Techniques of Anesthesia-GA with Muscle Relaxant

GA with muscle relaxant
The basic principal is based on a triangle. One side represents perfect muscle relaxation, the second represents amnesia which is achieved with N2O or low concentration of any anaesthetic agent hyperventilation – Alkalosis depressing the awareness column of the Central Nervous System.
Ether 2% N2O or trichloroethylene 1 to 1.5% suffice (Halothane 0.5% muscle relaxant is administered as supplement where necessary Hyperventilation (alkalosis) potentiates both muscle relaxant action + amnesia. The muscle relaxant should be given as and when necessary and not at fixed timing depending on the pharmacological action. Do not use muscle relaxant for last 15 min. one should give small supplement of Thiopentone to achieve the goal. Reverse the muscle relaxant with atropine and prostigmine. It is mandatory. Even 0.25 or 0.5 mg of prostigmine makes an appreciable difference in patients who do not exhibit much relaxant effect.
Some points:
-Closed circuit, carbon dioxide absorber
-Never practice completely closed circuit
-The gas flow should not be less than 4 lit/min.
-Do not completely depend on the carbon-dioxide absorber
-Rising BP and tachycardia + lightness of anaesthesia should be taken as inefficient
-carbon dioxide absorption or elimination