The nurse usually has difficulty in remembering the stages of anesthesia. However, they are very similar to those seen following the intake of alcohol. Consequently, she can always refresh her memory, even outside hospital, of the possible effects of anesthesia by recalling or observing the antics of the local population after partaking of wines and spirits or other alcoholic beverages. In the comparison below, between a patient who is given an anesthetic and a person who has taken alcohol, rightly or wrongly the latter is referred to as 'the drunk'. His state is regarded as being due to 'alcoholic anesthesia' (intoxication). The condition of the patient receiving a gaseous anesthetic is referred to as 'general anesthesia'. There are four stages of general anesthesia, namely: analgesia - stage 1, delirium - stage 2, surgical anesthesia - stage 3 and respiratory arrest - stage 4. As the patient is increasingly affected by the anesthetic his anesthesia is said to become 'deeper'. During recovery from anesthesia he is said to become 'lighter'. As anesthesia deepens he passes from stage 1 towards stage 4. As anesthesia lightens he passes from the state of surgical anesthesia (stage 3) towards stage 1 and the recovery of consciousness.

The drunk walks into a tree, apologizes, walks away and is apparently unaware of the pain from his cut head. He is in a state of alcoholic analgesia. Awareness of pain is the first sensation to diminish or disappear. This stage of analgesia is used in midwifery to reduce the intensity of labour pains. A 50070 nitrous oxide - 50070 oxygen mixture or a trichloroethylene inhaler relieves the pain but allows the patient to remain conscious and cooperative.

All pal ties start quietly. As the Many patients pass through stage consumption of alcohol increases 2 without causing any disturbso does the amount and noise of ance, but will remark that they the conversation. Eventually dreamed as they were going to different reactions emerge. Some sleep. However, delirium often people become garrulous, others occurs and may manifest itself in noisy, aggressive or affectionate. Several ways. They are in the stage of alcoholic The patient may move his arms delirium.

Regurgitation of stomach contents can occur and cause fatal asphyxia. Such an outcome is not uncommon in acute alcohol poisoning. The unconscious drunk in hospital (or elsewhere) should be placed on his side, treated and observed as if unconsciousness were due to receiving a general anesthetic.

Cerebral depression may be so profound as to depress the respiratory centre sufficiently to cause respiratory arrest and death. Skilful administration of a general anesthetic ensures that respiratory arrest rarely occurs. However, if it does the anesthetic is discontinued and air or oxygen is given by means of a resuscitation bag or anesthetic machine until the patient becomes lighter and spontaneous respiration returns.

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