As a nurse, you may care for a patient prior to surgery (preoperative), during surgery (perioperative), or after surgery (postoperative). One of your roles is to monitor the effects of anesthetics on your patient’s vitals signs, paying close attention to respiratory status (respiratory rate, depth, quality, and SpO2), as well as their level of consciousness and pain level.
There are three categories of anesthetics:
- Local: Local anesthetic is when a medication (e.g., lidocaine) is injected into the skin at the site of the procedure to achieve numbness for procedures like suturing. Read more information about lidocaine in Table 10.11.
- Conscious Sedation: Conscious sedation is a combination of medications that allow the patient to be relaxed (midazolam) and free of pain (e.g., fentanyl) during a medical procedure (e.g., colonoscopy). This allows the patient to remain awake and aware, without feeling discomfort. The patient may or may not be able to speak or respond in this state.
- General Anesthesia: General anesthesia is a medication-induced reversible unconsciousness with loss of protective reflexes. Arousal, even to painful stimuli, cannot occur. General anesthesia requires the establishment and maintenance of airway control.[1] Propofol is an example of an intravenous general anesthetic. The intravenous (IV) injection of propofol induces anesthesia within 40 seconds from the start of injection.[2]
Table 10.11 Local Anesthetics
| Class/Subclass | Prototype/Generic | Administration Considerations | Therapeutic Effects | Adverse/Side Effects |
|---|---|---|---|---|
| Anesthetics | lidocaine (Xylocaine) | The appropriate dosage of lidocaine varies depending on the indication being treated, patient age, weight, and other factors
Can be administered topically, via injection, or by other routes, depending on the specific indication |
Used to numb a specific area of the body before a medical procedure | Dizziness, nausea, and numbness |
- Frandsen, G., & Pennington, S. (2018). Abrams’ clinical drug: Rationales for nursing practice (11th ed.). pp. 305, 310, 952-953, 959-960. Wolters Kluwer. ↵
- This work is a derivative of DailyMed by U.S. National Library of Medicine in the Public Domain. ↵
