Medical-Surgical Nursing: An
Integrated Approach, 2E
Chapter 15
Anesthesia
Anasthesia & Analgesia
Essential to healthcare delivery today.
 Anasthesia – absence of normal
sensation
 Analgesia – pain relief without anasthesia
Preanesthetic Preparation
Avoidance of foods and drink prevents
passive regurgitation of gastric contents
 Clients should typically continue
medications up to surgery
 Consent must be received

Sedation
Reduction of stress, excitement, or
irritability and some suppression of CNS
 Typically used to relieve anxiety and
discomfort during a procedure
 Residual effects include amnesia and
letheragy

Regional Anesthesia

A region of the body is rendered
insensible to pain.
Types of Regional Anesthesia
Local
 Nerve blocks
 Spinal & Epidural blocks

Residual Effects
Motor Block
 Sensory Block
 Sympathetic Block

General Anesthesia
Involves unconsciousness and complete
insensibility to pain
 There are four stages of General
Anesthesia:

Induction
 Maintenance
 Emergence
 Recovery

Induction & Airway Management
Shortest stage of Anesthesia but critical
 Immediately after induction, the airway
must be secured using a cuffed
Endotracheal tube (ETT)

Maintenence
General Anesthesia is maintained with a
combination of IV and inhaled drugs
 Sometimes specialized medicines are
applied to achieve complete paralysis,
relax skeletal muscles and more

Emergence
Client’s awareness returns as drug wears
off
 Emergence must be carefully controlled
and monitored

Recovery
Recovery may be an extended process
with memory and other aspects affected
for a long period
 Many anesthetics are absorbed into body
fat and released slowly into the system

Common Concerns




Client may suffer from apnea, decline in
respirations
Few direct heart rate and blood pressure
effects, but these should be closely monitored
Client may have trouble regulating body
temperature
Client may have abnormal fluid levels
Post Operative Pain Management

Post-Operative pain results from:
Tissue injury
 Inflammation
 Hormonal changes
 Hyperexcitability and more

Methods for Controlling Pain
Patient Controlled Analgesia
 Regional Analgesia

Local anasthetics
 Opioids
