Metabolism of volatile anesthetics is discussed here. Once thought to be chemically inert, inhalation agents, especially the older ones, undergo significant metabolism, bio-transformation and breakdown to potentially toxic intermediates. This process is affected by age, disease, drug interaction and genetics. Inhalation agents are administered in great excess of the amount metabolized unlike other drugs. For […]
The anesthesiologist should know that the essential element of an “anesthetic” for an Awake Craniotomy Anesthesia is the surgeon’s local anesthetic technique. Craniotomy is required for removal of space occupying lesions, intracranial vascular pathologies and for drainage of extradural or intradural haematoma. Most important postoperative considerations are regulation of patient’s ICP status, maintenance of cerebral
Postoperative Nausea and Vomiting (PONV) is one of the most distressing experiences associated with surgery, and many patients find it more troublesome than postoperative pain itself. It is not only very uncomfortable to the patient in the postoperative period but it also delays the time of starting enteral feeding and normal functions. Especially in day care
There is rapid desflurane induction of anesthesia because of low solubility in blood, but a mask induction may produce coughing, breath holding, secretions and desaturation. Also the high initial percentage of desflurane induction may cause tachycardia and hypertension due to sympathetic effects. It is not recommended for inhalation induction. Recovery from desflurane induction is faster
Nasotracheal Intubation can be accomplished by special nasal tubes or by simple oral tubes. It is a specialized technique in which the Endotracheal tube is passed in to the larynx via the nose rather than the mouth. A first the tube size is selected, which should be a size less than that used in the
Introduction to Laparoscopic Appendicectomy Laparoscopic appendicectomy, a minimally invasive surgical procedure, has gained prominence as an effective treatment for acute appendicitis. This technique involves the use of small incisions and specialized instruments, allowing surgeons to remove the inflamed appendix with reduced trauma to the surrounding tissues. The primary indications for laparoscopic appendicectomy include acute appendicitis,
Anaesthesia for Laparoscopic Appendicectomy: A Comprehensive Guide Read More »
Chloroform anesthesia is prepared from chloroform chemical formula and is a potent, pleasant, non-irritant anaesthetic agent, very popular in the early days of anaesthesia. Physical properties of Chloroform chemical formula are that, it is colourless, sweet odour, non flammable, bp 6 1°C, VP 80mm Hg, blood/gas coefficient 10.3, oil/gas 394, MAC 0.62, metabolism 50% to
The diaphragm function is the most important determinant of the depth of respiration especially the inspiration. The Diaphragm is the muscle that separates the thorax from the abdomen. It is a thin sheet like muscle that has the right and the left crura. The diaphragm act as a partition between the two major cavities of the
In Isoflurane cardiac function , the effect is that the cardiac output is maintained due to the slight increase in heart rate reflexly due to hypotension. There is a dose-dependent decrease in arterial pressure due to peripheral vasodilatation and myocardial depression, less than that due to halothane. There is a selective coronary vasodilatation and decrease
Excess Oxygen can cause pulmonary oxygen toxicity which results in a lot of damage to the body tissues. To summarize briefly, the excess oxygen can cause, pulmonary toxicity, Acute respiratory distress syndrome, rertolental fibroplasia, convulsions and Paul burt effect. Here we will be dicussing the mechanisms of these tissue injuries that occur with use of excess oxygen. The following the changes
