Anesthesia: Inhalation Agents

Front 1

What are the MACs of the common agents?

Back 1

1. N2O - 105
2. Sevo - 2.0
3. Iso - 1.2
4. Des - 6.0
5. Halothane - 0.75

Front 2

Nitrous Oxide (NO)
1. Blood/gas solubility (induction speed)

Back 2

1. 0.47 (Low - fast induction!)

Front 3

Nitrous Oxide (NO)
1. CV effects

Back 3

1. INCREASES EVETYTHING - direct depressant, but causes release of catacholamines (similar concept to ketamine, if depleted can see HoTN.
2. Can cause pulm HTN (NitrIC Oxide is used to treat, NitrOUS Oxide can cause)

Front 4

Nitrous Oxide (NO)
1. Resp effects

Back 4

1. Tachypnea in peds
2. Otherwise minimal changes

*give 100% O2 if use for > 5 mins

Front 5

Nitrous Oxide (NO)
1. Neuro effects
2. NM effects

Back 5

1. INCREASES ALL (CMRO2, ICP, CBF)
2. Potentiates paralytics

Front 6

Nitrous Oxide (NO)
1. AEs

Back 6

1. N/V
2. Gas accumulation
3. Inhibits B12 dependant enzymes
4. CONTRAINDICATED IN PULM HTN

Front 7

Nitrous Oxide (NO)
1. Summary on CV, Resp, and Neuro

Back 7

1. Stimulates CV, no change in resp, and Increases neuro

Front 8

Halothane
1. Vapor pressure
2. Blood/gas solubility
3. Induction speed

Back 8

1. 243 mmHg (similar to Iso)
2. 2.4 (opposite of NO)
3. Slow

Front 9

Halothane
1. CV effects

Back 9

1. DECREASES but SVR not affected.
2. Bradycardia due to affect on SA node
3. SENSITIZES HEART TO EPI (limit dose to 1.5 mcg/kg)

Front 10

Halothane
1. Resp effects

Back 10

1. Shallow breathing, increase in EtCO2
2. POTENT BRONCHODILATOR

Front 11

Halothane
1. Neuro effects

Back 11

1. Increases CBF and ICP but decreases CMRO2

Front 12

Halothane
1. AEs

Back 12

1. Halothane Hepatitis (1:3,500)
2. MH Trigger

Front 13

Halothane
1. Summary of effects on CV, resp, and neuro

Back 13

1. Decreases CV, Decreases Resp, and Mixed Neuro

Front 14

Isoflurane
1. Vapor pressure
2. Blood/gas solubility
3. Induction speed

Back 14

1. 240 mmHg (similar to halothane)
2. 1.4 (middle of the road)
3. Medium speed induction

Front 15

Isoflurane
1. CV effects

Back 15

1. Minimal depression
2. CORONARY STEAL

Front 16

Isoflurane
1. Resp effects

Back 16

1. DEPRESSION
2. Bronchodilation

Front 17

Isoflurane
1. Neuro effects
2. Hepatic

Back 17

1. Mixed (high ICP and CBF, but Low CMRO2)
2. Decreases portal and hepatic aa. flow, no enzyme changes though

Front 18

Isoflurane
1. AEs

Back 18

1. Pungent smell
2. Fluoride build up if on gas for too long
3. Coronary Steal

Front 19

Isoflurane
1. Summary of effect on CV, resp, and neuro

Back 19

1. Minimal CV, Depressed Resp, and Mixed Neuro

Front 20

Desflurane (blue)
1. Vapor Pressure
2. Blood/gas solubility
3. Induction onset

Back 20

1. 681 mmHg (high)
2. 0.42 (very low like NO - 0.47)
3. FAST induction

Front 21

Desflurane (blue)
1. CV effects

Back 21

1. CO stable, some decrease in SVR and MAP
2. No coronary steal

Front 22

Desflurane (blue)
1. Resp effects

Back 22

1. Depression
2. PUNGENT, LARYNGOSPASM

Front 23

Desflurane (blue)
1. Neuro effects

Back 23

1. Mixed (Increase in CBF and ICP, but decrease in CMRO2 - seems like a trend for all inhaled volatile anesthetics)

Front 24

Desflurane (blue)
1. AEs

Back 24

1. Carbon Monoxide poisoning! (Blue makes you blue) Can prevent by using fresh absorbent.
2. Watch for emergence delerium in peds

Front 25

Desflurane (blue)
1. Summary of effects on CV, Resp, and Neuro

Back 25

1. Stable CV, Depressed Resp, and Mixed Neuro

Front 26

Sevoflurane (Yellow)
1. Vapor Pressure
2. Blood/gas solubility
3. Induction Speed

Back 26

1. 160 mmHg (similar to Enflurane)
2. 0.65
3. Fast-ish

Front 27

Sevoflurane (Yellow)
1. CV effect

Back 27

1. Mild depression
2. No coronary steal
3. Can prolong Q-T interval

Front 28

Sevoflurane (Yellow)
1. Resp effect

Back 28

1. Depression
2. Reverses bronchospasm

Front 29

Sevoflurane (Yellow)
1. Neuro effect

Back 29

1. Mixed (Increases CBF and ICP but decreases CMRO2 - same as the others)
2. > 1.5 MAC can impair CBF autoregulation

Front 30

Sevoflurane (Yellow)
1. AEs

Back 30

1. Compound A (Keep flows > 2 L/min) which is caused by degredation of sevo by soda lime - only proven in rats
2. Decreases portal vein flow but increases hepatic aa flow
3. Contraindicated in hypovolemia or Hx of MH

Front 31

Sevoflurane (Yellow)
1. Summary of effect on CV, Resp, and Neuro

Back 31

1. Mild CV depression, Resp depression, Mixed neuro (same as others).