Anesthesia Basics & ASA-PS Classification Explained | NEET PG | FMGE | INI-CET High-Yield

Added: 2026-06-03

[00:00:00]So, first we start off with very simple introduction to anesthesia. There are three types of anesthesia, as we all know. When the patient is completely unconscious, and he is paralyzed during the surgery, and patient has no memory or recall of what has happened during the surgery, that is nothing but general anesthesia. In general anesthesia, as I told you, we will be giving the patient IV anesthetic agents like propofol or ketamine or etomidate, inhalational anesthetics like halothane, sevoflurane, isoflurane, and muscle relaxants like succinylcholine or vecuronium, rocuronium. Okay, so all that comes in general anesthesia. The next type of anesthesia is where we are blocking only a part of the body. So, if you're blocking only the lower half of the body, let's say you are blocking the lower half of the body for cesarean section. That is called as regional anesthesia. The specific one over there is spinal anesthesia. Now, let's say I have a fracture of this arm, and I want to block only this arm for the surgery. The rest of the body, you want to keep the patient awake during the surgery. So, if you want to block only this part of your body, one part of your body, that is done by giving a brachial plexus block.

[00:01:13]So, that kind of anesthesia, where only one part of your body is blocked, that is called as regional anesthesia. In regional anesthesia, as we all know, we have your spinal and epidural and caudal anesthesia, and this forms a part of the central neuraxial blockade, okay? The second type of regional anesthesia is peripheral nerve blockade, where you block individual nerves. So, suppose you're blocking the femoral nerve, or you're blocking the sciatic nerve to do surgery of the lower leg, or you're blocking the lumbar plexus, so or you're blocking the brachial plexus to do surgery of the upper limb, lumbar plexus for surgery of the lower limb. So, those all are regional anesthesia. In regional anesthesia, we use only one class of drugs and that is local anesthetic agents where we use drugs like lignocaine, bupivacaine, and so so on and so forth. Okay? Now, the third type of anesthesia is where you are only giving the patient sedatives and anxiolytics. You are not giving any anesthesia to the patient. Patient is not going to be unconscious during the procedure. You are simply monitoring the patient, specially high-risk patients during the procedure. For example, there is an 80-year-old woman with IHD or stroke who comes in for a small colonoscopy procedure.

[00:02:40]You sedate her with midazolam and you just watch her vitals so that she's stable. That kind of anesthesia is called as MAC or monitored anesthesia care. Okay? So, three types of anesthesia: general, regional, monitored anesthesia care.

[00:02:54]Now, let's move on to the next topic and its important features. Pre-anesthetic evaluation that we do prior to surgery.

[00:03:01]So, in that, something that is asked in the exam again and again is American Society of Anesthesiologist physical status classification. It is also called as the ASA PS classification. Now, in INI CET, they simply asked what is ASA status three. Okay? So, you should know just the individual words. So, we have six ASA classes: 1 2 3 4 5 6. As I say, one is a normal healthy patient. No comorbidities in the patient. Patient is not a smoker or an alcoholic.

[00:03:38]Then, after one normal healthy patient, we go to the opposite end, that is ASA six. What is the opposite of being normal and healthy? The opposite of being normal and healthy is being dead.

[00:03:50]Okay? So, ASA class six is a brain dead patient who is posted for organ transplant. Then we go one about being dead. So, before being dead, what are you? Before being dead, you are a moribund patient who will die without surgery. So, ASA class five is a patient if you don't operate on him, he will die without surgery. So, moribund patient who will die without surgery, for example, someone with an aortic dissection and aortic dissection is going to bleed a lot and if you don't operate on the patient immediately, patient will die.

[00:04:24]So, we finished ASA one is normal healthy, ASA six is brain dead, ASA five is moribund patient who will die without surgery. Then we have ASA two, three, and four. Mild systemic disease, moderate to severe systemic disease, and severe systemic disease that is a constant threat to life. Okay? So, see this. ASA two is mild systemic disease or a controlled systemic disease.

[00:04:50]Someone with hypertension or diabetes but controlled. ASA status three is a moderate to severe systemic disease and ASA four is severe systemic disease that is a constant threat to life. Especially ASA four, they ask a lot of questions.

[00:05:06]So, we say that constant threat to life means patient has had a less than three month history of having an MI, stroke, TIA, or a stent or a coronary artery disease in him. Okay? So, this is something that you need to remember. You will be given examples of the same or you will be asked simple questions. For example, in INICT, they asked ASA status three is what and the answer was it is moderate to severe systemic disease.

[00:05:35]Okay?

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