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ANESTHETIC GASES.pptx
1.
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
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
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%
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
