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Stage I – analgesia – ether is achieved after 3-5 minutes, the patient is in consciousness, sleep, lethargic, responds to questions in monosyllables, no surface pain sensitivity, tactile and thermal sensitivity saved. In this period of time may be running short of surgery, this stage is short, lasting 3-4 minutes. The facial skin is red, and the pupils are the same as before the start of anesthesia, react to light.

The transition into stage II of anesthesia – arousal characterized by loss of consciousness. Along with this, there is muscle tension, motor activity, verbal stimulation, face flushed, pupils dilated but react to light, tachycardia, blood pressure increased, increased secretion of salivary glands. In this stage there is vomiting, you may experience regurgitation, respiratory arrest due to hypercapnia. The initiation phase lasts from 1 to 12 minutes, occurs in 5-7 minutes. Stage of excitation is absent in anesthesia barbiturates, nitrous oxide, cyclopropane, therefore, these substances are used for induction of anesthesia.

Stage III – anesthetic sleep (surgical stage) – it decided to allocate 4 levels.

The I-th level of the patient is quiet, smooth breathing, blood pressure and heart rate reach the initial values. The pupil begins to narrow, the response to light is preserved. It is noted the smooth movement of the eyeballs. Eyeballs are eccentric. Retained corneal and pharyngeal-laryngeal reflexes. Muscle tone is kept, is a difficult abdominal operations.

II level – eye movement stops and they are located in a Central position. The pupils, reaction to light is preserved, corneal reflex disappears (level corneal reflex). The breath is calm, the tone is weakened, it is possible to operate.

The third level – the maximum permissible level of pupil dilation. Eyes wide, only respond to a strong light irritation, corneal reflex absent, complete relaxation of the muscles (and intercostals). Breathing is shallow – jaw may be retraction of the tongue. Anesthesia at III level is undesirable and it is not used as with the introduction of muscle relaxants and their preparations can be conducted anesthesia and on a more superficial level. Further deepening of anesthesia is associated usually with errors in his charge to the transition in level IV, which is characterized by sharp respiratory depression (level diaphragmatic breathing, eyes wide and not react to light, pulse is thready, BP not specified – post-clinical death).

Stage IV – the awakening. Once stops the supply of narcotic substances, the concentration of anesthetic in the blood is reduced, the patient in reverse order takes place, all the stages of anesthesia and there comes the awakening.

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Noninhalation narcosis depending on ways of introduction of anesthetic divided into: intravenous (their primary effect is loss of consciousness, and the development of General anesthesia occurs secondary with the deep narcotic CNS depression), intraosseous, subcutaneous.

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Neuroleptanalgesia. (NFA). Method of anesthesia is achieved in/with the introduction of analgesic and neuroleptic drug that allows you to perform various surgical interventions without the addition of drugs. Analgesia is achieved by introducing a powerful analgesic. Neuroleptic agent used in the NFA, causes the loss of mental activity until he lost consciousness, advancing due to CNS depression. These include: dehydrobenzperidol – droperidol, inapsine. The most perfect analgesic remedy for the NFA serves as fentanyl (superior to morphine in 100 times). Effects on the body: the NFA provides stability with the a/C system even during the most traumatic phases of the operation. Effect on the respiratory centre is dose of fentanyl. A pronounced analgesic effect of fentanyl in doses has oppressive breathing, so if the NFA is used as the main component of anesthesia, you should use the ventilator.

Athralgia is a turning off of consciousness using sedatives or tranquilizers in combination with analgesics (seduksen, fentanyl).