What drugs are used?
General anesthesia consists of three groups of drugs. The first group are the anaesthetics which are intended to switch off consciousness. These include, for example, Propofol or some gases.
The second group are the painkillers. In most cases these are narcotics, such as Fentanyl. The last group are the muscle relaxants.
These are necessary so that the ventilation does not have to work against the muscles. These are succinylcholine or rocuronium. The exact choice of medication is individually adapted to the patient.
In most anaesthetic induction procedures, the first step is to start the consciousness with propofol or anaesthetic gas. This ensures that the patient is aware as little as possible of the anaesthetic induction. Afterwards, the painkiller is usually given and then the muscle relaxant. As soon as the muscles slacken, ventilation must be started. Particularly anxious patients or children are given a sedative in the ward beforehand, so that they are hardly aware of the actual induction.
Special features for children
“Children are not little adults”, one of the most famous phrases in pediatrics. Children are usually given a sedative before entering the operating area to take away their fear. The medication has to be adapted very carefully to the child, because the metabolism works differently and children are very light. Children also need smaller tools for ventilation, which must be available in the appropriate and adjacent sizes.
In rescue service
Anaesthetic induction in the rescue service, i.e. in the living room, on the street or at best in an ambulance, is always associated with a significantly increased risk.The patient is completely unknown to the team. Neither the medical history nor allergies can be evaluated. In addition, the patient will usually not be fasting, which can significantly endanger the ventilation situation.
Such emergency anesthesia is only performed if there is no alternative. Preferred is a strong pain and sedation therapy and a quick transport to the next clinic.
