Local & General Anesthetics

Ch 11

General Anesthesia
Alters responses of the Central Nervous
system
Causes one or more of the following

Pain relief
Muscle relaxation
Relaxation of reflexes
Deep sleep

Commonly used during surgery

Main Categories

Inhaled may be liquid or gas

Nitrous oxide gas
Halothane liquid

Several

others that end with ane

Inhaled drugs are used together with IV

drugs to provide the best level of sedation
for the patient & procedure = Balanced
Anesthesia

Intravenous

Fentanyl

Versed

Anticholinergic decreases secretions

Demerol, morphine

Benzodiazepine - amnesia

Atropine

Opioid analgesic pain relief

Opioid analgesics lighter pain relief

Vistaril, phenergan, seconal

Sedative/hypnotic lighter amnesia/sedation

Local Anesthetics

AKA Regional anesthetics

Block nerve conduction in specific area of body
Prevents pain sensation

2 Forms
Topical
Parenteral (injected)

Topical

May be patch, cream or lotion, liquid, spray

Dermoplast
Lidocaine
Pontocaine
EMLA cream

Parenteral

Spinal

Into the space surrounding the spinal cord

Epidural
Through catheter into the epidural space just
outside the spinal cord
May remain in place for continuous infusion

Infiltration to numb area to be sutured

Nerve block stop impulses from specific
nerve (example: chronic back pain)

Neuromuscular Blockers

Used during surgery

Paralyze respiratory and skeletal muscles
Requires artificial ventilation
Also used in ICU with ventilator patients

CNS Depressants &

Muscle Relaxants
Ch 12

Sedatives
Reduce nervousness
Reduce excitability
Reduce irritability
Do Not cause sleepiness

Hypnotics
Reduce nervousness
Reduce excitability
Reduce irritability
Do cause sleep

Sedative-Hypnotics
Drugs that can have either sedative or
hypnotic effect
3 classifications

Barbiturates
Benzodiazepines
Miscellaneous agents

Barbiturates
Are Habit-forming (addictive)
Rapidly lead to toxicity
Depress respirations
Used for

Anesthesia
Control convulsive conditions
Prevent epileptic seizures

Barbiturates, contd

Phenobarbital

Most commonly prescribed

Forms
Tablets
Capsules
Elixirs
Injections
Suppositories

Benzodiapines
Relatively safe
Most commonly prescribed
Used for

Sedation
Sleep induction
Skeletal muscle relaxation
Reduce anxiety

Benzodiazapines, contd

Examples
Temazepam = restoril
Zolpidem = ambien

Antidote is flumazenil = romazicon

Muscle Relaxants
Act on the CNS
Benefit is more from sedation than from
relaxation of muscles
Primarily used for relief of muscle spasms

Best when used with physical therapy

No specific antidote

Miscellaneous agents

Chloral hydrate = Noctec

Oldest in this category
Relatively short duration of action
Does not suppress REM sleep

Tizanidine = zanaflex

Treats muscle spasms

Antiepileptic Agents
Ch 13

Epilepsy
Common name for seizure disorder
Not a disease
CNS dysfunction

Momentary lapses to total body convulsions

Action not completely known

Alter electrolytes

Treatment
Diazepam = valium
to stop seizure once it has started
Phenytoin = dilantin
to prevent future seizure activity