10 Questions
Which inhalational anesthetic has a low blood solubility and a high potency, allowing for excellent anesthesia control?
Sevoflurane
Which of the following statements is true about nitrous oxide?
It has minimal effects on the liver, kidney, or GI tract
Which inhalational anesthetic is associated with an increase in fluoride levels, potentially causing renal damage?
Sevoflurane
What is the primary advantage of using nitrous oxide as an adjunct to other inhalational agents?
It reduces the dosage requirements of other agents
What is the term for the rapid transfer of nitrous oxide from the blood and tissues to the alveoli, resulting in decreased arterial tension of oxygen?
Diffusional hypoxia
Which of the following inhalational anesthetics has a high MAC value and is not suitable as a sole anaesthetic agent?
Nitrous oxide
What is the primary limitation of nitrous oxide as an anaesthetic agent?
It has weak anaesthetic potency
Which of the following is a characteristic of sevoflurane that allows for excellent anesthesia control?
Low blood solubility and high potency
What is the advantage of using nitrous oxide in combination with a skeletal muscle relaxant?
It reduces the dosage requirements of the muscle relaxant
Which of the following inhalational anesthetics has a significant effect on muscle relaxation, allowing for intubation and reducing the dosage requirements of muscle relaxants?
None of the above
Study Notes
Stages of Anaesthesia
- Stage III (Surgical Anaesthesia): spontaneous movement ceases, respiration becomes regular, and muscles relax
- Stage IV (Medullary Paralysis): respiration and vasomotor control cease, and death occurs within a few minutes
Pharmacokinetics of Inhalational Anaesthetics
- Speed of induction and recovery depend on solubility in blood (blood: gas partition coefficient) and lipid solubility
- Agents with low blood: gas partition coefficients (e.g., nitrous oxide, enflurane) produce rapid induction and recovery
- Agents with high blood: gas partition coefficients (e.g., halothane) show slow induction and recovery
- Agents with high lipid solubility (e.g., halothane and methoxyflurane) accumulate gradually in fat tissues and may produce prolonged hangover
Pre-anaesthetic Medication
- Sedative-hypnotics (e.g., benzodiazepines, barbiturates): anxiolytic, sedation, and relatively little respiratory and cardiac depression
- Opioid analgesics (e.g., morphine, meperidine, fentanyl): presurgical pain relief, anxiolytic, sedation, and reduction in required general anaesthesia
- Anticholinergics (e.g., atropine, scopolamine): decrease vagal effects, reduce secretions, and block parasympathetic effects
Specific Anaesthetic Agents
- Sevoflurane (Sevorane, Ultane): low blood solubility, high potency, and excellent anesthesia control
- Nitrous Oxide: effective analgesic, often combined with other agents, and has minimal effects on circulation, respiratory drive, and skeletal muscle relaxation
This quiz covers the stages of anaesthesia, including surgical anaesthesia, and the various reflexes that occur during this state, such as cough reflex and gagging. It also discusses the importance of eliminating this state in modern anaesthetic procedures.
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