Types of anesthesia in children for operations, adult women, men. Which is better, the consequences for the organism

When conducting the surgery an important point is the use of anesthesia. Different types of anesthesia provide an analgesic effect in operations and also affect the psychological state of the patient.

Why the need for anesthesia

Types of anesthesia, which are now used in operations, became known to mankind even in 1 in. BC. Then Dioscorides - the philosopher of Greece, described the actions of the mandrake per person. More and more studying anesthesia, people have concluded that it is without this tool will not do, no surgery.

Anesthesia is not just for analgesia during surgery, it helps to monitor the patient's condition. Indeed, during the human organism can respond most unusual manner, for example by increasing the pressure. Any such modification interferes with the normal procedure.

remains calm With anesthesia state of the body, he is just "asleep". Upon awakening, the patient does not remember what it did to him during surgery, does not feel pain. The feeling of fear as a result of retreats, recovery is faster. 2 kinds of anesthesia - general and local.

general anesthesia

During the anesthesia such a person is immersed in a deep sleep, and then does not feel anything and does not feel discomfort. General anesthesia is used in difficult operations, since it ensures full muscle relaxation, sleep reflexes nervous system. The patient at this time is under the supervision of a doctor, it introduced products from amnesia, heart failure and others.

All medicines are applied taking into account the characteristics of the body of the operated, and its susceptibility to them.

Hence there are three subspecies of general anesthesia:

• mononarkoza - use only one drug;
• mixed - 2 different drug;
• Combined - there are several different drugs that bind to each other and act on the body system.

General anesthesia is divided not only on these grounds. A distinction is also 3 subspecies anesthesia, but they differ in the type of administration of the substance.

• substance may enter by inhalation, through inhalation;
• also applies administering intramuscularly, intramuscularly, rectally;
• combined method.

lung ventilation is performed with the subsequent movement of the tube into the respiratory system.

local anesthesia

Local anesthesia is performed in the place where the operation will take place then. Doctors use drugs that paralyze the nervous activity in a particular area of ​​the body. This form is used for minor injuries. the patient's consciousness at this moment is stored.

Local anesthesia also includes several subspecies:

1. Superficial anesthesia is applied to the specific area of ​​skin or mucosal surface from above. Anesthetic in this case absorbed into the skin, stopping the nerves, resulting in that place disappears sensitivity. The most commonly used in dentistry.
2. Spinal - is administered into the spinal fluid, that is, the inside of the spine, resulting in a sense locked in the nerve roots. This subspecies is used during operations on the spine or legs.
3. There is another method in which the agent is administered through spinal fluid, but it uses a catheter that is inserted into the epidural region. Epidural anesthesia is used in obstetrics.
4. Paraneural anesthetic is injected into the zone, and as a result of blocked neural activity of a large nerve trunk. This subspecies is used by doctors in gynecology or thyroid operations.
5. In a specific place where must make surgery, by injection administered drug. Sensitivity in this area of ​​the body is completely blocked and the person does not feel anything.

With local anesthesia part of the body is simply "numb", but the patient to sleep does not sink.

action anesthesia

Types of anesthesia during operations have different effects on the human body.

And if local anesthesia person feels numb and may even observe what is happening, under the influence of general anesthesia organism goes through several stages:

1. Disappears sensitivity to pain and touch. When you touch the hair to the cornea reflex eyelids do not close. Eyeballs are rejected, there is a narrowing of the pupils. Breathing deeply, the vocal cords are relaxed, which is why it may be snoring. Skeletal muscles are not relaxed, pulse frequent.
2. Eyeballs are in the central position, the eyes do not react to light. Muscles have relaxed, but not much. superficial surgical procedure is done at this stage.
3. In the third stage of human breathing becomes shallow, quickens adding carbon dioxide. Blood pressure is reduced. body reflexes hardly appear, except those that provide circulation and respiration. In this condition, your doctor may cause some reflections on their own, for example, the emptying of the bladder. It is also important to fix the patient's tongue, because at this stage, all the muscles are relaxed, and perhaps ceasing language.
4. The last stage - a deep anesthesia. The patient is literally located on the border between life and death. Breathing is also superficial, has tolchkoobrazny character. Weakens heartbeat, very low blood pressure. Mucous membranes have a bluish tint. Eyeballs are not moving, dry eyes. Control of the readings made by instruments measuring pressure (measurements are made both manually and automatically), heart rate, ECG, and others. Also watch out for body temperature, eye reaction, the state of the bladder.

