CNS

Anesthetics (General & Local)

CNS Medications

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Examples

propofol, sevoflurane (general)lidocaine, bupivacaine (local)

Prefix / Suffix: Local anesthetics often end in -caine

Physiology

General anesthetics produce unconsciousness, amnesia, and analgesia by depressing the CNS. Local anesthetics block nerve conduction in a specific area without loss of consciousness.

Mechanism of Action

General anesthetics enhance GABA or block NMDA receptors to depress the CNS. Local anesthetics block sodium channels in nerve fibers, preventing pain signal transmission.

Indications

  • General anesthesia for surgery
  • Procedural sedation
  • Local/regional anesthesia (dental, minor procedures, epidural, spinal)

Side Effects / Adverse Effects

  • General: respiratory depression, hypotension, nausea/vomiting, malignant hyperthermia (rare)
  • Local: allergic reactions, systemic toxicity if injected IV (seizures, arrhythmias)
  • Propofol infusion syndrome (prolonged high-dose use)

Contraindications

  • Allergy to anesthetic agent
  • Severe cardiovascular instability
  • Malignant hyperthermia history (volatile anesthetics, succinylcholine)

Nursing Considerations

  • Monitor airway, breathing, circulation continuously during and after anesthesia
  • Have emergency airway equipment and reversal agents ready
  • Aspirate before injecting local anesthetic (avoid IV injection — systemic toxicity)
  • Monitor for malignant hyperthermia (sudden hyperthermia, muscle rigidity) — treat with dantrolene
  • Assess return of sensation/movement after local/regional anesthesia
  • Monitor for post-op nausea, pain, level of consciousness
  • Keep NPO before general anesthesia (aspiration risk)

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Disclaimer: PharmPal Nurse is for education only and is not medical advice. Do not use it to diagnose, treat, prescribe, or make patient-care decisions; always verify with current drug references, your instructor, facility policy, and a licensed provider. In emergencies, call local emergency services.