Pain and Mobility
10.10 Anesthetics
As a nurse, you may care for a client prior to surgery (preoperative), during surgery (perioperative, or after surgery (postoperative). It is important that you are aware of the type of anesthetic that your client has received or been prescribed, so that you know how to detect adverse side effects and properly manage care.
Local Anesthesia
Local anesthetic is when a medication (e.g., lidocaine) is injected into the skin at the site of the procedure to achieve numbness for procedures like suturing.[1]
General Anesthesia
General anesthesia is a medication-induced reversible unconsciousness with loss of protective reflexes. General anesthesia requires the establishment and maintenance of airway control.[2] Propofol is an example of an intravenous general anesthetic. The intravenous (IV) injection of propofol induces anesthesia within 40 seconds from the start of injection. [3]
Regional Anesthesia
Regional anesthesia numbs a large part of the body such as below the waist (epidural or spinal), or a limb (nerve block). This type of anesthesia is beneficial to reduce the overall need for high levels of opiates such as post-surgical or to decrease pain for labouring mothers.[4]
Epidurals allow for local anesthetic (i.e. lidocaine) to be injected with or without an opioid into the epidural space of the spine. This can be a one-time dose or a continual infusion. The benefit of epidurals is it allows for pain relief without significant motor impairment. Alternatively, spinal anesthesia is an intermittent dose that creates a larger nerve and motor block.[5]
Conscious Sedation
Conscious sedation is a combination of medications that allow the client to be relaxed (midazolam) and free of pain (e.g., fentanyl) during a medical procedure (e.g., colonoscopy). This allows the client to remain awake and aware, without feeling discomfort. The client may or may not be able to speak or respond in this state.
- Urban, Bernd W. & Bleckwenn, Markus. (2002). Concepts and correlations relevant to general anaesthesia. British Journal of Anaesthesia. 89(3-16). 10.1093/bja/aef164. ↵
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). pg. 305, 310, 952-953, 959-960. Wolters Kluwer. ↵
- This work is a derivative of Daily Med by U.S. National Library of Medicine in the public domain. ↵
- American Society of Anesthesiologists. (2021). Regional anesthesia. https://www.asahq.org/madeforthismoment/anesthesia-101/types-of-anesthesia/regional-anesthesia/ ↵
- Urban, W. & Bleckwenn, M. (2002). Concepts and correlations relevant to general anaesthesia. British Journal of Anaesthesia. 89, 3-16. 10.1093/bja/aef164. ↵