Inhaled Anesthetics

Question 1

What are qualities of a low gas to blood partition coefficient?

Answer 1

Means it is a low concentration to become equilibrium in the blood.

• Fast Equilibrium = Fast INDUCTION
• Fast Recovery

Question 2

What are the qualities of high partition coefficient from gas to blood?

Answer 2

Means the concentration of equilibrium in blood is high and can hold more drug.
- Slower induction time

Question 3

What is the problem with a high partition coefficent from blood to fat?

Answer 3

The more amount of drug in the fat, the longer recovery takes, due to the slow leakage back into the blood.

Question 4

What factors affect induction with inhaled anesthetic?

Answer 4

• Concentration in inhaled air
• Pulmonary ventilation
• Pulmonary blood flow
• Arteriovenous concentration
• Elimination rate

Question 5

What partition coefficients are eliminated the fastest from the blood?

Answer 5

Low partition coefficients from air to blood - eliminated the fastest due to the lowest concentration in blood

Question 6

What is common among all inhaled anesthetics?

Answer 6

Depress Respiration and increase pCO2, due to CNS depression.

Question 7

Which inhaled anesthetic has a moderate blood:gas partition coefficient and is used for both induction and maintenance?

Answer 7

Isoflurane

Question 8

What are common side effects of Isoflurane?

Answer 8

Resp: Decreases tidal volume and increase resp rate
CV: Increases Risk of arrhythmias, Dilates Blood Vessels lowering blood pressure.

Question 9

What inhaled anesthetic has the fastest induction time, but why is it not used for induction?

Answer 9

Desflurane, but causes respiratory irritation unable to be used for induction.
–ONLY used to Maintain–

Question 10

Which inhaled anesthetic is used in outpatient surgeries?

Answer 10

Desflurane - due to fast recovery time - low coefficient

Question 11

What is an extra effect of using Desflurane?

Answer 11

Relaxes skeletal muscles.

Question 12

What are the side effects of Desflurane?

Answer 12

Similar to Isoflurane. Can cause decreased tidal volume, hypotension, and cardiac arrhythmias.

Question 13

Which inhaled anesthetic should be avoided in renal insufficiency patients?

Answer 13

Seroflurane, due to partial metabolism in the liver creating fluoride ions transferred to kidney.

Question 14

What are the benefits of using Seroflurane?

Answer 14

Can be used to induce and maintain. Less respiratory depression compared to the others. Can be used in inpatient and outpatient.

Question 15

What gas is typically uses to help induce anesthesia?

Answer 15

Nitrous Oxide

Question 16

How can Nitrous oxide reduce the amount of inhaled anesthetic needed?

Answer 16

Nitrous Oxide is rapidly uptaken through the lungs, which if administered at the same time as others, then they will be taken in as well more quickly causing equilibrium.

Question 17

What is unique about emergence from anesthesia by Nitrous Oxide?

Answer 17

The outflow of NO from the lungs can dilute oxygen flowing into the lungs, so O2 needs to be administered upon emergence.

Question 18

What are limitations and side effects of NO?

Answer 18

Should not be used with pneumothorax. Negative inotropic reducing contractility.
Limited Effects on Respiration
–Abuse Liability–