Sunday, December 08, 2013

General anesthesia


Recent media and social networking have discuss the alleged medical malpractice incident. The last case is the case of the death bustling performed cesarean section patients in Manado Indonesia. Cesarean section is the usual case by gynecologists, performed using general anesthesia or regional anesthesia or a combination of both, which is performed by the anesthetist. Actually, if the anesthesiologist 's role in an operation ? Perhaps the article below can explain or add insight in understanding anesthesia .

Anesthetic techniques can be divided into two major categories, namely general anesthesia and regional anesthesia or anesthetic half body. General anesthesia removes the awareness and pain so that a patient does not feel the surgery. Regional anesthesia only make a certain body area becomes numb, and the patient remains conscious, for example in the abdominal area down operations. In certain circumstances, sometimes it takes a combination of general and regional anesthesia. In general anesthesia, muscle relaxants can be given, so patients need to receive artificial respiration of the anesthesiologist. An anesthesiologist is usually assisted by a nurse anesthetist assigned to assist the process of anesthesia until the operation is completed.

There are several techniques of general anesthesia whose election depends on the type of surgery , patient age, and condition of the patient. The general anesthetic technique election will be decided by the anesthetist and will be communicated to the patient. Techniques include anesthesia with general anesthesia drugs given through a vein or total intravenous anesthesia (TIVA), and anesthesia using anesthetic gases that make the patient sleep. Techniques that use gas anesthesia administered through a face mask manner (face mask ), the laryngeal mask airway ( LMA ), and intubation with an endotracheal tube or pipe laryng ( ET ) is put up into the airways ( laryng ) .

Total intravenous anesthesia
Anesthetic technique is done by giving anesthetic drugs through the veins or intravenous . The drug is injected to make the patient fall asleep and do not feel pain during the surgery. The drug can be administered continuously using a pump syrinx, or discontinuous ( intermittent ). How this is done in a surgical anesthetic that is relatively short, and do not need perfect relaxation of the muscles of the body, such as the content of curettage surgery, incision lipoma or fatty lumps, mounting casts, and others. Currently Tiva anesthesia can replace with gas anesthesia .

Anesthesia with gas
Anesthetic technique is done by giving anesthetic drugs through continuous gas inhaled anesthetic patients. As a result of inhalation of this gas , making the patient is unconscious and can do surgery. This technique is performed on patients who need to sleep in such a mounting plate operation on a broken collarbone, and pediatric patients. Gas anesthesia can be administered through a facemask and LMA. Surgery in patients with head and neck area, it can be given anesthesia using endotracheal pipe fitting ( ET ), which require muscle relaxants, such as tonsillectomy, cutting the intestine, and the operating area of the chest cavity.

Selection of general anesthesia techniques whether using gas or Tiva, depends on the condition of the patient, and the availability of equipment. One of the disadvantages of using gas is air pollution, due to anesthetic gases can spread throughout the operating room, it can lead to all personnel in the operating room and participate inhaling anesthetic gas exposure and its long- term side effects that may be caused, such as liver damage. In some modern anesthesia machines, anesthesia gas machines will be sucked out of the engine and discharged into the atmosphere outside the operating room. In the end, no method is 100 percent safe anesthesia. All there is a risk that actions can occur, ranging from allergic itching, until respiratory arrest and cardiac arrest requiring resuscitation or rescue action. Always communicate with the anesthetist who will perform anesthesia, so that all can understand the benefits and risks that may arise.


Anesthesia Machine with vital sign monitor

Kuliah Siklus Krebs dan Bioenergetika