17 topics with brief breakdowns: definitions, key facts, and class questions.
The chapter is dedicated to the cornerstone of surgery: protecting the patient from surgical trauma and pain. We will review a brief history of the development of anesthesiology and the modern principles of balanced anesthesia.
The section consistently covers all levels of pain impulse blockade. You will study techniques of local, infiltration, regional, intravenous, and intraosseous anesthesia, as well as therapeutic procaine blocks. A separate section is devoted to neuraxial methods (spinal and epidural anesthesia) and types of general anesthesia. We will analyze in detail the preparation for anesthesia, the features of intravenous, inhalation, and endotracheal anesthesia, as well as the basic design of breathing apparatuses.
During practical classes and exams, three things are strictly examined: indications for a specific type of pain relief, rules for monitoring the patient's condition, and algorithms for managing anesthesia complications. Without a clear understanding of these topics, safe work in the operating room is impossible.
Who is considered the creator of ether anesthesia?
Officially, W.T. Morton, his mentor C. Jackson, and H. Wells are recognized as the founders. However, historically, it is important that in 1844 in Russia, Ya.A. Chistovich published an article on amputation under sulfuric ether, anticipating Morton's discovery.
Why is Laborit and Huguenard's method of artificial hibernation not used today?
The lytic mixtures ("cocktails") for hibernation included chlorpromazine, which caused excessively deep neurovegetative blockade and dangerously suppressed the body's compensatory reactions.
Will I feel anything during surgery under local anesthesia?
Yes, you will be conscious and retain tactile and deep sensitivity (sensation of touch and pressure), but the feeling of pain will be completely absent.
Why doesn't overdose occur when administering up to 1000 ml of anesthetic?
Safety is ensured by two factors: using a very weak concentration of the drug (0.25%) and the fact that a significant volume of fluid mechanically flows out into the surgical wound as the fascial sheaths are opened.
What is the difference between endoneural and perineural administration?
During perineural administration, the solution is distributed in the tissues around the nerve trunk, while during endoneural administration, the drug is injected directly into the thickness of the nerve itself.
How to understand that the needle has reached the desired space during a paranephric block?
At the moment of piercing the lumbar fascia, the physician feels the overcoming of resistance ("give" or "pop"), and when the syringe is disconnected from the needle, droplets of the solution should not leak back.
Master the entire topic in the "General Surgery" course
This is a summary. The course covers everything tested in classes and exams.
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Assignments and quizzes after every topic — just like in a colloquium