Inhalation anaesthetic is a type of general anaesthesia that is used for induction and maintenance of anaesthesia in the operating theatre. In general, all inhalation anaesthetics provide amnesia and immobility except for nitrous oxide which also provides pain relief. These are mainly used in combination with intravenous anaesthetics.

What Happens While Administering Inhalation Anaesthetic?

Inhalation anaesthesia works by interrupting nerve signals in your brain and body. This makes it difficult for your brain to process pain and remember what happened during the surgery.

Before your surgery, an anaesthesiologist will put a mask on your nose and mouth to breathe in the gas. In addition to this, the doctor may also put a tube through your mouth into your windpipe. This tube will ensure that you get adequate oxygen during the surgery.

Before administering anaesthesia, the doctor will monitor your vitals and body functions, including:

• Breathing.
• Temperature.
• Blood pressure.
• Heart rate.
• Blood oxygen level.
• Fluid levels.

Based on the above measurements, your anaesthesiologist will provide you with blood or fluids if required. After the surgery, you will stop receiving the anaesthetic and move to a recovery room where you’ll slowly wake up.

What Are the Stages of General Anaesthesia?

General anaesthesia has 4 stages, viz.,

The first stage of anaesthesia is induction which starts when you take the medication and until you go to sleep. During this phase, you will experience calmness and will be able to talk for a while. Slowly, your breathing will slow down and you will stop feeling any pain.

The second stage is dangerous and an anaesthesiologist will want you to get past this stage as quickly as possible. During this phase, you may have uncontrolled movements, a pacing heartbeat, and irregular breathing. Some people might even vomit which may make it difficult to breathe.

This is the stage when your surgeries will take place. During this phase, your eyes will stop moving, your muscles will relax, and you may even stop breathing without the help of machines. The goal of an anaesthesiologist is to keep you in this stage until your surgery is over.

In case you receive more than the required dose of anaesthesia, your brain will stop working and eventually, your heart and lungs may also fail. Although this stage is rare, it can be fatal.

What Are the Risks Associated with Inhalation Anaesthesia?

Apart from drowsiness, the other risks include:

• Nausea and vomiting.
• Sore throat.
• Dry mouth.
• Sleepiness.
• Muscle ache.
• Shivering.
• Itching.

Intravenous anaesthetic is a type of general anaesthesia given through a tube placed in a vein. It helps you to relax, prevents you from feeling pain, and is mainly used for minor surgical procedures that do not want you to be in a deeper stage of anaesthesia.

What Happens While Administering Inhalation Anaesthetic?

Intravenous anaesthesia works by interrupting nerve signals in your brain and body. This makes it difficult for your brain to process pain and remember what happened during the surgery.

Before your surgery, an anesthesiologist will administer the dose of anaesthetic through an IV line that goes into a vein in your arm or hand. In addition to this, the doctor may also put a tube through your mouth into your windpipe. This tube will ensure that you get adequate oxygen during the surgery.

Before administering anaesthesia, the doctor will monitor your vitals and body functions, including:

• Breathing.
• Temperature.
• Blood pressure.
• Heart rate.
• Blood oxygen level.
• Fluid levels. 

Based on the above measurements, your anaesthesiologist will provide you with blood or fluids if required. After the surgery, you will stop receiving the anaesthetic and move to a recovery room where you’ll slowly wake up.

What Are the Stages of General Anaesthesia?

General anaesthesia has 4 stages, viz.,

The first stage of anaesthesia is induction which starts when you take the medication and until you go to sleep. During this phase, you will experience calmness and will be able to talk for a while. Slowly, your breathing will slow down and you will stop feeling any pain.

The second stage is dangerous and an anaesthesiologist will want you to get past this stage as quickly as possible. During this phase, you may have uncontrolled movements, a pacing heartbeat, and irregular breathing. Some people might even vomit which may make it difficult to breathe.

This is the stage when your surgeries will take place. During this phase, your eyes will stop moving, your muscles will relax, and you may even stop breathing without the help of machines. The goal of an anaesthesiologist is to keep you in this stage until your surgery is over.

In case you receive more than the required dose of anaesthesia, your brain will stop working and eventually, your heart and lungs may also fail. Although this stage is rare, it can be fatal. What Are the Risks Associated with Intravenous Anaesthesia? Apart from drowsiness, the other risks include:

• Nausea and vomiting.
• Sore throat.
• Dry mouth.
• Sleepiness.
• Muscle ache.
• Shivering.
• Itching.

