Benzodiazepines or BDZ are compounds have largely replaced the barbiturates as hypnotics and act as sedatives, anticonvulsants, muscle relaxants and anesthetic agents. Mechanism of action of Benzodiazepines or BDZ Benzodiazepines or BDZ bind selectively to the a subunit of the GABA-A receptors surrounding the chloride channels in the CNS, a site distinct from that to which
In alveoli gas exchange , if a second vapour is also administered along with N2O, the percentage of the second gas is also increased due to the shrinking of the alveoli as a result of the speedy uptake of N2O by blood. Diffusion in Alveoli During reversal of anaesthesia, a similar phenomenon is observed in
N20 is minimally metabolized. Nitrous oxide metabolism shows us that N20 oxidizes the cobalt in vitamin B12, converting the monovalent form to bivalent form which fails to function as a methyl carrier. Nitrous oxide metabolism is an irreversible oxidation. Vitamin B12 is a cofactor for methionine synthetase and is involved in the production of 5,10
Halothane Anesthesia is an alkane, halogenated hydrocarbon introduced in 1256. (M Johnston, UK). Physical Properties: Halothane Anesthesia is colorless, sweet smelling, nonirritating, bp 50 degrees C, VP 243 mm Hg, blood/gas 2.5, oil/gas 224, metabolism 20—40%, MAC in 02 ofQ7 /o and 0.29% with N20. It is relat Istable, decopcs on exposure tq.ajr, hence stored
The anatomy of larynx is extremely important for an anesthesiologist. A through knowledge of the anatomy of larynx is essential for mastering the skill of intubation with a tracheal tube. Larynx is the organ of voice extending from the root of the tongue to trachea and lies opposite C3 to C6 vertebrae. The distance between
Some of the Enflurane side effects are studied below. There is a narrow margin of safety between adequate anaesthesia, unacceptable hypotension and myocardial depression. One of the enflurane side effects includes the seizure activity is rare and without sequelae. Hepatic dysfunction is rare but cross sensitization with other volatile inhalation agents possible. With prolonged anaesthesia
Isoflurane renal effects are minimal, only 0.2% metabolites are excreted in the urine and fluoride excretion is minimal. In patients for renal transplantation where there is a risk of arrhythmia, due to alteration in plasma electrolyte concentration, release of renin and catecholamines; there is hemodynamic stability. Skeletal muscle tone is reduced to a greater extent
Desflurane undergoes very little desflurane metabolism because of low blood/gas and low blood/tissue solubility. However, 0.02% is metabolized during desflurane metabolism with the production of trifluoroacetic acid which may interact with hepatic proteins and induce an immune response in susceptible patients. Previous exposure to halothane may produce antibodies. In desflurane metabolism , the elimination is almost exclusively by
Desflurane inhalation agent was synthesized by Dr Terell (1992) among 600 compounds. Desflurane inhalation agent is a halogenated ether. It has the lowest blood/gas solubility coefficient amongst all inhalation agents, including N20, hence quick induction and recovery. Et does not contain chlorine or bromine, so it does not deplete ozone layer in the atmosphere. Physical
Clinical studies using this strategy have claimed that even Normal Cerebral Perfusion Pressure values as low as 50 mm Hg are well tolerated with 8% mortality, and good recovery at 6 months after injury with little or moderate disability in 80% of patients. An increase in MAP may increase brain oedema. Therefore, lower intravascular pressures
