Intravenous Anaesthesia

Intravenous Anaesthesia

  Intravenous Anaesthesia is a method whereby the anaesthetic introduced to the body via a needle inserted  into a vein, such as one on the inner aspect of the arm or on the back of the hand.
 The skin is swabbed with a disinfectant and the needle is pushed through the skin into an underlying vein. The syringe plunger is slightly withdrawn to aspirate blood, thus ensuring that the needle is actually in the vein. A measured quantity of anaesthetic is then injected.

Indications for intravenous Anaesthesia

  1. Induction of anaesthesia: It is therefore unnecessary to apply a face mask to conscious, nervous patients. As soon as they go to sleep from the effects of a single dose of intravenous drug, the anaesthetic is continued with gas.
  2. Simple extraction of one or two teeth.
  3. Conservation under general anaesthesia: occasionally patients are kept asleep by means of continuous drip of drug into vein. This is thought by some operators to be suitable for highly nervous patients. The dose is sometimes adjusted so that the patient is relaxed but virtually awake.
  4. The most commonly used drug is methohexitone sodium (Brietal). Other are thiopentone and epontol (propanidid).
Read: Local and General anaesthesia

How to prepare patient for anaesthesia?

The surgery assistant must ensure that the patient has not eaten during the four hours prior to anaesthesia, as there is a danger that this could cause  vomiting, with the risk of vomit being inhaled and choking the patient. He should go to the lavatory as relaxation of his muscles might allow his bladder to empty during the anaesthetic and operation.
  The patient should be seated with his hips well back in the chair.
It is useful first to remove the foot rest of the chair, if there is one, to prevent patients bracing themselves against this during anaesthesia.
  Hand should either be placed in pocket or across the lap. Restraining straps are occasionally placed across the pelvis to stop the patient hurting himself whilst asleep.

How to setup operation room for anaesthesia patient?

 A prop should be placed between the teeth to keep the mouth open. As soon as the patient is asleep a gauze pack is carefully placed to separate the pharynx from the oral cavity, thus ensuring that no blood or debris is inhaled. A piece of cord attached to the pack prevents this being inhaled.
 If the operator wishes to change sides during the operation, a mouth gag is applied to the side already operated on and slightly opened, allowing the original prop to be removed. It is essential to ensure that no blood is allowed to run backwards, and to ensure that the operator can see properly. The assistant should therefore continually be on hand with an efficient aspirator.

Stages of anaesthesia

  1. Recovery
  2. Maintenance at stage of surgical anaesthesia.
  3. Induction.

Signs of anaesthesia

  1. The muscles are relaxed
  2. The pupils of the eye get smaller
  3. Patient breathes quietly and regularly
  4. The skin is usually pink with a slight bluish tinge as opposed to blackish color due to anoxia or lack of oxygen.

Post Operative care for anaesthesia patient

  All props and gags must be removed from the mouth, and patients head held gently forward  to prevent blood or debris reaching the pharynx. It is essential to watch for vomiting or fainting. In the latter case, the patient's head is lowered and the anaesthetist informed immediately. Under no circumstances should the patient be left alone until he or she has fully recovered consciousness. Heor she should not leave the building until in full possession of his faculties, and preferably accompanied by a responsible adult. Under no circumstances should he or she be allowed to drive a car for the rest of the day.

How to care for anaesthetic equipment?

  It is essential to check anaesthetic equipment prior to each session, to ensure that everything is working correctly and safely. Otherwise a patient may come to harm. Gas machines should be checked by a skilled mechanic every six months.
  Anaesthetic emergency kits should be kept up to date, and should be on hand during the operation. Drugs with a limited shelf life must be checked to ensure that none have deteriorated.


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