INTRO TO ANESTHESIA

SFC HILL

Joint Special Operations Medical Training Center

ANESTHESIA
ANESTHESIA - Partial or complete loss of
sensation with or with out loss of
consciousness as result of disease, injury,
or administration of an anesthetic agent,
usually by injection or inhalation.

Joint Special Operations Medical Training Center

HISTORY OF ANESTHESIA
PRIMITIVE TECHNIQUES

Club
Strangulation
Alcohol
Mesmerism
Plants

Joint Special Operations Medical Training Center

HISTORY OF ANESTHESIA
INHALATION AGENTS
Nitrous Oxide
1799 Davy
1824 Hickman
1844 Wells

Ether
1842 Long
1847 Snow

Modern Agents

Halothane 1956
Enflurane 1972
Isoflurane 1981
Sevoflurane and
Desflurane

Joint Special Operations Medical Training Center

HISTORY OF ANESTHESIA
LOCAL/REGIONAL

1836 needle trochar

1844 hollow needle
1851 syringe
1884 Koller opthalmic
anesthesia
1885 Hallstead/Hall
local/regional blocks
1898 Bier spinal

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 1 (Amnesia): From induction of anesthesia
to loss of conciousness (loss of eyelid reflex). Pain
perception threshold is not lowered.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 2 (Delirium/Excitement): Characterized by
uninhibited excitation. Pupils are dilated and eyes
divergent. Agitation, delirium, irregular respiration,
and breatholding are commonly seen. Potentially
dangerous responses can occur during this stage
including vomiting, laryngospasm, HTN, tachycardia,
and uncontrolled movement.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 3 (Surgical Anesthesia): Central
gaze,constricted pupils, and regular respirations.
Target depth of anesthesia is sufficient when painful
stimulation does not elicit somatic reflexes or
deleterious autonomic reflexes.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 3
Plane 1 From the return of regular respirations to
the cessation of REM.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 3
Plane 2 The Surgical Plane
From the cessation of REM to the onset of paresis of
the intercostal muscles.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 3
Plane 3 From the onset to the complete paralysis of
the intercostal muscles.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 3
Plane 4
From the paralysis of the intercostal of this plane the
patient will be apneic. muscles to the paralysis of the
diaphragm - at the end

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
STAGES OF GENERAL
ANESTHESIA
STAGE 4 (Impending Death/Overdose): Onset of
apnea, dilated and nonreactive pupils, and
hypotension to complete circulatory failure.

Joint Special Operations Medical Training Center

ANESTHESIA OVERVIEW
COMPONENTS OF GENERAL
ANESTHESIA
1. Unconsciousness (Hypnosis)
2. Analgesia (Areflexia)
3. Muscle relaxation

Joint Special Operations Medical Training Center