Nitrous/Sevoflurane Flashcards Preview

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Flashcards in Nitrous/Sevoflurane Deck (34):
1

What is the MAC value of Nitrous?

104%

2

What is the metabolism rate of Nitrous?

0.004%

3

In a Nitrous tank when the pressure begins to decrease, about how much is remaining in the cylinder?

~400 L

4

What is the BGPC of Nitrous?

0.46

5

What property does Nitrous have that no other VA shares with it?

prominent analgesic effects--->10% nitrous = 7.5 mg morphine

6

Can Nitrous cause skeletal muscle relaxation?

No actually can cause rigidity

7

What is the mechanism of action related to the analgesic effects of Nitrous?

N2O produces analgesia via opioid like neurons in the periaqueductal gray matter of the brain stem. These neurons project to the dorsal horn of the spinal cord where they act through alpa-2B adrenergic receptors inhibiting nociception

***Nitrous provides analgesia by inhibition of the dorsal horn nociceptive neurons***

8

Nitrous may increase motor activity with ___ and ___.

clonus and opisthotonus

9

Substitution of nitrous for a portion of VA ___ the magnitude of BP decrease produced by the same MAC {} of the VA alone.

decreases

10

Is PHT contraindicated for N2O administration?

yes due to increased CVP secondary to increased PVR

11

Which type of shunt patient should not receive N2O?

those with Right to Left shunts

12

Nitrous do's:

hastens inhalation induction-second gas effect
lower VA MACS
deeper levels of anesthesia
Hasten emergence with Iso/Sevo
Analgesia

13

Nitrous don'ts:

laparoscopic cases
bowel cases
cases with potential for air emboli
PONV patients
Vitamin B12/folate metabolism deficiencies
Pneumothorax
abuse
Muscle relaxation
potential for hypoxia
free flaps
hasten Desflurane emergence
PHT
R to L shunts

14

What is the BGPC of Sevoflurane?

0.69

15

What agent is in Sevo making it nonflammable?

Fluorines--->they replace the hydrogens

16

What is the MAC value of Sevo?

2.1%(or 1.8% in some text)

17

What is the MAC BAR of Sevo(blocked autonomic reflex)?

1.5 x MAC

18

On how much MAC Sevo can you intubate?

2 x MAC

19

Hyperthermia reduce or increase the amount of VA needed?

reduce

20

Patients with lower cardiac outputs will take longer or be faster to put to sleep?

Lower CO faster to sleep

21

What percentage of the body mass is the VRG?

10%

22

What percent of the body's CO goes to the VRG?

75%

23

At what percentage does the cerebral metabolic oxygen requirements begin to decrease on Sevo?

0.4 MAC

24

At what level does EEG activity cease while on sevo?

2 MAC

25

At what MAC does Sevo cause EEG burst suppression?

1.5 MAC

26

At what MAC does Sevo cause increased blood flow to the brain--->increased ICP?

0.6 MAC

27

Sevo circulatory effect will disappear in about ___ hours?

5 hrs

28

Sevo neuro alterations will disappear in about ___ hours

4 hrs

29

In contrast to Iso and Des, neurocirculatory responses do not accompay.....?

abrupt increases in Sevo concentrations. Sevo is smoother

30

Can Sevo cause Halothane hepatitis?

Sevo cannot form trifluoracetylated protein antibodies resulting in immune mediated hepatotoxicity. The chemical structure of sevo does not allow metabolism to an acetyl halide

31

Should Sevo be avoided in patients with ESRD?

yes

32

What % Sevo is metabolized?

5%

33

Compound A can be caused from ?

HGF
LGF
closed circuits
Metabolism rates
Higher temps

***mostly LGF and minimal flow anesthesia***

34

Is Sevo a triggering agent for MH?

yes