Anesthesia & PACU management

Anesthesia

— Blocks nerve impulse transmission

— Suppresses reflexes

— Promotes muscle relaxation

— Achieves a controlled level of consciousness

Beginning

— Losing consciousness, lightly sedated

— Decrease vital signs

— Decrease their pain sensation

Excitement

— Delirium

— Loss of consciousness

— Irregularities in breathing, but airway reflex is still present

Surgical

— Unconscious, and muscle is relaxed

Medullary

— Excessive anesthesia causing respiratory and cardiovascular depression

— Life threatening

— Emergency medical assistance

General Anesthesia

— Patient is Unconscious/unresponsive

— May develop temporary amnesia

Regional anesthesia

— Specific body/area

— Conscious/Lightly sedated

Minimal sedation

— Patient is relaxed and conscious

— Airway is normal

Moderate sedation/conscious

— Sleepy and can respond

— Does not need O2 support

Deep sedation analgesia

— Patient is very sleepy and difficult to awaken but still responds

— May require oxygen support

— Depressed respiratory system

Hypotension

— Usually caused by blood/fluid loss

— PREVENTION:

• Infuse 500-800 mL of IV

• if not prone to CHF

— INTERVENTION:

• Trendelenburg position ▪ 10-20 mins after induction

• Vasoactive drugs: Ephedrine

Respiratory Paralysis

— happens when drug reaches upper thoracic and cervical cord in large amount or in heavy doses

Phase I - Immediate Recovery

— Immediate care after surgery

— Requires close and intensive monitoring

— Focuses on early detection of complications

— Receive and review the complete OR report and patient records

— Monitor airway, breathing, circulation, and vital signs

Phase II

— For patients stable

— Requires less intensive monitoring

— Prepares patients for inpatient transfer or discharge

— Focuses on continued recovery and readiness for discharge

Hemorrhage

— Signs: hypotension, rapid thready pulse, restlessness/ confusion, oliguria, cold/pale skin

— Apply pressure dressing and notify surgeon

— Severe bleeding may require return to OR