Anesthetics General/Local

Anesthetics General/Local


Action: Anesthetics (General) act on the CNS to produce tranquilization and sleep before invasive procedures. Anesthetics (Local) inhibit conduction of nerve impulses from sensory nerves.

Uses: General anesthetics are used to premedicate for surgery, indection and maintenance in general anesthesia. For local anesthetics, refer to individual product listing for indications.

Side effects / Adverse reactions: The most common side effects are dystonia, akathisia, flexion of ares, fine tremors, drowsiness, restlessness, and hypotension. Also common are chills, respiratory depression, and laryngospasm.

Contraindications: Persons with CVA, increased intracranial pressure, severe hypertension, cardiac decompensation should not use these products, since severe adverse reactions can occur.

Precautions: Anesthetics (General) should be used with caution in the elderly, cardiovascular disease (hypotension, bradydysrhythmias), renal disease, liver disease, Parkinson’s disease, children below 2 years old. The precaution for anesthetics (Local) is pregnancy.

Interactions: MAOIs, tricyclics, phenothiazines may cause severe hypotension or hypertension when used with local anesthetics. CNS depressants will potentiate general and local anesthetics.

Possible nursing diagnoses:
General:
» Risk for injury [adverse reactions]
» Knowledge deficit [teaching]
Local:
» Pain [uses]
» Knowledge deficit [teaching]

Nursing Considerations


Assess:
» VS q10min during IV administration, q30min after IM dose

Administer:
» Anticholinergic preoperatively to decrease secretions
» Only with crash cart, resuscitative equipment nearby

Perform/Provide:
» Quiet environment for recovery to decrease psychotic symptoms

Evaluate:
» Therapeutic response: maintenance of anesthesia, decreased pain

Selected Generic Names (Injectables)


General anesthetics
droperidol
etomidate
fentanyl
fentanyl/droperidol
fentanyl transdermal
ketamine
methohexital
midazolam
propofol
thiopental

Local anesthetics
lidocaine
procaine
ropivacaine
tetracaine

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