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8.general anesthetics and local anaesthetics
1.
2. General anaesthetics (GAs) are drugs
which produce reversible loss of all
sensations and consciousness.
Features of GA are :
1.Reversible loss of consciousness
2.Reversible loss of sensations
3.Analgesia & amnesia
4.Muscle relaxation & abolition of
reflexes
4. 2. Parenteral GA –
a) Inducing drugs – Thiopentone sodium
Propofol
Etomidate
b) Slow-acting drugs –
BZDs : Diazepam, lorazepam
Ketamine : Dissociative anesthesia
Opioids : Fentanyl, alfentanil
5. Therapeutic uses :
For operations on head, neck & face
For induction and maintenance of
anaesthesia – cardiac catheterization,
bronchoscopy
Short procedures – dressing of burns
As an adjuvant to anaesthetics for effective
analgesia
Postoperative pain
6. Complications of GA –
A. During anaesthesia :
respiratory depression
salivation, respiratory secretions
cardiac arrhythmias, asystole
fall in BP
aspiration of gastric contents
laryngospasm & asphyxia
delirium, convulsions
7. B. After anaesthesia :
nausea & vomiting
persisting sedation
pneumonia
organ toxicities – liver & kidney damage
nerve palsies
cognitive defects
9. LAs are drugs which when applied
topically or injected locally, block nerve
conduction & cause reversible loss of all
sensations in the part supplied by the
nerve.
11. Mechanism of action -
Local anaesthetics
Block voltage-gated Na+
channels
No entry of Na+
ions into the cell – no
depolarization
No generation of action potential
No generation and conduction of impulse to CNS
Local anaesthesia
12. Therapeutic uses :
Anaesthetize mucous membrane of the
eyes, nose, mouth, cornea, urinary & upper
respiratory tracts
Abscess drainage
Surgery – lower & upper limbs, lower abdomen,
perineum, caesarean section
Excision of small swellings, suturing of
cut wounds, dental procedures