Inhalation anesthetic mechanism of action after being administered and excreted via the lungs. The dose of the agent is defined by the fraction of inhaled concentration that equates with the blood concentration and not the total amount of drug administered. The minimum alveolar concentration (MAC) was introduced in 1963 as a comparison of potency of […]
Critically ill patients often require cardiac inotrope and/or cardiac pressors support to maintain adequate cardiac output and adequate blood pressure to sustain end-organ perfusion. Because end-organ perfusion has already likely been compromised and may continue to be problematic despite use of these agents, anaerobic metabolism rather than aerobic metabolism is likely to be generating a
Halogenated volatile agents are inhalational anesthesia gases used during surgeries to provide general anesthesia. They are metabolized to varying degrees. There is biotransformation in the liver resulting in cleavage and dehalogenation by the specific enzyme P450, which is a haemocytochrome present in the hepatic cell. Desflurane (CHF2-O-CHFCHF3): It is one of the halogenated volatile agents
The primary mechanism of protection of barbiturates drugs in cerebral ischemia has been attributed to its ability to decrease the cerebral metabolic rate of oxygen consumption (CMRO2), thereby increasing the ratio of oxygen supply to oxygen demand. Barbiturates drugs have been the prototype for anesthetic protection against cerebral ischemia. The decrease in CMRO2 is accompanied by a parallel
Effect of barbiturates drugs in cerebral ischemia Read More »
Diazepam remains a popular oral drug for preoperative medication of adults and is the benzodiazepine most likely to be selected for management of delirium tremens and treatment of local anesthetic induced seizures. This is considered to be one of the diazepam uses that are very common. Production of skeletal muscle relaxation by diazepam is often
The Ketamine induction dose of anaesthesia is, 1 to 2 mg/kg IV or 4 to 8 mg/kg IM. Injection of ketamine IV does not produce pain or venous irritation. Consciousness is lost in 30 to 60 seconds after IV administration and in 2 to 4 minutes after IM injection. Unconsciousness is associated with maintenance of
Etomidate dosage may be viewed as an alternative to propofol or barbiturates for the IV induction of anaesthesia, especially in the presence of an unstable cardiovascular system. After a standard induction dose of 0.2 to 0.4 mg/kg IV, the onset of unconsciousness occurs within one arm-to-brain circulation time. Involuntary myoclonic movements are common during the
Propofol is a global central nervous system depressant. Propofol general anesthesia decreases cerebral metabolic rate for oxygen (CMRO2), cerebral blood flow (CBF), and intracranial pressure (ICP). Decrease in CBF is more than sevoflurane. Propofol is a cerebral vasoconstrictor and thus lowers ICP. Propofol decreases ICP greater than isoflurane and sevoflurane while cerebral perfusion pressure is
Subhypnotic doses of IV like Propofol 10 mg have been used to treat pruritus caused by neuraxial opioids. However, this beneficial effect has not been achieved in other studies. Propofol has been shown to possess antipruritic effect. Subhypnotic doses of propofol may be effective for the short-term symptomatic relief of pruritus associated with liver disease. Such
The versed side effects related to Respiratory are respiratory arrest, respiratory failure, apnoea, hypoxia, oxygen desaturation. Danger of respiratory disorders may increase when midazolam is administered with opioids. Therefore, the dosage of both agents should be reduced. Limited information is available from published literature regarding the use of midazolam in paediatric patients. However, based on
