Exploration of a surgical case study The patient (Mr Griffin) involved in the case study is 64 years old single Australian male, retired costume designer, of weight 70kg and height 5’8’’, admitted in the hospital for the repair of right inguinal hernia, with the length of stay of 0 to 7 days, requiring admission within 90 days under the Medicare scheme, requesting admission through rooms. In this essay we would discuss the anticipated questions from the patient on self-reading his report. The first question the patient may ask could be anaesthesia section, regarding the GA3 grade and airway management and why they are important?
As known earlier, the inguinal hernia is a condition, where there is protrusion of the abdominal content through the inguinal canal, the most common day care surgery, and in the direct type, which occurs with increase in age, where there is weakness in abdominal fascia. (Lichtenstein & Shulman). The GA 3- means General anesthesia to be administered in the level as designated as 3 by American Society of Anaesthesiologist. General anesthesia is still the widely used and effective anesthesia advised for older adult, by many research studies.
The General anaesthesia could be described as a state where the subject could feel absence of pain sensation- a state of unconsciousness with the absence of pain over the body. This is achieved either by administering the anaesthetic drugs through vein or breathed into lungs as gases that would be further carried to brain by blood. These stop the brain recognizing messages coming from the nerves in the body. Here the intravenous means, the drug given through the vein.
The general anesthesia works by inhibiting the flow of a molecule called sodium in the brain, flow of which gives the feeling, memory and sensation to brain. The class three, means patient with definite functional limitation, (here a previous myositis, stroke, epilepsy, diabetic, hyper sensitive) etc as opposed to the also 1 healthy and 2 mild underlying disorders. The type and amount of anesthesia to be used varies with this classification. In the supine posture means the position of lying straight. In intravenous, the drug is given through a cannula injected into the vein.
(Adachi etal. ,2001). The airway management is important, as General anesthesia commonly interferes with the passage of gas (air) between the mouth and trachea, due mainly to the soft tissues of the oral-pharynx and relaxed tongue causing partial (or complete) obstruction. The skill of maintaining airway patency is fundamental to anesthetic practice. If an airway problem is not apparent until after anesthesia has commenced, a life-threatening situation can result. Assessment of the airway preoperatively is clearly one of the anesthetist’s prime goals. (http: //en. wikipedia. org/wiki/Herniorrhaphy, viewed, 2007). The Preoperative airway assessment attempts to identify two potential hazards: The patient in whom the airway is difficult to maintain manually The patient in whom it is difficult or impossible to successfully visualise the larynx with a laryngoscope.
The features (Appendix 1) are usually observed and caution is taken care of in pre anaesthesia check up. Another important point of concern when administering the general anaesthesia would be the loss of protective airway reflexes and patency as coughing, as there is a loss of consciousness among the subject.
At times a loss of regular breathing pattern as the residual effect of anesthetics, opiods and relaxants could also be observed. In this condition a breathing tube is inserted after the patient becomes unconscious. This helps the anaesthetist to maintain an open airway, rendering him control over breathing regulation. Thus a device that helps in mechanical ventilation includes an endotracheal tube – intubations, and other alternative devices such as facemasks or laryngeal mask airways.