Intraoperative Period
I. Two main types of anesthesia: Anesthesia is classified according to the effect it has on the pt's CNS
& pain perception
A. Regional anesthesia: loss of sensation to a region of the body without loss of consciousness
when a specific nerve or group is blocked with administration of a local anesthetic
1. The pt may be given medication(s) to produce mild sedation or to relieve anxiety.
2. The nurse must avoid careless conversation, unnecessary noise, and unpleasant smells
which can be noticed by pt & cause OR experience to be negative
3. An example of regional: a. spinal., b. epidural., & c. peripheral nerve block
B. General anesthesia is the loss of sensation with loss of consciousness, skeletal muscle
relaxation, analgesia, and elimination of the somatic, autonomic & endocrine responses
including coughing, gagging, vomiting, & sympathetic NS responsiveness
1. General anesthesia is usually the technique of choice for pts having surgical procedures
a. that require significant skeletal muscle relaxation
b. last for long period of time
c. require awkward positions because of location of incision site
d. or require control of respiration
e. The client is extremely anxious & unable to have local or regional due to
contraindications or refuse
f. or if client is unable to remain immobile for long period of time. ie. head injury,
or intoxication
2. General anesthesia is most commonly administered by inhalation & to lesser extent by IV
3. An advantage to general anesthesia is the rapid excretion of the anesthetic agent &
prompt reversal of its effects when desired. It can be used with all age groups & any
type of surgery
4. Disadvantages of general anesthesia include risks associated with circulatory, respiratory,
hepatic, & renal side effects
a. If pt has a history of CHF or emphysema = greater risk for complications
b. Pts with hepatic & renal disorders can't excrete – liver not metabolize well
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