Cerebral Aneurysm Clipping is one of the important modalities for the treatment of aneuryms apart from coiling so the anesthetic management of such cases is as follows. Skull is a fixed vault and most intracerebral structures are relatively in compressible, hence even a small haemorrhage can result in a significant anatomic distortion producing significant rise in ICP […]
Hepatotoxicily has been seen since the introduction of anesthetics. Chloroform and trichloroethylene have been abandoned for toxicity of inhalational anesthesia . The toxicity may be intrinsic as seen with Chloroform or acetaminophen. Halothane exhibits an allergic or hypersensitivity reaction to a drug metabolite protein. The toxicity of inhalational anesthesia with the incidence of liver injury is Halothane> Isoflurane
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
CEA Anesthesia or Carotid endarterectomy anesthesia can be general or regional or combined. Here is a discussion on the relative advantages and disadvantageous of the different types. Mc CaI Thyet al conducted a prospective, randomized trial investigating patient experience of CEA Anesthesia under local or general anesthesia in 176 patients and found that the recovery
Ethyl Chloride Anesthesia is a potent anesthetic. If it has a boiling point of 12.5°C and hence is a gas at room temperature, so it is liquefied and stored under pressure in a bottle with a cap and seal. It is used as a spray. Though ethyl chloride induces anesthesia quickly, the maintenance of a steady
The MAC of halothane pharmacokinetics varies from 1.08 in neonates to 0.64 in the elderly, Addition of N20 in adults reduces MAC to 0.29%. The distribution of halothane is to lungs, VRG organs, muscle, fat around VRG organs and finally peripheral fat. Excretion is primarily through the lungs in a reverse manner. Halothane Pharmacokinetics undergoes
Sevoflurane Inhalation anesthetic was synthesized by Baxter Laboratories (1960) but introduced into clinical practice in Japan in 1990, now widely used the world over. Unlike isoflurane it does not exist as an optical isomer, it does not have an asymmetric atom. It contains only fluorine atoms, so it does not affect the ozone layer in
McNarry and Goldhill compared ACDU Scale (Alert, Confused, Drowsy, Unresponsive) and AVPU scale (Alert, responds to Voice, responds to Pain, Unresponsive) by the American college of surgeons with GCS scale for neurological assessment of critically ill ward patients. Just like GCS the ACDS Scale is a method to assess the neurological status and level of
Many common critical care drugs are among the safe drugs during pregnancy, whereas some should be used with caution and others avoided entirely. When treating pregnant patients, it is the physician’s responsibility to treat the mother as the primary patient. Fetal considerations are secondary to ensuring maternal well-being because maternal demise will generally result in
Enflurane Structure is a halogenated methyl ethyl ether and is an isomer of isoflurane. Enflurane structure makes it a colourless liquid, noncorrosive to aluminium, iron as well as copper, non-flammable, stable to light and UV light, does not need a chemical stabilizer. Physical properties: The bp is 56.5°C, The SVP 172 mm Hg (22.9 kPa),
