1. Non toxic to staff, 2. High potency 3. pleasant to inhale 4. No biotransformation 5. low blood sol 6. minimal effects on other systems
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Xe - Xenon
is the ideal GA, as non toxic, minimal side effects but just so expensive
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Historical GAs
diethyl esther+ cyclopropane - good but v flamm. chloroform- heptatoxic and can induce hypertension
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MAC
minimal alveolar conc - way of measuring the potency of inhalation GAs
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lower the MAC
higher the potency
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MAC over what can be lethal
>2
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Therapeutic index
lethal dose/theraputic dose
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high TI
good
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N2O
nitrous oxide- is the oldest GA, aka laughing gas, still used today
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N2O use
not used for deep an. but used effectively with other inhalation agents to increase TI by reducing MAC
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side effects of volatile agents
can cause muscle to release alot of heat - leading to overheating due to release of Ca. this is called malignant hypothermia and is rare and due to genetics
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intravenous GAs
to quickly knock out, not to be used for long periods of time. use to knock out then maintain using vol agent. too dangerous
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Ketamine
dissociate anesthetic - disconnects sensory cortex from rest of cortex- no recollection of pain - this allows less anesthetic to be used - safer
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preoperatives
to relax muscle
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post operatives
to relieve side effects
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adjuncts
to reduce amount of anesthetic req. ie opiods use for pain relief.
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Monitoring consciousness
1. by monitoring behaviors - ie response to stimulus (not the best method) 2. EEG
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