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1 - Introduction To Anestesiology

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INTRODUCTION TO

ANESTESIOLOGY

Dr. Aldy Heriwardito, SpAn, KAKV.

Departement of Anesthesiology and Intensive Therapy


Faculty of Medicine, University of Indonesia
Dr Cipto Mangunkusumo Nasional
General Hospital
ANESTHESIOLOGY

The basic of anesthesiology :

• PERIOPERATIVE MEDICINE
• LIFE SUPPORT
• CRITICAL CARE
ANESTHESIOLOGY

The role of anesthesiolgists covers:


• Mass disaster
• Prehospital
• Emergency department
• Operating room
• Intensive care unit
• Wards
ANESTHESIOLOGY

Anesthesiology services consists of :


• Anesthesia procedures
• Pain management
• Critical Care
ANESTHESIOLOGY

• ANESTHESIA PROCEDURE :
- Operating Room
- Non Operating Room
ANESTHETIC MACHINE
ANESTHESIOLOGY

Operating Room
- In-patient elective surgery
- Out-patient, ambulatory, one day surgery
- Emergency operation
ANESTHESIOLOGY

Non operating room :


• Diagnostic procedure :
❖ CT-Scan, MRI
❖ Radiotherapy
❖ Heart Catheterization
❖ Angiography
❖ Endoscopy

• electro convulsive therapy


• ovum aspiration
ANESTHESIOLOGY

PAIN MANAGEMENT :
• Acute pain : postoperative pain (Acute
Pain Service)
• Chronic pain : Cancer pain, neuropathic
etc
• Painless Labour : analgesia epidural,
intrathecal labour analgesia)
CRITICAL CARE :
• Mass Disaster : triage, resuscitation, transportation
• Prehospital : airway management, resuscitation,
transportation,
• Emergency unit : airway management, fluid
resuscitation , Cardio Pulmonar Resuscitation
• Operating Room : life support & monitoring
• Recovery Room : monitoring, treat
complication/side effects
• ICU : intensive therapy
ANESTHESIA TECHNIQUE

FASILITATE SURGERY

GENERAL ANESTHESIA :
•Inhalation Anesthesia
•Intravenous Anesthesia

REGIONAL ANESTHESIA
•Epidural Anesthesia
•Spinal Anethesia (Intrathekal)
PROCEDURE OF GENERAL
ANESTHESIA

1. PREMEDICATION
2. INDUCTION
3. AIRWAY MANAGEMENT
4. MAINTENANCE ANESTHESIA
5. EMERGENCE
6. POSTOPERATIVE CARE
STEPS OF GENERAL ANESTHESIA

induction extubation
postop

----
Maintance of anesthesia
premedication
Emergence of anesthesia
Intubation/
Airway management
MAINTENANCE ANESTHESIA
DRUGS :
- INHALATION AGENTS :

✔ ETHER
✔ N2O

❖ FLUOTHANE
❖ ENFLURANE
❖ ISOFLURANE
❖ SEVOFLURANE
❖ DESFLURANE
ANESTHESIA DRUGS :

I.V. AGENTS : OPIOIDS


PREMEDICATION PREMEDICATION
DRUGS: & MAINTENANCE
▪MIDAZOLAM DRUGS :
▪DIAZEPAM
✔ MORPHIN
INDUCTION DRUGS: ✔ PETHIDIN
▪PENTOTHAL ✔ FENTANYL
▪KETAMINE ✔ SUFENTANYL
▪ETHOMIDATE ✔ ALFENTANYL
▪PROPOFOL ✔ TRAMADOL
ANESTHESIA DRUGS :

- MUSCLE RELAXANTS :

❖ SUCCYNILCHOLIN
❖ ATRACURIUM
❖ PANCURONIUM
❖ VECURONIUM
❖ ROCURONIUM
CHOICE OF ANESTHESIA
TECHNIQUE
GENERAL ANESTHESIA :
• Balance Anestesia
• Intravenous Anesthesia
• Total I.V. Anesthesia
• Hypotensive Anestesia

LOCAL/REGIONAL ANALGESIAL :
• Infiltration
• Nerve Block, Plexus Block
• Epidural Analgesia
• Spinal Analgesia
• I.V. Regional Analgesia

COMBINED GENERAL – REGIONAL ANESTHESIA


DIVISION OF ANESTHESIA :

✔OBSTETRIC ANESTHESIA
✔ PEDIATRIC ANESTHESIA
✔ THORAC CARDIOVASCULAR ANESTHESIA
✔ NEURO ANESTHESIA
✔ AMBULATORY ANESTESIA
✔ REGIONAL ANESTESIA
✔ INTENSIVE CARE
Pre-hospital
PRE-HOSPITAL IN THE
AMBULANCE
High roof for
more space

High head-clearance
for ambulance personnel
treat the patients while
transporting
EMERGENCY /RESUSITATION ROOM

INTRA-HOSPITAL FACILITY
IN THE OPERATION ROOM
IN THE INTENSIVE CARE UNIT

Trauma patient with multiple fracture of the ribs,


Life support with mechanical ventilator

2
LOCATION OF DISASTER

FIELD HOSPITAL
THANK YOU

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