Awakening from anesthesia is also monitored by doctors. The patient may behave somewhat inadequate.

For children

Before operate the child using the anesthetic, the doctor finds his age and degree of maturity of the body's systems. Equally important is the experience of the anesthesiologist. The use of general anesthesia with a sedative effect prevents the traumatized child by administering it to sleep.

Necessary factor is the control of the small patient mobility, and this also helps to general anesthesia. Children (especially infants), the sensitivity and response to the impact from the outside is much higher than that of an adult.

That is why in addition to anesthetics during operations introduced muscle relaxants - drugs that block the body's reactions, could interfere with the proper conduct of proceedings. Most often children used inhaled endotracheal anesthesia. Unlike other species, it is much easier to apply to a small patient.

However, the following factors are taken into account before applying:

• the degree of narrowness of the respiratory tract;
• vulnerability;
• risk mucosal edema;
• high salivation.

Their presence can lead to serious problems and affect the patient's breathing. Calculation of the dose for a child is very different from the dosage for an adult human. This is due to a low amount of fat and muscle tissue, lower binding capacity of proteins.

adult

Adults anesthesia may be administered as an intravenous (or intramuscular) or by inhalation. But more common is the intravenous route, as it provides the fastest delivery of substances in the blood, the control of their blood. However, such individual characteristics as the narrowness of the respiratory tract and others are no longer a concern.

The patient catheter, through which drugs act. Often a combination of intravenous and inhalation process.

The specific dose for an adult is not present, the amount of anesthetic is calculated individually based on the Difficulty operations administered medications and body features (weight, sex, age, available disease). A particular drug has a dose, e.g., about 3 mg per kg, 2 mg per kg and others.

for elderly

Types of anesthesia in operations for the elderly have some differences from those conducted adults. First of all, changes in general and local anesthetic will depend on the age and condition of the patient. It is important to note that it takes into account the biological age. It is influenced by climate, economic conditions, and other psychological health.

Anesthetist, working with the elderly, should take into account such factors as:

• chronic illness (respiratory system diseases, atherosclerosis);
• Disorders of the kidneys, impaired liver function;
• rigidity of the chest;
• presence of ulcers of the stomach and its mucosal changes.

Before administered anesthesia, an elderly person is prepared for operation.

In just a few days before they take low molecular weight heparins. Then, taking these drugs is stopped (for 5-6 hours. before surgery), and after surgery resumed again. Preference is given epidural anesthesia, it is most suitable for the elderly.

For pregnant

During pregnancy, a woman can also be the case that one can not do without surgery with anesthesia and analgesia. Thus ingress of substances in the mother's blood significantly affects both its internal systems and on the fruit, which is formed inside it and has not yet fully formed organ systems.

For this reason, pregnant women, in most cases administered local anesthesia. This method significantly reduces the effect of drug action on the system. It should nevertheless be noted that the development of abnormalities in children whose mothers were exposed to anesthetics are a small percentage.

The risk of fetal death occurs under the influence of general anesthesia, at a time when they begin to form organ systems. If possible, the mother of the operation is transferred at the time of the third trimester. The use of anesthesia depends on the health of the woman, her susceptibility to the drug.

Contraindications

Types of anesthesia during operations have their contraindications. These are diseases that are already present in the patient, and can also be chronic.

Diseases in which it is impossible to conduct anesthesia, are:

• diseases of the cardiovascular system: unstable angina, cardiac insufficiency, acute coronary syndrome, congenital heart defects, atrioventricular block, atrial fibrillation;
• kidney and liver: hepatic and renal failure, viral hepatitis (exacerbation), liver cirrhosis, pyelonephritis, glomerulonephritis;
• respiratory system diseases: pneumonia, emphysema, bronchitis, cough with SARS, tracheitis;
• infection: abscess, skin inflammation;
• sepsis.

For children has its contraindications:

• rickets;
• spazmofiliya;
• recent vaccination;
• purulent diseases;
• chicken pox, measles, rubella;
• fever.

