Emergence from anesthesia has cardiorespiratory, metabolic/endocrine and neurologic consequences. Awakening and extubation after anesthesia are associated with haemodynamic arousal lasting 10-25 minutes. This activation is partially mediated by elevations in catecholamine levels and partially by nociceptive stimuli. The aim of emergence after a neurosurgical procedure is to maintain intracerebral and extra-cerebral homeostasis. This implies maintenance […]
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
Enflurane metabolism is briefly discussed. About 80-90% of enflurane is eliminated in expired air, up to 5% is metabolized by hepatic cytochrome P450 (2E1) to difluoromethoxy difluoroacetic acid and free fluoride. Carbon monoxide may be produced in the presence of dry soda lime or baralyme, at higher temperatures and higher anaesthetic concentrations. Also while studying
Halothane cardiovascular effect plays a critical role. The main haemodynamic effect is a reduction in blood pressure secondary to a fall in cardiac output, reduced cardiac contractility and stroke volume, due to alterations in Ca-metabolism and a reduction in intracellular calcium. So, the coronary blood flow is reduced. The heart rate often falls due to
The kinetics of the anaesthetic agents during recovery from inhalant anesthesia are a reversal of the mechanism seen during induction. On cessation of anaesthetic agent, the fall in alveolar concentration is immediate. The gradient between venous blood and alveoli drives the anaesthetic into the alveoli. In terms of recovery from inhalant anesthesia , the poorly
A lot of Doctors and famous anesthesiologists have contributed to the evolution of the science of anesthesia. Their hard work and discoveries have made anesthesia a safe and crucial field in pain management and as a medical specialty. The discovery of Nitrous oxide was a major breakthrough, that was later found out to be a
Cardiovascular effects of inhalation anesthetics occur on all aspects of cardiovascular function, namely, inotropic, chronotropic, dromotropic and lusitropic state of the heart. Their effects are as follows: a) Myocardial b) Coronary circulation c) Conduction d) Circulation Cardiovascular effects of inhalation anesthetics produce dose-related myodial depression of LV, RV and LA contractility as well LV diastolic
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Acoustic Surgery can be accomplished with suboccipital, translabyrinthine and middle fossa approaches. The sitting, supine, lateral or park-bench position can be used for the suboccipital approach. Small or medium sized tumours are associated with essentially no mortality, whereas large tumors (>4 cm) have mortality rates of 2-4%. Compromise of the anterior inferior cerebellar artery and
Halothane neuromuscular junction effect produces moderate muscle relaxation, it increases the degree and duration of relaxation produced by nondepolarizing muscle relax- ants. The action is at the postjunctional membrane. There is relaxation of the uterine muscle, which is useful in podalic version procedure but may hinder uterine contraction postpartum. Halothane neuromuscular junction effect may produce
Anesthesia gases are the gases used to anesthetize a patient for surgery. The common gases used in general Anesthesia are: Oxygen Nitrous Oxide Air Halothane Sevoflurane Desflurane Isoflurane and many more… Nitrous oxide (N2O) is one of the popular anesthesia gases and is not metabolized in human tissue, however it reacts with vitamin 812 and
