Means of desensitization
1-Definition of anesthesia
The term anesthesia comes from a Greek word meaning “absence of sensation”. Anesthesia has the effect of temporarily suppressing sensations, particularly pain. It can target a limb, a region or the entire body. There are several types of anesthesia, including:
a- General anesthesia
General anesthesia is used for surgical, interventional or diagnostic procedures. General anesthesia is most often used for surgical, interventional or diagnostic procedures. It is administered intravenously and/or by inhalation (anesthetic gas), which induce artificial sleep. It causes changes in the state of consciousness, perception of pain, breathing and muscle tone. In order to ensure proper oxygenation of the blood, a respirator is used to insufflate air into your lungs. Sedation is a general anesthesia where certain reflexes of the body are preserved. The safety measures will be the same as for any general anesthesia. Sedation is mainly used during medical examinations.
b-Loco-regional anesthesia
It concerns a limb or a specific region of your body, Loco-regional anesthesia is practiced at all levels of the nervous system depending on the region to be anesthetized. It consists of injecting local anesthetics near the nervous tissue: spinal cord or nerve. We speak of “block” because this technique consists of blocking nerve conduction in the corresponding territory. The goal is to numb a specific region of your body. It is recommended as anesthesia alone or as a complement in order to guarantee multimodal pain management.
They require moderate doses of local anesthetics for great effectiveness.
Central blocks include anesthesia performed at the spinal column level.
- Spinal anesthesia (= spinal anesthesia, spinal anesthesia). It is performed at the level of the lumbar vertebrae. The injection of a local anesthetic into the cerebrospinal fluid gives anesthesia to the lower half of the body.
- Epidural or epidural (= infiltration of the epidural space). It is performed over the entire height of the spine. Depending on the level infiltrated, it numbs the lower part of the body or several metameres (= levels) on the trunk.
The peripheral blocks include:
- Truncal blocks: consist of infiltrating a nerve trunk (a nerve) to obtain anesthesia of its territory. For example, the tibial (ulnar) nerve block results in anesthesia of the plantar arch.
- Plexus block: involves infiltrating a plexus (a set of nerves) to achieve anesthesia of an entire region. For example, infiltration of the brachial plexus results in anesthesia of the entire upper limb.
Peripheral loco-regional anesthesia techniques use ultrasound. In particular, it allows the visualization of nerve structures in order to have permanent control during infiltrations.
Indications for general anesthesia are surgical procedures that cannot be performed under local-regional anesthesia or if the latter is contraindicated.
There are two types of general anesthesia:
- with oro- or naso-tracheal intubation (tube in the trachea) which allows control of the patient’s upper airway and ventilation.
- without intubation, either with a face mask or a laryngeal mask, which allows spontaneous ventilation of the patient, but without protection of the patient’s airway
General anesthesia with tracheal intubation is indicated:
- when surgical procedures do not allow for local-regional anesthesia
- in cases of long-term surgery
- when there is no access to the airway during surgery (neurosurgery, ENT for example)
- in case of cardiac, visceral, urological, pulmonary or laparoscopic surgery
- in case of patient refusal to have local-regional anesthesia
- Combined anesthesia
It combines general anesthesia with local-regional anesthesia at the level of the operated part.
- Hypnosedation Hypnosedation
combines hypnosis, conscious intravenous sedation and local anesthesia of the surgical site. It is reserved for certain types of surgeries.
Means of desensitization
c/ Local anesthesia
Local anesthesia involves injecting local anesthetics near a nerve or spinal cord to numb a given region of the body. The patient’s state of consciousness is preserved.
Local anesthesia is recommended as a supplement or as the sole anesthesia to maintain multimodal pain management.
It is used at all levels of the nervous system depending on the region to be anesthetized. Loco-regional anesthesia, which is more effective than simple local anesthesia, anesthetizes a given nerve or area, often larger than the surgical area concerned.
Means of desensitization
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