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ANESTHETIC GASES.pptx
- 2. INHALATIONAL ANESTHETIC • CHEMICAL HAVING GENERAL ANESTHETIC PROPERTIES WHICH CAN BE DELIVERED VIA INHALATION. • ADMINISTERED THROUGH TRACHEAL TUBE LARYNGEAL MASK AIRWAY FACE MASK
- 3. MAC MINIMUM ALVEOLAR CONCENTRATION • Volume Of Vapor In Alveoli To Prevent Movement In 50% Of Subjects In Response To Pain • Used To Compare Strength Or Potency Of Anesthetic Vapor Lower Mac More Potent Volatile Anesthetic • Concept Of Mac Given In 1965 • Mac Of Volatile Substance Is Inversely Proportional To Its Lipid Solubilty , Meyer Overton Hypothesis
- 5. MAC VALUES
- 6. BLOOD GAS PARTITION COEFFICIENT • Ratio Of Concentration Of Gas In Each Of Two Phases Of Matter At Steady State • Lower The Coefficient Less Soluble Anesthetic Is In Blood • Known As Ostwald Coefficient
- 8. VOLATILE ANESTHETIC AGENTS • THEY ARE EMITTED AS GASES FROM CERTAIN SOLIDS OR LIQUIDS • LIQUID AT ROOM TEMPERATURE • REQUIRE USE OF VAPORIZERS FOR INHALATION HALOTHANE DESFLURANE ISOFLURANE SEVOFLURANE
- 9. ANESTHETIC GASES • NITROUS OXIDE(LAUGHING GAS) • COLORLESS , NON FLAMMABLE GAS • LAUGHING GAS EFFECT COINED BY HUMPHREY DAVID • USED AS A DISSOCIATIVE ANESTHETIC • USED WITH OXYGEN AS MIXTURE IN RATIO 2:1 • WEAK GENERAL ANESTHETIC USED ALONG WITH OTHER POWERFUL GENERAL ANESTHETIC • MAC 105% BLOOD/GAS PARTITION COFFICIENT 0.46 • USED TO RELIEVE PAIN ASSOCIATED WITH LABOR, SURGERY ETC
- 10. ENTONOX • GAS MIXTURE OF HALF OXYGEN AND HALF NITROUS OXIDE USED FOR PAIN RELIEF • USED DURING LABOR, TRAUMA , PALLIATIVE CARE • EFFECT STARTS IN 30 SECONDS AND ENDS ABOUT A MINUTE • NOT FOR PEOPLE WITH PNEUMOTHORAX OR BOWEL OBSTRUCTION
- 11. ENTONOX
- 12. ENTONOX • IT IS MADE VIA POYNTING EFFECT • GASEOUS OXYGEN IS BUBBLED THROUGH LIQUID NITROGEN FORING GASEOUS MIXTURE OF BOTH • SEPERATES AT LOW TEMPERATURE <4 DEGREE C THUS CYLINDER IS SHAKEN BY INVERTING IT • CYLINDER WITH SCHRADER VALVE ATTACHMENT USAble ONLY ON DEMAND BASED SETS
- 13. XENON • DISCOVERED IN 1898 BY WILLIAM RAMSAY • MAC VALUE 63.1 % • BLOOD GAS PARTITION COEFFICIENT 0.14 • COLORLESS ODOURLESS GAS • LOW BLOOD SOLUBILTY • LEAST SIDE EFFECTS FASTER RECOVERY
- 15. HALOTHANE • ALSO KNOWN AS FLUTHANE • USED TO INDUCE OR MAINTAIN ANESTHESIA • DOES NOT INCREASE PRODUCTION OF SALIVA THUS VERY USEFUL FOR PATIENTS WITH DIFFICULT INTUBATION • METABOLIZED BY HEPATIC CIRCULATION • EXCRETED BY KIDNEY AND RESPIRATORY WAYS • SIDE EFFECTS ARRYTHMIAS , RESPIRATORY DEPRESSION , HEPATOTOXICITY • NOT TO BE USED IN PEOPLE WITH HISTORY OF MALIGNANT HYPERTHERMIA
- 16. HALOTHANE • DISCOVERED IN 1955 • MAC 0.74% • BLOOD GAS PARTITION COEFFICENT 2.4 • VAPOR PRESSURE 244 mmhg • Sweet CHLOFORM LIKE ODOR
- 17. ISOFLURANE • ALSO KNOWN AS FLORANE • CAN IRRITATE AIRWAY THUS OTHER MEDICIN NEEDED BEFORE GIVING IT • SIDE EFFECTS HYPOTENSION, HYPERKALEMIA • PUNGENT GAS • USED AS MAINTENANCE AGENT • NOT TO BE USED IN HYPOVOLEMIC PATIENTS CAN GIVE IRRITBLE AND TOXIC FUMES IF EXPOSED TO FLAME
- 18. DESFLURANE • USED FOR MAINTENACE OF GENERAL ANESTHESIA • COSTLY • RAPID ONSET OF ACTION • KNOWN AS SUPRANE • CAN CAUSE TACHYCARDIA • VAPOR PRESSURE 672 mmhg • MAC 6 • BRONCHODILATOR • HIGH RISK OF LARYNGOSPASM IN PAEDIATRIC PATIENTS
- 19. ENFLURANE • FORMULATED BY ROSS TERRELL IN 1963 • NOT USED NOWDAYS COMMONLY • MAC 1.68 • VAPOR PRESSURE 172 mmhg • DECREASED MYOCARDIAL CONTACTIBILTY • KNOWN AS ENTHRANE • INCREASE ICP • INCREASEED CHANCES OF HAVING SEIZURES
- 20. SEVOFLURANE • SEVORANE • 2ND FASTEST ACTING INHALATIONAL AGENT • METABOLISED BY LIVER • MAY ACCELERATE ALZHEIMR • LESS IRRITATES MUCOUS MEMBRANES
- 21. METHOXYFLURANE • KNOWN AS PENTHROX • USED MAINLY TO REDUCE TRAUMA RELATED PAIN • CAN CAUSE NEPHROTOXICITY • MAC 0.16%
- 22. VAPOR PRESSURE
- 23. KEY POINTS • FASTEST ACTING INHALATIONAL AGENT – DESFLURANE SEVOFLURANE • INDEX OF POTENCY OF GENERAL ANESTHESIA – MAC • LIPID SOLUBILTY OF INHALATIONAL AGENT BY – OIL GAS PARTITION COEFFICIENT  PUNGENT VOLATILE ANESTHETIC – ISOFLURANE DESFLURANE  SODALIME SHOULD NOT BE USED WITH SEVOFLURANE AND TRILENE AS IT CAN FORM NEUROTOXIC GAS  LEAST ANALGESIC PROPERT - HALOTHANEE
- 24. KEY POINTS • EPILEPTOGENIC – ENFLURANE , SEVOFLURANE • LOWER MAC HIGHEST POTENCY