_Adults

Anaesthetics for adults

The types of anaesthetics used today can be divided into two groups:

• general anaesthetics and
• local anaesthetics

General anaesthesia

General anaesthesia is a condition similar to deep sleep, which is induced by an infusion on the arm or back of the hand and the injection of a fast-acting anaesthetic agent. The anaesthesia is maintained by the administration of either a special anaesthetic gas through the respiratory tract or an anaesthetic agent which is constantly injected with the infusion. This ensures no pain is felt and the patient is unconscious. Usually the breathing has to be supported (artificial respiration), which the patient, however, does not feel. This is provided by a face mask with a so-called laryngeal mask or with a respiratory tube (intubation). At the end of the operation the supply of the anaesthetic agent is interrupted and the patient wakes up within a few minutes. This is followed by an observation period in a separate room.

Local anaesthesia

Local anaesthetics offer the chance to only eliminate the perception of pain in the part of the body to be operated on. They include: die brachial plexus anaesthetics, spinal or peridural anaesthetics, i.v. block, special blocks of individual large nerve trunks. Click here to login for 3D-animation films

Brachial plexus anaesthesia

In brachial plexus anaesthesia (a blockage of the plexus) the local anaesthetic is injected into the armpit or below the collarbone close to the nerves responsible for the arm and hand, once the arm has been correspondingly positioned and the skin in the area has been locally anaesthetised. The consequences are an inability to move the arm and feel pain.

Peridural anaesthesia

Spinal and peridural anaesthesia are suitable for operations in the lower abdomen, pelvic and leg area. After a prior local anaesthetic has been applied to the skin, a puncture is made with a special needle at the height of the waist in the dorsal midline, usually via the lumbar spine. The local anaesthetic is injected, in spinal anaesthesia, into thefluid in the spinal region. Due to the injection the nerves running through the spinal cord are anaesthetised and the detection of pain in the operation area is blocked.

In peridural anaesthesia (also called epidural anaesthesia) the injection needle is not inserted into the area of the spine, but merely into the gap between the meninge of the spinal cord and the vertebral canal. Before or after the injection of the local anaesthesia a fine plastic tube can also be inserted here, through which further injections can be made to extend the anaesthesia or to treat pain after the operation.

I.V. block

The i.v. block (i.v. = intravenous) is used for arm, hand, leg and feet operations. A sleeve is applied to the upper arm, upper or lower leg for this procedure. An injection canal is inserted - depending on the place of the operation – on the back of the hand or the back of the foot. Once the arm or leg has been made bloodless by raising the area and uncoiling with a wide rubber band, the sleeve can be inflated. Here the aim is to block the circulation of blood. In order to do so the pressure in the sleeve has to be higher than the blood pressure. A local anaesthetic is now injected through the existing injection canal, which is distributed through the blood circulation system and migrates into the surrounding tissue. This interrupts the perception of pain in the operation area and causes movement to be restricted. As soon as the operation has ended the sleeve is detached; the local anaesthetic is now transported out of the operated extremity and feeling and movement quickly return to the area.