General Anaesthesia: I Made Agus Kresna Sucandra
General Anaesthesia: I Made Agus Kresna Sucandra
General Anaesthesia: I Made Agus Kresna Sucandra
ANAESTHESIA
I Made Agus Kresna Sucandra
Anasthesia
Balanced Anastesia
Komponen Balanced Anasthesia
Hilangnya kesadaran
Analgesia
Relaksasi otot
Inhalation anaesthetics:
Advantage of controlling the depth of anesthesia.
Metabolism is very minimal.
Excreted by exhalation.
INHALATIONAL
ANAESTHETICS
Non-halogenated gas
• Nitrous oxide
Halogenated hydrocarbons
• Halothane
• Enflurane
• Isoflurane
• Desflurane
• Sevoflurane
• Methoxyflurane – nephrotoxicity.
The important characteristics of Inhalational
anaesthetics which govern the anaesthesia are
0.8
1.4 220
Inhalation MAC value Oil: Gas
Anesthetic % partition
Nitrous >100 1.4
oxide
Desflurane 7.2 23
Sevoflurane 2.5 53
Isoflurane 1.3 91
• The rapid uptake of N2O from alveolar gas serves to concentrate coadministered
halogenated anesthetics.
Enflurane:
• Sweet and ethereal odor.
• Generally do not sensitizes the heart to
catecholamines.
• Seizures occurs at deeper levels –
contraindicated in epileptics.
• Caution in renal failure due to fluoride.
INHALATIONAL ANESTHETICS
Isoflurane:
• It is commonly used with oxygen or nitrous
oxide.
• It do not sensitize the heart to
catecholamines.
• Its pungency can irritate the respiratory
system.
INHALATIONAL ANESTHETICS
Desflurane:
• It is delivered through special vaporizer.
• Induction and recovery is fast, cognitive and
motor impairment are short lived
• It is a popular anesthetic for day care surgery.
• It irritates the air passages producing cough
and laryngospasm.
INHALATIONAL ANESTHETICS
Sevoflurane:
• Induction and recovery is fast.
• It is pleasant and acceptable due to lack of
pungency.
• It does not cause air way irritancy.
• Concerns about nephrotoxicity.
Anesthetic B:G PC O:G PC Features Notes