An endotracheal intubation or simply intubation is a procedure during which your doctor inserts a tube through your mouth or nose down into your trachea. This tube helps in keeping your trachea open so that air cannot get through. At times, this tube may also be connected to a machine to deliver air or oxygen directly to your body.

Why Do You Need an Intubation?

Intubation is required if you have a blockage in your airway or if it is damaged. It may also be required if you have:

• Airway obstruction.
• Cardiac arrest.
• Injury or trauma to your neck, abdomen, or chest.
• Loss of consciousness.
• Respiratory failure.
• Risk for aspiration.

What Happens During Intubation?

Intubation is a part of surgery and even emergency medical services to help you breathe. During the procedure, your doctor will:

• Insert an intravenous (IV) needle into your arm.
• Deliver medications through the IV to put you to sleep and prevent pain during the procedure.
• Place an oxygen mask over your mouth and nose to give extra oxygen.
• Remove the mask.
• Tilt your head back and insert a laryngoscope into your mouth.
• Adjust the tool towards the back of your mouth and avoid touching your teeth.
• Raise the epiglottis and insert the laryngoscope into your larynx and your trachea.
• Inflate a small balloon around the tube to make sure that it stays in place.
• Remove the laryngoscope.
• Place a tape on the side of your mouth to keep the tracheal tube in place.
• Test if the tube is working properly.

What Are the Risks Associated with an Intubation?

Intubation is a common and safe procedure. It may, however, cause:

• Aspiration.
• Infection.
• Injury to the trachea.
• Problem coming out of the anaesthesia.

A laryngeal mask airway or LMA is a device that is inserted into the area behind the nose and mouth, connecting them to the food pipe to allow oxygenation, ventilation, and administration of anaesthetic gases without the need for endotracheal intubation.

The device consists of an airway tube that is connected to an elliptical mask with a cuff inserted through the patient’s mouth. It is designed in a way to sit in the patient’s throat forming an airtight seal on top of the vocal cord and allowing a secure airway.

Why Do You Need LMA Insertion?

You may require LMA insertion for:

• Elective ventilation.
• Difficult airway.
• Cardiac arrest.

What Are the Risks Associated with a LMA Insertion?

Although rare, LMA can cause:

• Local irritation.
• Upper airway injuries.
• Aspiration.
• Obstruction.
• Laryngospasm.
• Pulmonary oedema.
• Bronchoconstriction.

A central venous catheter or central line or CVC is a device that helps you in receiving treatment for various medical conditions. The device is comprised of a long, thin, flexible tube that enters your body through a vein. The tube travels through one or more veins until the tip reaches the large vein that empties into your heart. The other end of the tube is located just above your chest. If the other end is on the outer side of your skin, it is called a hub. If the other end is inside your skin, it is called a portal. A CVC allows your doctor to access your bloodstream easily and reduces the need for needle sticks into your vein. This is ideal for people requiring long-term medications.

Why Do You Need a CVC?

You may need a CVC if you also need:

• Blood or platelet transfusion.
• Chemotherapy.
• Fluids or blood in an emergency.
• Haemodialysis.
• Long-term antibiotics.
• Nutrients are delivered directly into their blood.
• Vena cava filter placement.

What Happens During CVC?

The CVC procedure depends on the type of CVC you need. Regardless of the type, the general procedure includes:

• Cleaning the area on your skin where the needle must be inserted.
• Giving you medicine to numb the area.
•  Insert a needle into your skin preferably on your arm, neck, upper chest, and groin.
• Threading a wire through the needle and moving the wire forward in your vein.
•  Using a scalpel to make the needle puncture site a bit wider.
• Threading a device called a dilator into the opening in your skin. This device helps in creating a space for your catheter to enter and move through your vein.
• Gently push the dilator further into your soft tissue.
• Removing the dilator, and threading the catheter over the guidewire.
• Moving the catheter through one or more veins until the tip is in the correct location.
• Sewing the out end against your skin and applying a bandage over it to keep it clean.

What Are the Risks Associated with a CVC?

CVC is safe, it may, however, cause:

• Arrhythmia.
• Collapsed lungs.
• Bleeding.
• Damage to your trachea.
• Damage to artery or vein.
• Delayed breathing

An arterial line refers to a thin and flexible tube that is put into your artery to easily check your blood pressure. This is required during certain surgeries when your blood pressure is fluctuating.

Why Do You Need an Arterial Line Placement?

With an arterial line, your blood pressure can be always monitored. This allows your doctor to immediately know if your blood pressure is quickly rising or dropping. In addition, this alone also allows them to easily take as many blood samples for testing.

What Happens During Arterial Line Placement?

The procedure takes about 15 minutes, during which your doctor will:

• Check blood flow in arterial areas in your arm, foot, or groin.
• Clean the insertion site.
• Inject local anaesthesia in your skin near the insertion site.
• Insert a needle through your skin into the artery. This needle guides the catheter into the artery. Once the catheter has reached the location, the needle is removed.
• Cover the site with a clear bandage.
• Attach this line to saline and connect it to a monitor for checking blood pressure.

What Are the Risks Associated with Arterial Line Placement?

Although safe, an arterial line placement can cause:

• Bleeding.
• Pain.
• Infection.
• Blocked catheter.
• Blood clots.
• Haematoma or collection of blood at the insertion site.
• Damage to surrounding nerves or arteries.

General anaesthesia is a crucial part of any major or critical surgical procedure. It is administered to facilitate a pain-free and reversible state of unconsciousness with or without paralysis.

The 3 main components of any general anaesthetics are:

• Induction.
• Maintenance.
• Emergence.

What is Induction?

Induction refers to the starting phase of an anaesthetic. This involves securing the airway and administering the medications to begin the process of loss of consciousness before starting the surgical procedure.

An anesthesiologist begins this stage with an ABCDEF approach:

A: Airway adjuncts and considerations.

B: Breathing.

C: Cardiovascular system and emergency drugs.

D: Hypnosis, muscle relaxation.

E: Monitoring, type, and duration of surgery.

F: Fluids, intravenous access.

Once an anaesthesiologist finds it safe to administer the drug, an inhalation or intravenous anaesthetic is administered. Loss of consciousness is confirmed by the loss of vocal response or eyelash reflex.

What is Maintenance?

Once the anaesthesia is injected, the aim is to maintain a pain-free, unconscious state throughout your surgery.

Maintenance involves 2 stages:

• Maintenance of unconsciousness: This is achieved via intravenous or inhalation medication that is delivered into a breathing circuit attached to a ventilator.

• Maintenance of analgesia: There is a difference between being unconscious and being pain-free. Hence, an anaesthesiologist not only focuses on making you unconscious but also ensuring that you are pain-free during the surgery. For instance, your anaesthesiologist may use a combination of drugs such as paracetamol along with your dose of anaesthesia to keep you pain-free and unconscious throughout the surgery.

Airway management refers to thorough assessment, planning, and a series of medical procedures to maintain or restore your ventilation or breathing. This is an essential skill in critical and emergency medicine.

What Are the Types of Artificial Airways?

Depending on your condition, your surgeon may open any of the three artificial airways:

• Oropharyngeal Airway (OPA): This is a medical device that is used to maintain your airway by preventing the tongue from covering the epiglottis. This is preferred in unresponsive patients.

• Nasopharyngeal Airway (NPA): This involves a tube that is passed through your nasal passage to secure an open airway. This is also preferred when the patient is unresponsive.

• Endotracheal Airway (ETA): This involves a plastic tube that is inserted through the mouth and into the trachea or windpipe and connected to a ventilator to mechanically deliver oxygen to the lungs.

Why Do You Need Airway Management?

Airway management is required in emergencies, such as:

• Trauma.
• Cardiac arrest.
• Difficulty breathing.

Haemodynamic monitoring involves a procedure to check your blood circulation and evaluate how well your heart is working.

Why Do You Need Haemodynamic Monitoring?

You may need haemodynamic monitoring, if you have:

• A reduced blood flow to your brain.
• Sudden drop in your heart rate or blood pressure.
• Change in blood volume or distribution.

What is Used for Haemodynamic Monitoring?

A haemodynamic monitoring will involve a series of tests, including:

• EKG Monitoring:

During this, electrodes will be attached to your chest to send information on an EKG monitoring. This machine records the electrical activity of your heart in the form of a graph.

• Blood Pressure Monitoring:

During this, the doctor will place a cuff on your arm to check blood pressure at different times during the test.

• Haemodynamic Echo:

Before starting the test, the doctor will perform an ECG. It will measure how much blood your heart is pumping.

• Nuclear Medicine Imaging:

During this, your doctor will use a gamma camera to take pictures during the test. The camera detects gamma rays from a radioactive tracer. Images from this camera allow your doctor to know about your heart and blood circulation.

What Happens During Haemodynamic Monitoring?

During the procedure, your doctor will:

• Insert an IV to administer a radioactive tracer into your before.
• Position the gamma camera over your chest.
• Ask you to remain still while the camera takes images.

What Happens After Haemodynamic Monitoring?

After the procedure, you will stay in the hospital for some time until the tracer leaves your body through your urine. You can go home on the same day after a few hours.