Intravenous anesthesia

Intravenous anesthesia is carried out by narcotic drugs that are administered intravenously. Intravenous anesthesia is used to perform short-term surgical interventions, since the drugs used for this anesthesia do not give prolonged anesthesia. The advantage of this anesthesia is a rapid introduction to anesthesia, patients quickly fall asleep, bypassing the stage of excitement.

For intravenous anesthesia, barbituric acid derivatives, viadryl, propanidide, sodium oxybutyrate, ketamine are used.

Thiopental sodium and hexenal are derivatives of barbituric acid. When they are used, narcotic sleep occurs quite quickly, bypassing the stage of excitation, the withdrawal from anesthesia is rapid. The clinical picture of anesthesia with thiopental and hexenal is similar, but hexenal less inhibits breathing. For anesthesia use freshly prepared solutions of barbiturates, injected slowly. The narcosis proceeds 10 15 minutes from the beginning of a narcotic dream after single injection of a preparation. The duration of anesthesia is maintained by the gradual administration of 100-200 mg of the drug. During anesthesia, an anesthetist should observe the pupils, the movement of the eyeballs, the presence of reflexes to control the level of anesthesia. The nurse measures and records in the anesthetic chart the pulse, blood pressure, and respiration rates.

When anesthesia with thiopental sodium is used, respiratory depression is possible, so a breathing apparatus is needed. If the patient has an apnea, it is necessary to immediately carry out artificial ventilation of the lungs. Anesthesia with the introduction of barbituric acid derivatives is used for short surgical interventions( opening of abscesses, directing of dislocations, reposition of bone fragments).Barbiturates are also used for induction anesthesia.

Viadryl( predion) is often used in small doses with nitrous oxide. If the drug is used in large doses;this can lead to hypotension, phlebitis and thrombophlebitis may develop. Viadryl is used for induction anesthesia, carrying out endoscopic studies.

Propanidide( sombrevin) is used to conduct an initial anesthesia. With the use of propanidide, short-term surgical operations are performed in the polyclinic. The drug is administered intravenously, quickly, with the anesthesia coming quickly. The duration of narcotic sleep is 5-6 minutes, the patient quickly awakens. The use of the drug can cause hyperventilation, apnea, which can occur immediately after a loss of consciousness. In such a situation, it is necessary to use artificial ventilation with a respiratory apparatus. The use of propanidide requires control of blood pressure, pulse, respiration.

Sodium oxybutyrate is used when it is necessary to obtain an initial anesthetic. This narcotic drug gives a superficial anesthetic, so it is used in conjunction with barbiturates, propanidide. The introduction should be done intravenously and very slowly.

Ketamine( ketalar) is used for mononarcosis and for induction anesthesia. Ketamine can be administered intravenously and intramuscularly. Its use causes superficial sleep, the patient can increase the figures of blood pressure, tachycardia, so the appointment of the drug to a patient with hypertensive disease is contraindicated. Ketamine is well used in patients with low-pressure shock. Side effects of ketamine are hallucinations at the end of anesthesia and on awakening.

There are clear criteria for the adequacy of anesthesia: the normal pulse and blood pressure, skin and visible mucosa should be of a normal color, the turgor should be preserved, the urination should be 30-50 ml / h, the normal oxygenation of the blood and the content of CO2 in itnormal parameters of electrocardiography. If the indicators deviate from the normal level by no more than 20% of the baseline - this is not considered a pathology.

During anesthesia, the nurse is anesthetized. In this card, there are indicators of blood pressure, pulse, central venous pressure, respiratory rate, parameters of ventilation. The anesthetic card also records the stages of anesthesia and operations, injected drugs and their doses, muscle relaxants, all additional medicines. The time of their introduction is indicated. An anesthesia card is necessarily stuck in the medical history.