Trait Indication Advantages
complications/ side effects
General anesthesia - Circumcision
Volatile Isoflurane, Enflurane,
(Halothane, Desflurane
Isoflurane, - Rapid induction
Enflurane, - Undergoes minimal
Desflurane) metabolism so produces
less organ toxicity
- Has good analgesics and
sedative effect
Halothane
- Has pleasant odor
- Has good sedative,
analgesic and skeletal
muscle relaxant properties
Gaseous (Nitrous - Has good analgesics and
Oxide) sedative properties
- No odor so fast induction
- No cardiopulmonary
depression
Opioid
Disadvantages/ Contraindication
- Irritant and pungent odor,
so may produce coughing
- Decreased cardiac output
- Unpredictable
hepatotoxicity
- No skeletal muscle
relaxant properties
- Lacks sufficient potency as
surgical anesthesia
- Postoperative nausea and
vomiting
Classical triad:
1. Pin point pupil
2. Depressed depression
3. Coma
Local anesthesia 1. Minor surgery - Technically simpler Neurotoxicity - Sepsis near field of
- Abscess drainage - General anaesthesia can - Light headedness, injection
- Excision of papilloma be avoided dizziness, restlessness, - When large amount is
- Laryngoscopy - Patient remains conscious tinnitus, tremor, visual needed, then possibilities f
- Bronchoscopy - Patient can have food disturbance toxicity
- Endoscopy earlier after surgery - In high conc. → - Non cooperative patient
2. Surgery at arm ,hand and Nystagmus, Shivering,
toes Tonic-clonic seizures,
3. Minor surgery on foot Respiratory depression,
coma and death
CVS toxicity
- Bradycardia
- Hypotension
Allergy
Local infection or hematoma
Spinal or sub- - Abdominal and vaginal - Patient remains conscious - Post-operative headache - Cardiac patient
arachnoid block or hysterectomy - Adequate relaxation - Post-operative vomiting - Allergy
intrathecal - C Section - No chance of post- - Severe hypotension - ↑ed intracranial pressure
- Lignocaine - Inguinal Hernia operative chest - Ventilator failure - Sepsis
- Bupivacaine - Orthopedic surgeries on complications as occurred - Infection - Spinal tumor
pelvis, femur, tibia in GA - Back pain and spinal
- Prostatectomy - Hemorrhage is less due to disease
- Nephrectomy overall fall in BP - Kyphosis, scoliosis
- Cholecystectomy - Economical
- Trauma surgeries in lower
limbs
Epidural - Widely used in Obstetric - It can be used for
surgery continuous repeated
prolonged anaesthesia
- Good muscle relaxations
- Do not produce
hypertension
- It can be used as post-
operative analgesia
- It can be kept for several
days
Topical or surface
- Post-operative headache
- Infection
- Nerve damage
- Spinal injuries
- It is technically more
difficult with higher failure
rate
- Epidural hematoma

Infiltration

Nerve block

Centrally acting skeletal muscle relaxant:

1. BDZ (via GABA-A)

2. Beclofen via (GABA-B)