Anesthesia
The word "Anesthesia" was first used by Greek philoposopher Dioscoides to describe the narcotic effect of plant mandragora. The sine qua non of Anaesthetized state is unconsciousness. General anesthesia is a state of reversible loss of all sensation and consciousness. An ideal anesthetic drug should include anesthesia smoothly and rapidly and permit rapid recovery as soon as administration ceased. It should also poses a wide margin of safety and be devoid of adverse affects. The modern practice most commonly involves the use of combination of drugs, taking advantage of their individual favorable properties while attempting to minimize their potential for harmful actions. American society of Anesthesiology (ASA) has prescribed standards for basic anesthetic monitoring. The patient's oxygenation, ventilation, circulation, and temperature shall be continually evaluated. Some important anesthetic agent and techniques used today are
- Ketamine is a phencyclidine derivative that produces dissociative anesthesia that resembles a cataleptic state in which the patient's eyes remain open with a slow nystagamic gaze. Patient is non communicative, amnesia is present and analgesia is intense. Ketamine has been used extensively for burn dressings, debridement, and skin grafting procedures.
- Benzodiazepines commonly used in perioperative period include diazepam, midazolam, and lorazepam.
- Tumescent local anesthesia (TLA) is a technique for regional anesthesia of skin and subcutaneous fatty tissues by means of direct infiltration of large volumes of dilute local anesthetic. TLA technique revolutionized the liposuction technique in 1980's. TLA technique uses small cannulas and involves infiltration of localized adiposities with large amounts of tumescent fluid containing lidocaine, 0.05%-0.125% and epinephrine 1:1000,000 to 1:2000,000 to obtain regional anesthesia and vasoconstriction.
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