The primary considerations in anaesthetic management of ophthalmic surgeries are the following:
• An immobile eye with extraocular muscle akinesia
• Control of the Airway with adequate ventilation
• Hemodynamic stability
• Well controlled intraocular pressure by avoiding raise in the central venous pressure prior to, during and after the surgery.
Children and infants present for ophthalmic procedures from birth onwards. Unlike in adults, where most of the intraocular procedures are done under local anesthesia, general anesthesia is the preferred choice of anesthesia for children undergoing ocular procedures. Most commonly the general anesthesia is given by using endotracheal intubation. General anaesthesia with endotracheal intubation is a time-tested procedure and most routinely practiced all over the world. The procedure has evolved over many years. The procedure of laryngoscopy and endotracheal intubation is associated with pressor response and rise in intraocular pressure. It is also characterised by increase in heart rate, transient rise in blood pressure and rise in Intraocular pressure. To obtund such
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Intraocular procedures may be closed intraocular or open intraocular procedures. In pure extraocular procedure, e.g. Strabismus correction, there is no impact of anesthesia on intraocular pressure. Whereas, in open intraocular procedures such as traditional intracapsular cataract extraction or in drainage operations in glaucoma, it is crucial that intraocular pressure is kept under control. Sudden decompression of a glaucomatous eye may be catastrophic with iris or lens prolapse, vitreous loss or expulsive choroidal haemorrhage. Similarly, any further rise in IOP in penetrating eye injuries will lead to permanent loss of vision. They present special challenges to the anaesthetist, and hence, proper anaesthetic management contributes significantly to a successful surgical
Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
IV sedation is reserved for our most complicated procedures and patients with very high levels of fear and anxiety. IV sedation creates a sleep-like state that allows you to wake up from a procedure with no memory of the sights, smells, sounds, or sensations that occurred during the treatment. This form of sedation is administered through an intravenous line and only by a licensed
John B. Pollard, Ann L. Zboray, Richard I Mazze. The International Anesthesia Research Society. (1996).
Anesthesia was not used in surgeries until 1846, so prior to that the patient was completely conscious when they operated on him or her, unless the patient passed out from pain. Patients were unwilling to be cut into while they were awake: “Dragged unwillingly or carried from the ward to the operating theatre by a couple of hospital attendants (in Edinburgh a large wicker basker was used for this purpose) the patient was laid on the operating table and if necessary strapped down” (Youngson 27). The tools used in surgeries can be seen here. Anesthetics Anesthetics were not used in surgery until October 16, 1846, at Massachusetts General Hospital (Youngson 51). Anesthesia is an inhaled gas known as ether.
Have you ever wondered why you have no feeling during surgery? The reasoning behind this is a doctor called an anesthesiologist. For those who are wondering who they are and what they do, anesthesiologists are doctors who, after completing many years of school and training, work many hours to make sure patients feel no pain during surgery, and earn a good salary along with good benefits.
Individuals need to understand the use of anesthesia always comes with risks. In most cases, however, it's safe when administered by someone with the proper training. Certain individuals, such as those with obstructive sleep apnea or ones who are obese, need to speak to their physician before being sedated, as their risk of complications is higher.
Brody, Michael, and Donald Martin. “The Role of Anesthesiologists.” Physicians Protecting Patients. N.p. N.d. Web. October 21, 2015. An anesthesiologist is a physician who has received at least 8 years of schooling and has completed a residency program dealing with anesthesiology. Now, a licensed physician, an anesthesiologist deals with the administration of anesthesia during many medical procedures, including surgical or obstetric procedures, and pain management for acute and chronic illnesses, or cancer related pain. Anesthesiologists are also in charge of “anesthesia care teams” that include the anesthesiologist, an anesthesia assistant, certified registered nurse anesthetist, and an anesthesia technician. As the leader of the care team, the anesthesiologist is responsible for assessing the patient before, during, and after medical procedures, as well as developing and monitoring performance and quality of practices and standards in regards to administering anesthesia. The entirety of
American Association of Nurse Anesthetists. Professional Aspects of Nurse Anesthesia Practice. Philadelphia: F. A. Davis Company, 1994. Print.
Stomberg, M., Sjöström, B., & Haljamäe, H. (2003). The Role of the Nurse Anesthetist in the Planning of Postoperative Pain Management. AANA Journal, 71(3), 197.
Certified Registered Nurse Anesthetists (CRNA) are high trained nurses who use their developed training in the use of anesthesia to alleviate patient pain and discomfort due to medical procedures. Nurse anesthetists have been providing anesthesia for more than 125 years, dating back to the early Civil War. ("Nurse anesthetist," 2014). They undergo rigorous training post nursing licensure that allows them to hold a high position in the nursing field working beside surgeons, anesthesiologist, dentists, podiatrist, and many other skilled healthcare professionals ("Nurse anesthetist," 2014). Pain management is one of the main aspects in any procedure, if not the most important to the patient, therefore giving nurse anesthetists a wide spectrum of work settings in the medical field that they can practice in.
...e operating table and the nurse anesthetist begins to place the monitors on them. Next, everyone in the room confirms the patient’s name and the scheduled operation. Then the nurse anesthetist puts the anesthesia in the patient’s IV. Once the patient is asleep, the CRNA manages his/her airway. To do this they place an endotracheal tube through the patient’s mouth, allowing them to breathe anesthesia gases. Now the operation can begin.
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
Everyday, people go through surgery and require a specialist that will monitor their surgery as well as give them what they need to be able to persevere the pain, which is exactly what anesthesiologists do. In order for the patients to be able to get into surgery and deal with the agonizing aches after the abscission, anesthesiologists have to give the sufferer the proper treatment before and after the surgery. Overall, anesthesiologists must be highly educated in both medicine and communication, they need to be able to give the patient the right amount of medicine as well as speak with the family of patients and other doctors to inform them all with what will be done during the surgery, and they need to be able to properly assist the surgeons during operations.
The role of the nurse in the preoperative area is to determine the patient’s psychological status to help with the use of coping during the surgery process. Determine physiologic factors directly or indirectly related to the surgical procedure that may cause operative risk factors. Establish baseline data for comparison in the intraoperative and postoperative period. Participate in the identification and documentation of the surgical site and or side of body on which the procedure is to be performed. Identify prescription drugs, over the counter, and herbal supplements that are taken by the patient that may interact and affect the surgical outcome. Document the results of all preoperative laboratory and diagnostic tests in the patient’s record