Spinal and epidural anesthesia should not be administered in case of:

• diseases of the skin in the place where the drug was to be administered;
• allergic to anesthetics;
• the patient himself may refuse to carry out such a local anesthetic (it is caused by fear, because during it the person is conscious);
• low blood pressure;
• a bleeding disorder.

Other subspecies of the local anesthetic is carried out in case of:

• allergy patients to drugs. before human operation carefully checked for allergic reactions;
• renal failure;
• of a lengthy operation. validity of anesthesia - 30-40 minutes. re-type drugs should not be - there will overdose.

Especially dangerous allergic to anesthetics angioedema - in such cases, the patient completely contraindicated anesthesia.

Side effects

Adverse reactions to the anesthesia are:

• nausea;
• itching;
• trembling of the body;
• muscle pain, back;
• headache, dizziness, blurred consciousness.

As a result of general anesthesia, complications may occur, if it has been done correctly:

• lung infection;
• oral trauma;
• nerve damage;
• allergy;
• eye damage;
• fatal outcome.

If the patient has the possibility of complications is too high, doctors will be forced to cancel the operation. Often the patients, especially the elderly, post-anesthesia there are some psychological problems such as depression, hallucinations, fear of death, panic attacks. When side effects to the patient best to consult a doctor.

Preparations for anesthesia

Types of anesthesia during operations always involve the use of muscle relaxants. They reduce the motility of the operated and immobilize it during the procedure. The indication of all muscle relaxants is to block seizures and muscle response to cold, the need for muscle relaxation during surgical procedures.

propofol

The main active ingredient of the drug - 2,6-diisopropylphenol. When used in medical applications it is important that propofol is almost insoluble in water but soluble in fats. Therefore, it is used together with fat solvents.

The drug looks like a liquid white and milky, slightly viscous. Due to the fact that propofol is dissolved in fats, it quickly penetrates into the brain, the drug starts to be effective early. After 1.5 min. after administration of the drug acts on the body, it binds to plasma proteins.

For adults, the dosage is 1-4 mg / kg per hour. It is used by inhalation, is introduced every 10-20 seconds. drip. To maintain the anesthetic dose was increased to 6.10 mg. Children 8 years - 2.5 mg / kg, the drug is introduced very slowly. Children under a specified age can not use the drug.

halothane

Active substance - halothane (50 mL). It has the form of a liquid. Another inhalants, it is often combined with other drugs in order to achieve the desired level of anesthesia. It is very easily absorbed from the respiratory tract, it acts quickly. The anesthetic used even in difficult operations on the lungs and peritoneal cavity, and is allowed for respiratory diseases.

Halothane relaxes the muscles, including the respiratory, secretory function blocks. The drug begins to act after 1.5 min., After the cessation of feeding a person wakes up after a few minutes. Inhalation not irritated mucous membranes.

Halothane used cautiously in patients with cardiovascular disease, and elevated levels of adrenaline. The drug is administered in combination with oxygen (concentration 0.5%), then the dose is increased to 3-5%. Maintenance dose - 0.5-2%.

ketamine

Ketamine released into ampoules for intramuscular administration of 2 and 5 ml. In one ampoule contains 57.6 mg of ketamine hydrochloride and auxiliary elements - sodium chloride, benzethonium chloride. The effect is achieved by blocking the ion channel receptors.

The drug inhibits the activity of neurons in the brain, including the hippocampus. Impact with opioid receptors leads analgesic effect. In the drug also has a number of consequences after recovery from anesthesia - delusions, hallucinations, drowsiness. Ketamine acts rapidly after intravenous injection - 15 seconds.

When using this product it is important to take into account the dosage:

adults	2-3 mg / kg - i.v. 4-8 mg / kg - IM The maximum dose - 8 mg / kg	Intramuscular and intravenous
children	Up to a year - 8-12 mg / kg 1-6 years - 6-10 mg / kg 7-14 years - 4-8 mg / kg	intramuscularly

To maintain the dose was reduced to 0.5-1 mg / kg (i.v.) or 2 mg / kg (i.m.) per hour infusion. Anesthesia, to what kind it is, helps not only in operations, but also in the process of recovery of the patient, removes and chronic pain. Anesthesia helps patients who are in intensive care units, and with cancer.

Videos about the kinds of anesthesia

Three types of anesthesia: