IV. Table of contents of studies

General anaesthesia is artificially predefined violation of functions of central nervous system, caused the action of anesthetics or electric current and accompanied a loss sensorium, by the decline of different types of sensitiveness, weakening of muscles, oppression of reflexes and other important functions of organism.

From the point of view pharmacologists - it deep sleep (reverse oppression of cages of central nervous system) which is accompanied the changes listed above is artificially caused a pharmacological way.

Depending on the method of introduction to the organism of narcotic matters select:

- inhalation anesthesia;

- uninhalation anesthesia.

Depending on the amount of utillized anesthetics:

- monocomponent;

- multicomponent.

Under inhalation anesthesia understand such anesthesia which is caused inhalation of vapor narcotic volatiles or narcotic gases. At inhalation anesthesia narcotic matters enter in an organism through respiratory tracts (trachea, carried, mouth, tracheostoma).

Monocomponent anesthesia is anesthesia, when one narcotic preparation is entered in an organism (for example, ether); multicomponent – when entered simultaneously two or more of narcotic grugs (for example, ether and protoxide nitrogen) and the combined anesthesia – when anaesthesia is arrived at simultaneous or successive using drugs of different action (general anesthetics, analgetics, tranquilizers, muscular relaxants). It is the most difficult type of anesthesia. Its components is: a base is anesthesia, introductory anesthesia and supporting anesthesia.

Base anesthesia is a seminarcosis on a background which entered basic anesthetic, used for diminishing of amount of the use of basic anesthetic and removal of emotional reactions for children and persons with a labile psyche. Narcotic matters for base anesthesia often enter in a rectum (enemas, candles), hypodermic, intravenously, intramuscular before an operation, as a rule, in a chamber. Base anesthesia shows the action to the operation, under time and some time after an operation.

Introductory anesthesia is of short duration anesthesia by which the removal of excitation and diminishing of satiation of organism is foreseen by main narcotic preparation.

Supporting (basic, main) is anesthesia which is applied during all operation. Distinguish incomplete and complete inhalation anesthesia.

Incomplete anesthesia – an analgesia is arrived at for a few minutes. Apply for short-term of operative interferences.

Complete anesthesia – apply at durational operations.

Theories of anesthesia

The mechanism of origin of narcotic sleep is explained in majority the physical and chemical or by physiology phenomena (coagulative theory of Claude Bernar (1875), lipoid theory of Meyer (1899), theory of oppression of nervous cages of Fervork (1912), adsorption theory of Traube (1904), theory of microcrystalline of Iiolinga (1961). Last years the special distribution was got by the diaphragm theory of mechanism of action of general narcotic matters at subcellular molecular level. It is explain development of anesthesia by influence of narcotic matters on the mechanisms of polarization and depolarization of cellular membranes. Anesthetics, dissolving in a cellular membrane worsen it penetration for the ions of sodium, violate the generation of excitation and reduce potential of action.

Premedication

Under premedication it follows to understand application of complex of medications at preparation of patient to anesthesia or local anaesthetizing with the purpose of diminishing of psychoemotion tension before an operation, providing of neurovegetative reactions, to prevention of indirect action of narcotic matters, facilitation of introduction to anesthesia and support of stability of him, in the process of leadthrough.

Before premedication include: antianxiety matters from the group of barbiturates, narcotic analgetics, neuroleptics and desensitizing drugs. The charts of premedication are resulted in textbooks from general surgery. At finding out of this question utillize tables, sliding seats, stands, hospital charts, protocols of implementation of anesthesia.