An introduction to anesthesia for undergraduates

2. Where to go.....?
Follow your heart
Know your heart
…..and most importantly……..have a heart!

3. Where to go.....?
If your favourite place in the world is the operating room, be a
surgeon.
If your favorite place in the hospital is the operating room, be
an anesthesiologist.

4. TRUE OR FALSE
You are more familiar with a surgical knife [1] and catgut than
an oropharyngeal airway ….[2]
You have observed breast lump excision or appendicectomy[3]
better than a peripheral vein cannulation…[4]
More often, learning to drive a car will prove easier and useful,
than learning to fly an aeroplane!

5. ….. Anaesthesiology…….?

6. What we do…
Practice clinical pharmacology and physiology!
Administrators of medications to alter physiology and
pathology: immediate response!

7. What we do..
Analysts and rapid problem solvers!
Team leaders.

8. What we do…
Our working environment: complex, technical, requires multi-
tasking!

9. Why anaesthesiology?
Clinical and Basic Research!

10. Skills
Assessment of patient readiness for surgery
Airway management!
Pharmacology!
Resuscitation!
Fluid replacement!
Postoperative pain control!
Regional anesthesia!
Oxygen transport!
Operative stress reduction!

11. We go to…..
• Operating rooms!
• • Intensive care units!
• • Labor and delivery suite!
• • Pain clinic!
• • Radiology suite!
• • Gastroenterology suite!
• • Ambulatory care centers

12. Procedures
.

13. Procedures
Sedation outside OR
Labour analgesia
Central venous cannulation
Arterial cannulation
Intubation
Percutaneous tracheostomy
Lumbar puncture
ACLS

14. Our tools….
• • Inhaled anesthetics!
• • Local anesthetics!
• • Induction agents!
• • Muscle relaxants!
• • Opioids!
• • NMDA antagonists!

15. Why anaesthesia?
The Objectives
• Loss of awareness / Amnesia!
• Analgesia!
• Reduce movement in response to stimuli!
• Minimize autonomic responses to surgical stimuli!
• Muscle relaxation- if required!
• Autonomic Regulation!

16. Youngster !
Unlike many other medical specialties, anesthesiology is
young.!
• Availability of effective surgical anesthesia:~150 years.!
• Greatest advances: since 1950.!

17. What a change!
1950: Death rate from anesthesia 1 : 1,500!
1995: Death rate from anesthesia 1 : 250,000!

18. Slide master
Your Text here

19. Big moment
This demonstration occurred at the Massachusetts General
Hospital on October 16, 1846
Dr. Warren removed a congenital vascular malformation from
20-year-old Edward Gilbert Abbott’s neck. After the surgery,
the patient replied, “I did not experience pain at any time,
though I knew that the operation was proceeding.”

20. Slide master
Your Text here

21. Safety
PULSEOXIMETER [1990]
ETCO2[1996]
TRANS ESOPHGEAL ECHO[TEE]
BISPECTRAL INDEX [BIS]
ENTROPY
FOB- INTUBATION / LAVAGE
PULMONARY ARTERIAL CATHETER

22. Steps
Your Text here

23. Evaluation
History
Physical examination
Lab tests

24. Optimization
Your Text here

25. Prepare them; prepare ourselves
Preop orders
Explanation
Preparing OT
Equipments and drugs
Choice of anaesthesia
Induction, Intubation
Monitoring
Reversal and extubation
PACU

26. Spinal and Epidural anaesthesia

27. Specializations
Critical care
Cardiac Anaesthesia
Pain and palliative care
Neuroanaesthesia
Obstetric , Pediatric Anaesthesia

28. Thoughts …….
Good judgment is based on experience and experience is based
on bad judgment.
Savor your successes but do so quickly and then move on—
dwelling on them causes overconfidence.

29. Thoughts …….
Some patients you think will get better will get worse.
Some patients you think will get worse will get better.
When you’re making decisions on rounds, put personal
problems aside.

30. Hello……
You get to interact with the whole menagerie of medical and
surgical specialties

31. What suits one customer might not suit the next;
individualize your Rx .....always

32. Support! different situations by specific tools
.

33. Patient is more imporant than our ego;
call for help, whenever patient is in
danger
Your Text here

34. Thank you
visit me @ www.thelaymedicalman.blogspot.in
www.facebook.com/groups/anaesthesiaindia
Macintosh noted: “for the surgeon the spinal
ends with the injection of the agent; for the
anesthetist it begins with the injection of the
agent.”

35. Slide master
Your Text here