Anaesthesia

2021 ◽  
pp. 31-34
Author(s):  
Chetan Srinath ◽  
Alan Yates
Keyword(s):  
Human Physiology ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Anaesthetic Agent ◽  
Active Agent ◽  
Anaesthetic Techniques ◽  
Complete Loss ◽  
Loss Of Consciousness ◽  
Public Demonstration

The evolution of surgical anaesthesia began nearly 175 years ago with the first public demonstration in 1846 by William G. Morton. Modern anaesthetic techniques have developed in keeping with our understanding of human physiology and the demands of surgical innovation. Anaesthesia can be local, regional, or general and plastic surgery lends itself to local or regional techniques. Local anaesthesia infiltrates the active agent throughout the area in question, while regional anaesthesia uses discrete placement of the anaesthetic agent to block the conduction in nerves supplying sensibility to a wide predictable area. General anaesthesia involves complete loss of consciousness and awareness.

Local anaesthesia for manipulation of nasal fractures: systematic review

2009 ◽  
Vol 123 (8) ◽  
pp. 830-836 ◽  
Author(s):  
N K Chadha ◽  
C Repanos ◽  
A J Carswell
Keyword(s):  
Systematic Review ◽  
General Anaesthesia ◽  
Local Anaesthetic ◽  
Local Anaesthesia ◽  
Randomised Controlled Trials ◽  
Anaesthetic Techniques ◽  
Cochrane Library ◽  
Controlled Trials ◽  
Randomised Controlled ◽  
Nasal Fractures

AbstractObjective:To determine the most effective local anaesthetic method for manipulation of nasal fractures, and to compare the efficacy of local anaesthesia with that of general anaesthesia.Method:Systematic review and meta-analysis.Databases:Medline, Embase, Cochrane Library, National Research Register and metaRegister of Controlled Trials.Included studies:We included randomised, controlled trials comparing general anaesthesia with local anaesthesia or comparing different local anaesthetic techniques. Non-randomised studies were also systematically reviewed and appraised. No language restrictions were applied.Results:Five randomised, controlled trials were included, three comparing general anaesthesia versus local anaesthesia and two comparing different local anaesthetic methods. No significant differences were found between local anaesthesia and general anaesthesia as regards pain, cosmesis or nasal patency. The least painful local anaesthetic method was topical tetracaine gel applied to the nasal dorsum together with topical intranasal cocaine solution. Minimal adverse events were reported with local anaesthesia.Conclusions:Local anaesthesia appears to be a safe and effective alternative to general anaesthesia for pain relief during nasal fracture manipulation, with no evidence of inferior outcomes. The least uncomfortable local anaesthetic method included topical tetracaine gel.

Perioperative morbidity and mortality of carotid artery surgery under loco-regional anaesthesia

VASA ◽  
2005 ◽  
Vol 34 (1) ◽  
pp. 41-45 ◽  
Author(s):  
Assadian ◽  
Senekowitsch ◽  
Assadian ◽  
Ptakovsky ◽  
Hagmüller
Keyword(s):  
Carotid Artery ◽  
Carotid Endarterectomy ◽  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Regional Anaesthesia ◽  
Carotid Arteries ◽  
Morbidity And Mortality ◽  
Single Centre ◽  
Carotid Artery Surgery ◽  
Fontaine Stage

