Anesthesia is as vital as the surgery itself. It is but proper to say that humanity was blessed when anesthesia was discovered. One can only imagine in absolute horror what surgery was like when modern anesthesia was not yet invented. Patients being operated on whether for a minor or major procedure have to endure the horrendous pain since anesthesia was not yet used.
In the early years of surgery, in ancient Mesopotamia, patients were being made to drink liquor to somehow sedate them for surgery. Unfortunately, in most cases liquors were not enough to mask the pain. During the end of the third millennium, opium poppy which has a hallucinogenic effect was used to pacify pain. The opium poppy was referred to as the “Plant of joy” by the Sumerians.
Hence, during these years when anesthesia was not yet available for surgeries, operations were considered as the last resort, and most patients would prefer to wait for death rather than undergo surgery.
It was until October of the year 1804 when anesthesia was at its early stage of development. Documentations show an operation, partial mastectomy, was executed with the aid of general anesthesia. The operation was performed by a Japanese surgeon, Hanaoka Seishu.
Nowadays, standardized, complete, and fully functioning anesthesia equipment and supplies are essential in achieving the goal of pain-free surgery for maximum comfort possible. A nurse anesthetist or an anesthesiologist will not be able to perform its responsibilities and functions efficiently if anesthesia equipment and supplies are incomplete and disorganized.
Anesthesia equipment and supplies are crucial in providing a patient undergoing surgery with sufficient and accurate delivery of anesthesia. Keeping the patient safe from overdose and other complications that can be fatal, while ensuring adequate sedation for pain-free surgery.
There are two main components of the anesthesia apparatus that play a great role in carrying out tasks of a nurse anesthetist or an anesthesiologist. These are the anesthesia machine and the anesthesia cart.
Anesthesia machines may vary in appearance according to model and manufacturer. Whatever the model or manufacturer is, its primary function is to provide means of transforming anesthetic agents and other medical elements, from a liquid state into gas which can be accurately calibrated and given to a patient.
Typical up to date machines have features that are more efficient and convenient to use than the older models. Located on the upper portion of advanced models of anesthetic machines are built-in or attached mechanical ventilator, suction machine, worktop space, cardiac monitors, and other patient monitoring devices. It also has a vaporizer and regulators or flows meters to safely titrate or control the administration of different medical gases such as oxygen, nitrous oxide, and inhalation anesthetic agents, e.g., Isoflurane. The lower half of the anesthesia machine has shelves for storage of frequently used supplies and accessories.
The other vital equipment in anesthesia administration is the anesthesia cart. This is usually a separate appliance from the anesthesia machine but is always situated near to each other for convenience. The cart has several layers that are systematically arranged and regularly filled with standard supplies. Organization of the cart’s contents prior to each surgery is crucial for easy access during anesthesia administration, and in keeping the patient safety throughout the procedure.
Generally, the top and second shelves of the cart contain vials and pre-filled syringes of essential cardiac drugs, sedatives, anxiolytics, anticholinergic drugs, and others. Examples of these drugs are the following but not limited to; Diazepam, Atropine, Fentanyl, Midazolam, Nembutal, Etomidate, Pentothal, Propofol, Succinylcholine, Ketamine, Demerol, Sodium Bicarbonate, and epinephrine.
The third shelf holds appliances that are used in establishing patent airways and measuring the depth of anesthesia. Such supplies are the following; endotracheal tubes, suction catheters, intravenous catheters, Bispectral index (BIS) monitors, oral and nasal airways of varying sizes, laryngoscopes, and stilettos.
The fourth shelf has the medical/patient warmer device to be used for unintended hypothermia, such as the Bair huggers. It also contains the following supplies; different sizes and gauges of intravenous catheters and tubing, Magill Forceps, Laryngoscopes, and also-gastric appliances.
The last shelf holds various intravenous fluid bags, and bottles of volatile anesthetic agents such as sevoflurane, desflurane, enflurane, etc.
Anesthesia cart set-up varies according to institutional policy or protocols. The difference in set-up and contents is even more evident, depending on access to and availability of supplies and appliances. Such an issue is very noticeable among government-funded hospitals in third world countries.