Anesthesia

is the administration of medication to allow medical procedures to be

done without pain, and in some cases, without the patient being aware
during the procedure. There are a variety of types of anesthesia, as well
as several different medical professions that are able to give
anesthesia.

Types of Anesthesia
There are four types of anesthesia:

 General Anesthesia
 Regional Anesthesia
 Local Anesthesia
 Monitored Anesthesia Care (MAC)

The type of anesthesia used during your surgery typically

depends on the type of surgery, your state of health, the length of the
surgery and the preferences of your anesthesia provider and surgeon.

Stages of Anesthesia
Stage I (analgesia stage)

– Conscious and rational

– Perception of pain is diminished

Stage II (delirium stage)

– Unconscious

– Body responds reflexively and irrationally

– Breath holding, pupils dilated

– Muscle tone intact

Stage III (surgical anesthesia)

– Increasing degrees of muscular relaxation

– Unable to protect airway Stage IV (medullary depression)

– Depression of cardiovascular and respiratory centers

Complete sedation :
 Neuromascular blocking

Neuromuscular blocking drugs (NMBDs) are used frequently in human

anesthesia to provide laryngeal relaxation for endotracheal intubation
and to enhance skeletal muscle relaxation to facilitate surgery. The
administration of NMBDs to horses facilitates delicate ophthalmic
surgeries (phacoemulsification of cataracts), fracture repair, and
ventilation when intraabdominal pressure is high and deep levels of
anesthesia are contraindicated because of cardiovascular instability.
Relaxation of abdominal muscles is especially useful when a flank
incision is used (e.g., for excision of granulosa cell tumors).
Neuromuscular blockade also allows better control of horses that are
difficult to manage because of unreliable signs of anesthesia.

 Hypnotic

Sedative-hypnotics are drugs that depress or slow down the body's

functions. Often these drugs are referred to as tranquilizers and
sleeping pills or sometimes just as sedatives. Their effects range from
calming down anxious people to promoting sleep. Both tranquilizers
and sleeping pills can have either effect, depending on how much is
taken.

Barbiturates and benzodiazepines are the two major categories of

sedative-hypnotic. Some well-known barbiturates are secobarbital
(Seconal) and pentobarbital (Nembutal), diazepam (Valium),
chlordiazepoxide (Librium), chlorazepate (Tranxene), lorazepam
(Ativan), and alprazolam (Xanax). A few sedative-hypnotics do not fit
in either category. They include methaqualone (Quaalude),
ethchlorvynol (Placidyl), chloralhydrate (Noctec), and mebrobamate
(Miltown). Additionally, alcohol belongs to the sedative-hypnotic group.

 Pain killer

Painkillers are medicines that are used to treat pain. There are a large
number of painkillers available and they all come in various different
brand names. They can be taken:

 By mouth as liquids, tablets, or capsules.

 By injection.

 Via the back passage (rectum) as suppositories.

Some painkillers are also available as creams, ointments or patches.
 Even though there are a large number of painkillers available, there are
only three main types (each works in a different way). They are:

 Non-steroidal anti-inflammatory drugs (NSAIDS). Examples of NSAIDs

include ibuprofen, diclofenac and naproxen. Aspirin is also an NSAID.
However, it is mainly prescribed (in low doses) to help to keep the
blood from clotting - for example, for people who have had a heart
attack in the past.
 Paracetamol.
 Weak opioids and strong opioids (sometimes called opiates). Examples
of weak opioids include codeine and dihydrocodeine. Although
commonly described as 'weak opioids', they are extremely effective
analgesics often used to treat severe pain; however, they can lead to
significant addiction and adverse effects, so should not be
underestimated. Examples of strong opioids
include morphine, oxycodone, pethidine and tramadol. Many people
who need strong opioids are in hospital.

Different types of painkillers are sometimes combined together into one

tablet - for example, paracetamol plus codeine (co-codamol).
In addition to the above, some antidepressants and antiepileptic
medicines can be used to treat neuropathic pain. The rest of this leaflet
does not discuss these types of medicines. For more information on
them see the separate leaflet called Neuropathic Pain.

References :

https://www.verywellhealth.com/anesthesia-and-surgery-3157215

http://www.leedsth.nhs.uk/a-z-of-services/endoscopy/before-your-
procedure/sedation-and-pain-relief-options/

https://patient.info/health/painkillers