Background: Loco-regional anaesthesia for carotid artery surgery has many advantages over general anaesthesia. It may be associated with a reduction in neurological, and equally important, non-neurological morbidity and mortality. However, sufficiently powered randomised controlled trials comparing general anaesthesia with local anaesthesia for carotid artery surgery are not yet published. Herein, we present our single centre experience of carotid endarterectomy under local anaesthesia and their respective procedure-related morbidity and mortality rates. Patients and methods: From January 1996 to December 2002, 1271 patients were operated on their carotid arteries. Of these, 1210 (95%) patients and 1355 carotid arteries were operated on in loco-regional anaesthesia and included in a prospective recording. The patients age ranged from 47 to 100 years (mean 70.5 years), 711 patients were male, 499 female. 496 patients (41%) were asymptomatic (Fontaine stage I), 460 have had a transient neurological deficit (TIA) prior to admission (Fontaine stage II) and 254 patients have had a stroke (Fontaine stage IV). Results: The combined stroke rate was 2.2% (n = 30). The overall 30 day mortality was 0.2% (n = 3). The rate of haematoma indicating revision was 3% (n = 40). The revision in all cases was within 12 hours of surgery. No patient developed respiratory insufficiency after surgery. However, of the 40 patients with revision for haematoma, 4 (10%) needed prolonged respiratory assistance and one patient ultimately died of respiratory insufficiency and stroke. No cardiac mortality was observed. The over all rate of myocardial infarction observed postoperatively was 1.4% (n = 19), of which 1.1% (n = 15) were non q-wave infarcts. The combined shunting-rate for all stages was 18.6% (n = 252). Conclusion: Morbidity and mortality of carotid endarterectomy in loco-regional anaesthesia is comparable to recently published single-centre results. Patients with severe COPD, usually unsuitable candidates for general anaesthesia, can also be treated safely.

Paediatric regional anaesthesia: Comparing caudal Anaesthesia and Ilioinguinal block for Paediatric Inguinal Herniotomy

2016 ◽  
Vol 2 (1) ◽  
pp. 45-50
Author(s):  
Srinivas Teja ◽  
N.V. Rama Rao ◽  
P. Sharmila Nirojini ◽  
Venkateswara rao ◽  
Ramarao Nadendla
Keyword(s):  
Medical Students ◽  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Anaesthetic Techniques ◽  
Review Article ◽  
Opioid Analgesia ◽  
Paediatric Surgery ◽  
Safety And Efficacy ◽  
Caudal Anaesthesia ◽  
Inguinal Herniotomy

Caudal anaesthesia and ilioinguinal block are effective, safe anaesthetic techniques for paediatric inguinal herniotomy. This review article aims to educate medical students about these techniques by examining their safety and efficacy in paediatric surgery, as well as discussing the relevant anatomy and pharmacology. The roles of general anaesthesia in combination with regional anaesthesia, and that of awake regional anaesthesia, are discussed, as is the administration of caudal adjuvants and concomitant intravenous opioid analgesia.

scholarly journals Altered stimulus representation in rat auditory cortex is not causal for loss of consciousness under general anaesthesia

2018 ◽  
Vol 121 (3) ◽  
pp. 605-615 ◽  
Author(s):  
M.I. Banks ◽  
N.S. Moran ◽  
B.M. Krause ◽  
S.M. Grady ◽  
D.J. Uhlrich ◽  
...  
Keyword(s):  
Auditory Cortex ◽  
General Anaesthesia ◽  
Loss Of Consciousness ◽  
Stimulus Representation

Ultrasound-Guided Regional Anaesthesia: A Safer Option than General Anaesthesia?

Clinical Risk ◽  
2012 ◽  
Vol 18 (6) ◽  
pp. 224-228
Author(s):  
Nicholas Goddard ◽  
Stuart Batistich ◽  
Zoë Smith ◽  
Jim Turner ◽  
Peter Tomlinson
Keyword(s):  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Ultrasound Guided

scholarly journals Corrected Scoliosis, Cholinesterase Deficiency, and Cesarean Section: A Case Report

2009 ◽  
Vol 2009 ◽  
pp. 1-3 ◽  
Author(s):  
Roy Somers ◽  
Yves Jacquemyn ◽  
Luc Sermeus ◽  
Marcel Vercauteren
Keyword(s):  
Case Report ◽  
Caesarean Section ◽  
Cesarean Section ◽  
General Anaesthesia ◽  
Spinal Anaesthesia ◽  
Regional Anaesthesia ◽  
Previous Caesarean Section ◽  
Corrective Surgery ◽  
Ultrasound Guided ◽  
Severe Scoliosis

We describe a patient with severe scoliosis for which corrective surgery was performed at the age of 12. During a previous caesarean section under general anaesthesia pseudocholinesterase deficiency was discovered. Ultrasound guided spinal anaesthesia was performed enabling a second caesarean section under loco-regional anaesthesia.

scholarly journals Regional Anaesthesia, The Seed of Opportunity In COVID-19 Crisis: The Balance Has Shifted

