Inhalation anesthesia

Narcosis Narcosis is a state of deep stupor or unconsciousness, produced by a chemical substance, such as a drug or anesthesia. Inhalation of certain chemicals can lead to narcosis. For example, diethyl ether and chloroform, two common organic solvents, were among the first examples of anesthesia known. Many other chemicals that you would not suspect can also cause narcosis. For example, even though nitrogen gas comprises 80% of the air we breathe and is considered chemically inert (unreactive) it can cause narcosis under certain conditions. Always work with adequate inhalation and avoid inhaling chemical fumes, mists, dusts etc. whenever possible. Use fume hoods and respirators as necessary. 

Veterinary Anesthesia Inhalation Anesthesia. Western College of Veterinary Medicine, University of Saskatchewan, http //www.usask.ca/wcvm/anes/anesman/anes07.htm... 

Anesthesia. Materials that have unquestionable anesthetic properties are chloral hydrate [302-17-0] paraldehyde, dimethoxymethane [109-87-5] and acetaldehyde diethyl acetal. In iadustrial exposures, however, any action as an anesthesia is overshadowed by effects as a primary irritant, which prevent voluntary inhalation of any significant quantities. The small quantities which can be tolerated by inhalation are usually metabolized so rapidly that no anesthetic symptoms occur. 

The onset of action is fast (within 60 seconds) for the intravenous anesthetic agents and somewhat slower for inhalation and local anesthetics. The induction time for inhalation agents is a function of the equiUbrium estabUshed between the alveolar concentration relative to the inspired concentration of the gas. Onset of anesthesia can be enhanced by increasing the inspired concentration to approximately twice the desired alveolar concentration, then reducing the concentration once induction is achieved (3). The onset of local anesthetic action is influenced by the site, route, dosage (volume and concentration), and pH at the injection site. 

The membrane enzyme luciferase, responsible for light emission in fireflies, is sensitive to anesthetics (20,21), and the concentrations of inhalational agents which inhibit luciferase are the same as those which cause general anesthesia. Studies of various classes of inhalational agents and luciferase demonstrated that above a certain chain length in a homologous series, a point is reached where higher members are not anesthetic. The same cut-off effect in efficacy is observed in anesthesia (22). This effect is not explainable by Hpid theory. 

Historical Inhalation Agents. Diethyl ether produces excellent surgical anesthesia, but it is flammable (see Ethers). Chloroform is a nonflammable, sweet smelling, colorless Hquid which provides analgesia at nonanesthetic doses and can provide potent anesthesia at 1% (see Chlorocarbons AND CHLOROHYDROCARBONs). However, a metabohte causes hepatic cell necrosis. Tdlene, a nonflammable colorless Hquid, has a slower onset and recovery and a higher toxicity and chemical reactivity than desirable. Cyclopropane is a colorless gas which has rapid induction (2 —3 min) and recovery characteristics and analgesia is obtained in the range of 3—5% with adequate skeletal muscle relaxation (see Hydrocarbons). The use of cyclopropane has ceased, however, because of its flammabiHty and marked predisposition to cause arrhythmias. 

Isoflurane is a respiratory depressant (71). At concentrations which are associated with surgical levels of anesthesia, there is Htde or no depression of myocardial function. In experimental animals, isoflurane is the safest of the oral clinical agents (72). Cardiac output is maintained despite a decrease in stroke volume. This is usually because of an increase in heart rate. The decrease in blood pressure can be used to produce "deHberate hypotension" necessary for some intracranial procedures (73). This agent produces less sensitization of the human heart to epinephrine relative to the other inhaled anesthetics. Isoflurane potentiates the action of neuromuscular blockers and when used alone can produce sufficient muscle relaxation (74). Of all the inhaled agents currently in use, isoflurane is metabolized to the least extent (75). Unlike halothane, isoflurane does not appear to produce Hver injury and unlike methoxyflurane, isoflurane is not associated with renal toxicity. 

The total U.S. market value for the anesthetic agents Hsted was 299.9 million ia 1990 (162). General inhalation agents, valued at 154.5 million, comprised over half (51.5%) of the 1990 market. General iv anesthetics were valued at 111.5 million (37.2%). Local iajectable agents, at 33.9 million, represented the smallest portion of the market (11.3%). U.S. sales for selected anesthesia pharmaceuticals are given ia Table 6. 

Health Hazards Information - Recommended Personal Protective Equipment Air pack or organic canister mask rubber gloves goggles Symptoms Following Exposure Inhalation causes anesthesia, nausea, dizziness, headache, and irritation of the eyes and nose. Contact of liquid with eyes causes only... 

Injection shock, bronchospasm during anesthesia, cardiac standstill and arrhythmias Inhalation acute bronchial asthma, emphysema, bronchitis, bronchiectasis... 

The anesthesiologist selects the anesthetic drug that will produce safe anesthesia, analgesia (absence of pain), and in some surgeries, effective skeletal muscle relaxation. General anesthesia is most commonly achieved when the anesthetic vapors are inhaled or administered intravenously (IV). Volatile liquid anesthetics produce anesthesia when their vapors are inhaled. Volatile liquids are liquids that evaporate on exposure to air. Examples of volatile liquids include halothane, desflurane, and enflurane. Gas anesthetics are combined with oxygen and administered by inhalation. Examples of gas anesthetics are nitrous oxide and cyclopropane. 

Sevoflurane (Ultane) is an inhalational analgesic. It is used for induction and maintenance of general anesthesia in adult and pediatric patients for inpatient and outpatient surgical procedures. 

Enflurane (Ethrane) is a volatile liquid anesthetic that is delivered by inhalation. Induction and recovery from anesthesia are rapid. Muscle relaxation for abdominal surgery is adequate, but greater relaxation may be necessary and may require the use of a skeletal muscle relaxant. Enflurane may produce mild stimulation of respiratory and bronchial secretions when used alone Hypotension may occur when anesthesia deepens. 

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