With respect to inhalation agent anesthetic , an increase in cardiac output and the consequent increased pulmonary blood flow removes more general anesthetic from the alveoli. The alveolar venous anesthetic gradient is determined by the amount of tissue uptake of an inhalation agent anesthetic . This depends on the tissue solubility, tissue blood flow and […]
Etomidate sedation infusion can be used as a suitable alternative for neuroanesthesia when nitrous oxide is contraindicated. Etomidate sedation (100 micrograms/kg/ minute) has been used as a part of total intravenous anesthetic technique with a mean recovery time of about 10 minutes. The infusion is associated with minimal incidences of side effects such as thrombophiebitis
Phenobarbital status epilepticus that does not respond to first-line benzodiazepines (lorazepam or diazepam) or to second-line antiepileptic drugs (phenytoin/fosphenytoin, phenobarbital or valproate) is usually considered refractory and requires more aggressive treatment. Barbiturate anaesthetics, such as pentobarbital and thiopental sodium, are the most frequently used agents and are highly effective for refractory GCSE both in children
One of the lorazepam uses , is that the Lorazepam undergoes reliable absorption after oral and I.M. injection. After oral administration, maximal plasma concentrations of lorazepam occur in 2 to 4 hours and persist at therapeutic levels for up to 24 to 48 hours. The recommended oral dose of lorazepam uses preoperative medication which is
The pharmacokinetics of ketamine is characterized by rapid onset of action, relatively short duration of action, and high lipid solubility. Ketamine half life has a pK of 7.5 at physiologic pH. Ketamine half life can be given by multiple routes: IV, TM, SC, oral, sublingual, rectal, nasal, transdermal, epidural, or intrathecal. Peak plasma concentrations of
Ketamine cardiovascular effects resemble sympathetic nervous system stimulation. Indeed, a direct negative cardiac inotropic effect is usually overshadowed by central sympathetic stimulation. HR and BP rise were similar between S(+)ketamine and racemic mixture. Systemic blood pressure, heart rate, cardiac output, cardiac work, and myocardial oxygen requirements all are increased after IV administration of ketamine cardiovascular
The original formulation of Etomidate injection contains propylene glycol as a solvent contributing to a high incidence of pain during IV injection and occasional venous irritation. The newer lipid emulsion formulation is devoid of pain on injection and venous complications such as reddening, swelling, induration; as well as allergic reactions, whereas the incidence of myoclonus
Commonly administered IV anesthetics can cause excitatory effects that my manifest as spontaneous movements, such as etomidate myoclonus ,dystonia, and tremor. These spontaneous movements, particularly myoclonus, occur in 50% to 80% of patients receiving etomidate in the absence of premedication. In one report, 87% of patients receiving etomidate developed excitatory effects, of which 69% were
Hypoxia mechanism Following phases are included in the Hypoxia mechanism : 1. Anoxic hypoxia—Gas phase. There is inadequate supply of oxygen to the lungs, or the lung is not functioning properly. 2. Anemic hypoxia—Fluid hypoxia (phase). There is a decrease in the oxygen carrying capacity of the blood. 3. Stagnant hypoxia—Fluid phase. There is decreases
The management of methods of pain relief is and will always remain a challenging task for the clinicians. Many a times in spite of understanding the pathophysiology of pain, it becomes extremely difficult to control that pain. Most of the times the pathophysiology itself, may be shrouded in the mist of uncertain methods of pain
