissue

(intestine, fallopian tube, ovary). Available
in short and long sizes.

Kocher

A Kocher is used to grasp heavy

tissue. May also be used as a clamp. The
jaws may be straight or curved. Other
names: Ochsner.

Foerster Sponge Stick

 A Foerster sponge stick is used to grasp
sponges. Other names: sponge forcep.

Dissector

A dissector is used to hold a peanut.

Backhaus towel clip

Backhaus towel clip

A Backhaus towel clip is used to hold

towels and drapes in place. Other name:
towel clip.

Pick ups, thumb forceps and tissue

forceps
Pick ups, thumb forceps and tissue
forceps are available in various lengths,
with or without teeth, and smooth or
serrated jaws.

Russian tissue forceps

Russian tissue forceps are used to grasp

tissue.

Bonney Forceps

Often used for grasping fascia during the closure

of abdominal surgery or for closure and suturing
 of large orthopedic procedures such as total knee
and total hip replacement surgery.

Adson pick ups

Adson pick ups are either smooth: used to

grasp delicate tissue; or with teeth: used to
grasp the skin. Other names: Dura forceps.

Smooth forceps

Long smooth pick-ups are called dressing

forceps. Short smooth pick-ups are used to
grasp delicate tissue.

DeBakey forceps

DeBakey forceps are used to grasp delicate

tissue, particularly in cardiovascular
surgery.

Single tooth forceps, many teeth Thumb forceps are used to grasp tough
forceps tissue (fascia, breast). Forceps may either
(top to bottom) have many teeth or a single tooth. Single
 tooth forceps are also called "rat tooth
forceps."

Short, medium & long

(top to bottom)
Mayo-Hegar needle holders are used to
hold needles when suturing. They may also
be placed in the sewing category.

IV. RETRACTING and EXPOSING INSTRUMENTS

Retracting and exposing instruments are used to hold back or retract organs or tissue to
gain exposure to the operative site. They are either "self-retaining" (stay open on their
own) or "manual" (held by hand). When identifying retractors, look at the blade, not
the handle.
Instruments Functions
Deaver retractor

A Deaver retractor (manual) is used to

retract deep abdominal or chest
incisions. Available in various widths.

Richardson retractor

A Richardson retractor (manual) is used to

retract deep abdominal or chest incisions.

Army Navy retractor

 An Army-Navy retractor (manual) is used to
retract shallow or superficial
incisions. Other names: USA, US Army.

Goulet

A goulet (manual) is used to retract shallow

or superficial incisions.
Malleable or ribbon retractor

A malleable or ribbon retractor (manual) is

used to retract deep wounds. May be bent
to various shapes.

Weitlaner retractor

A Weitlaner retractor (self-retaining) is

used to retract shallow incisions.

Gelpi retractor

A Gelpi retractor (self-retaining) is used to

retract shallow incisions.
Balfour A Balfour with bladder blade (self-
retaining) is used to retract wound edges
during deep abdominal procedures.

Baby Bennette Retractor

Elevating and Retracting Bone. Commonly in the

minor orthopedic instrument set.

V. SUCTIONING
~ Suctioning of blood and other secretions during surgery.
Instruments Functions
Frazier Suction Tip

Suction tip commonly use for orthopedic, neuro

and ENT surgery.