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General and local
anaesthetic agents
Learning objectives
Upon completion of this chapter, you should be able to:
1.
Describe the concept of balanced anaesthesia.
2.
Describe the actions and uses of local anaesthesia.
3.
Describe the therapeutic actions, indications, pharmacokinetics, contraindications, most common adverse
reactions and important drug–drug interactions associated with general and local anaesthetics.
4.
Outline the preoperative and postoperative needs of a person receiving general or local anaesthesia.
5.
Compare and contrast the prototype drugs thiopentone, midazolam, nitrous oxide and lignocaine with other
drugs in their respective classes.
6.
Outline the care considerations, including important teaching points, for people receiving general and local
anaesthetics.
Glossary of key terms
amnesia:
loss of memory of an event or procedure
anaesthetic:
drug used to cause complete or partial loss of sensation
analgesia:
loss of pain sensation
balanced anaesthesia:
use of several different types of drugs to achieve the quickest, most effective anaesthesia with the fewest
adverse effects
general anaesthesia:
use of drugs to induce a loss of consciousness, amnesia, analgesia and loss of reflexes to allow performance of
painful surgical procedures
induction:
time from the beginning of anaesthesia until achievement of surgical anaesthesia
local anaesthesia:
use of powerful nerve blockers that prevents depolarisation of nerve membranes, blocking the transmission of pain
stimuli and, in some cases, motor activity
plasma esterase:
enzyme found in plasma that immediately breaks down ester-type local anaesthetics
pre-medication:
medication administered prior to surgery to facilitate sedation and general anaesthesia
unconsciousness:
loss of awareness of one’s surroundings
volatile liquid:
liquid that is unstable at room temperature and releases vapours; used as an inhaled general anaesthetic, usually in the
form of a halogenated hydrocarbon
Test your current knowledge of general and local anaesthetic agents with a PrepU Practice Quiz!
GENERAL ANAESTHETIC
AGENTS
Barbiturate anaesthetics
thiopentone
Non-barbiturate general
anaesthetics
droperidol
ketamine
midazolam
propofol
Anaesthetic gases
ethylene
nitrous oxide
Volatile liquids
desflurane
isoflurane
methoxyflurane
sevoflurane
LOCAL ANAESTHETIC AGENTS
Esters
amethocaine
benzocaine
Amides
bupivacaine
cinchocaine
levobupivacaine
lignocaine
mepivacaine
prilocaine
ropivacaine