2020 ◽  
Vol 6 (3) ◽  
Keyword(s):  
Critical Care ◽  
General Anaesthesia ◽  
Regional Anaesthesia ◽  
Albert Einstein ◽  
Multimodal Analgesia ◽  
Nerve Blocks ◽  
Great Opportunity ◽  
Aerosol Generation ◽  
Number Of Patients ◽  
Alternative Drugs

Albert Einstein once said, “in the midst of every crisis, lies great opportunity.” There’s no question that we’re in the midst of a global crisis. There’s no doubt that a crisis creates problems, lots of them, but it also creates opportunities. Something that every anaesthetist does day in day out safely, intubation of trachea, is now become a risk factor for spread of the disease. So where is the opportunity in this crisis? In the west, regional anaesthesia is often used as an adjunct rather than as sole anaesthetic technique, as part of multimodal analgesia in patients who are being operated under general anaesthesia. Unfortunately, general anaesthesia requires airway manipulation that is associated with aerosol generation and risks transmission of corona virus. This is a risk that can be averted with use of regional anaesthesia techniques for procedures that can be done with patient awake rather than asleep. At the beginning of the pandemic with surge of patients requiring endotracheal intubation and ventilation, increased intensive care admissions affected anaesthesia services in many ways. The increased number of patients needing critical care increased the demand for drugs used in both anaesthesia and critical care and this demand led to shortage of anaesthesia drugs and led the Association of Anaesthetists (AOA) and the Royal College of Anaesthetists (RCoA), working closely with the Chief Pharmaceutical Officer at NHS England to produce a guidance which summarised potential mitigations to be used in the management of such demand. Direct alternative drugs and techniques were offered (1). The options identified in the guidelines were not exhaustive but give a way of thinking about this situation we all have landed up in. We were unsure of how long this demand would continue and how we would manage the situation. This is where the opportunity to use regional anaesthesia for procedures that could be done purely under neuraxial or peripheral nerve blocks became

scholarly journals Thyroidectomy under Local Anaesthesia; Experience from a Tertiary Hospital in Kumasi, Ghana

2020 ◽  
Vol 2 (2) ◽  
pp. 01-07
Author(s):  
Anna Konney ◽  
Mawutor Dzogbefia ◽  
Philip Oppong Peprah ◽  
Derrick Gyimah ◽  
Isaac Barnor
Keyword(s):  
General Anaesthesia ◽  
Local Anaesthesia ◽  
Operating Time ◽  
Cost Effective ◽  
Tertiary Hospital ◽  
Tertiary Referral Hospital ◽  
Thyroid Lobectomy ◽  
Cervical Plexus Block ◽  
Plexus Block ◽  
The Cost

Objectives: Improvement in anaesthesia has allowed thyroidectomies to be performed mainly under general anaesthesia. There is however a growing interest in performing thyroid surgery under local or regional anaesthesia. The objective of this study was to analyse and share our experience with safety of thyroidectomy under regional cervical plexus block/ local anaesthesia in a tertiary referral hospital in Ghana. Materials and Methods: A retrospective study was conducted on all patients who had thyroidectomy under local anaesthesia from 1st January 2017 to 31st May 2018 in KATH. Data collected were demography, grade of goitre, operating time, and duration of hospital stay, complications and cost effectiveness of the procedure. Data was analysed using Stata version 16.0software. Results: A total of 105 thyroidectomies were done in the study period out of which 16 were done under local anaesthesia. All 16 patients (16 females, 100%) and majority 11 (68.75%) were aged between 30 and 50 years. 11 (68.75) had grade IB goitres. The most frequently performed surgery was thyroid lobectomy 12 (75%) and in 75% of cases the surgery was completed between 60 and 90 minutes. Most patients, 9 (56.25%) were discharged home within 48 hours following surgery. The cost of treatment was averagely 30% less compared to same surgery under general anaesthesia. No complications were recorded in the post-operative period. Conclusions: Comprehensive clinical assessment and careful patient selection for thyroidectomy under local anaesthesia result in good surgical outcomes. The procedure is safe and cost-effective and should be performed by experienced surgeons for the best outcomes.

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