 Induced,

Reversible, controlled

loss of sensation
 • Components:
 1. Analgesia
 2. Muscle relaxation
 3. Amnesia
 4. Suppression of
excessive
autonomic responses
 Minimizing the potentially deleterious direct and indirect
effects of anaesthetic agents and techniques.

 Sustaining physiologic homeostasis during surgical

procedures that may involve major blood loss, tissue
ischemia.

 Improving postoperative outcomes of the surgical stress

response, which may lead to short- or long-term sequelae
 Haemodynamic :fall in blood pressure due to
 vasodilatation
 myocardial depression,
 sympathetic tone.
 Note: used with caution in trauma victims
 Reduce ventilatory drive & reflexes of airway
patency
 Gag reflex lost
 Regurgitation due to tone of lower oesophagel
sphincter
 Aspiration deaths reduced by Endotracheal
intubation (kuhn)
 Most common during surgery
 Due to exposed body cavities, cold i.v. fluids,
reduced metabolic rate.
 GA’s lower the core temp. set point(vasoconstrictor
area).
 Leads to perioperative morbidity,cardiac
complicationd
 Significant problem in postoperative
period
 Activation of brain stem vomiting
center
by serotonin, histamine,dopamine.
 Ondansetron (5-HT 3 blocker) is
effective
 Pre Anaesthetic
medication
 Induction

 Maintenance
 Recovery
 Post operative Care
 Use of drugs prior to anaesthesia to make it more pleasant &
safe.
 1. Anxiolysis\ Amnesia: to relieve anxiety
 BNZ- diazepam
 antihistamine- promethazine
 2. Analgesia: relieves pain.
 Opiates- fenatnyl
 Opiates mostly restricted
 3. anticholinergics: prevent hypotension & bradycardia
 Reduce salivary & bronchial secretions
 Atropine/hyoscine(glycopyrrolate)
 4. Anti-emetic : to prevent nausea & vomiting.
 Ondansetron, Metoclopramide
 5. Antacids : to prevent risk of gastric
regurgitation & aspiration pneumonia
 H2 blockers- rantidine, omeprazole
 6. adjuvant to GA: BNZ & ketamine
 Blood-gas partition coefficient

 Oil –gas coefficient

 Molecular mechanism:

 1) GABA mediated

 2)NMDA receptors

 3)glycine inhibitors
 Glutmate
type(excitatory)
 Ca+ selective
channels
 Inhibited byNitrous
oxide& ketamine
 Depends on
 1.Solubility in the blood

(blood: gas partition co-efficient)

2.Solubility in the fat
(oil: gas partition co-efficient)
 It is a measure of solubility in the blood
 It determines the rate of induction and recovery
of inhalational anesthetics
 Lower the blood:gas co-efficient - faster the
induction and recovery – nitrous oxide
 Higher the blood:gas co-efficient - slower
induction and recovery – Halothane
 Measure of inhalational anaesthetic potency

 MAC values are additive and lower in opiods

1.Stage of analgesia

2.Stage of delirium

3.Surgical anaesthesia

4.Medullary paralysis
Anaesthetic inhalation loss of consciousness

Reflexes & resp normal

Minor operations, incisions can be done