The four stages of general anesthesia and related nursing intervention

Regional or local anesthesia

- gag and cough reflexes stay intact - allows participation and cooperation by the patient - less disruption of physical and emotional body functions - No way to control agent after administration - increased NS stimulation (overdose) - no practical for extensive procedures because of the amount of drug that would be required to maintain anesthesia

Stage 1 nursing interventions

- close operating room doors, dim the light, and control traffic in the operating room - position patient securely with safety belts - Keep discussions about the patient to a minimum

Balanced anesthesia

- minimal disturbance to physiologic functions - can be used with older and high-risk patients - drug interaction can occur

Inhalation anesthesia

- most controlled method - induction and reversal accomplished with pulmonary ventilation - Must be used in combination with other agents for painful or prolonged procedures - limite muscle relaxant effects - postoperative nausea and shivering common

stage 2 general anesthesia nursing interventions

- avoid auditory and physical stimuli - protect the extremities - assist the anesthesiologist or CRNA with suctioning as needed - stay with patient

Intravenous anesthesia

- Rapid and pleasant induction - low incidence of postoperative NA/VO - must be metabolized and excreted from the body for complete reversal contradicted - liver and kidney dis increased cardiac and respiratory depression

Stage 4 general anesthesia rationales

- Teamwork and preparedness help decrease injuries and complications and promote the possibility of a desired outcomes for the patient

Stage 3 general anesthesia nursing interventions

- Assist the anesthesiologist or CRNA with intubation - Place patient into operative position - Prep (scrub) the patient's skin over the operative site as directed

Stage 4 general anesthesia - Danger

- Begins with depression of vital functions and ends with - respirator failure - cardiac arrest - possible death - respiratory muscles are paralyzed - apnea occurs - pupils are fixed and dilated

stage 1 - Analgesic - sedation - relaxation

- Begins with induction and ends with loss of consciousness Patient feels - drowsy - dizzy - reduced sensation to apin - is amnesic - hearing is exaggerated

Stage 4 general anesthesiaNursing interventions

- prepare for and assist in treatment of cardiac and/or pulmonary arrest - Document occurence in the patient's chart

Stage 3 general anesthesia rationales

- providing assistance helps promote smooth intubation and prevent injury - performing procedure as soon as possible promotes time management to minimize total anesthesia time for the patient

Stage 2 general anesthesia rationales

- sensory stimuli can contribute to the patient's response - safety measures help prevent injury - adequate suctioning of vomiting can prevent aspiration - staying with the patient is emotionally supportive

Stage 1 rationed

Avoiding external stimuli in the environment promotes relaxation using safety measures in stage 1 prepares for stage 2 Being sensitive to the patient maintains his or her dignity

Stage 3 general anesthesia - Operative anesthesia - surgical anesthesia

Begins with generalized muscle relaxation and ends with - loss of reflex - depression of vital functions - the jaw is relaxed - breathing is quiet and regular - patient cannot hear - sensation to pain is lost

Stage 2 general anesthesia - excitement - delirium

Begins with loss of consciousness and ends with - relaxation - regular breathing - loss of the eyelid reflex Patient may have - irregular breathing - increased muscle tone - involuntary movement of the extremities - laryngospasm or vomiting may occur