Apnea anesthesia

The side effects of barbiturates include sedation, poor physical coordination, and impaired mental performance. They also potentiate the intoxicating effects of alcohol. Barbiturates can be extremely dangerous in overdose, causing anesthesia, coma, and even death. In addition, barbiturates can cause dangerous suppression of breathing in patients with sleep apnea or other respiratory disorders. With repeated use over just a few weeks, physical dependence and tolerance to their effects can develop, leading to increasing doses to maintain the desired therapeutic effect. If a... 

In mice, exposure to 520,000 ppm was lethal to 100% of the animals within an average of 28 minutes. Near the LC50 dose, mice exhibit central nervous system depression, rapid and shallow respiration, and apnea. At concentrations of 3 50,000 ppm, loss of posture occurred after 25 minutes exposure to 150,000 ppm for 60 minutes or 230,000ppm for 26 minutes produced light anesthesia. 

General anesthesia - Remifentanil is not recommended as the sole agent in general anesthesia because loss of consciousness cannot be assured and because of a high incidence of apnea, muscle rigidity, and tachycardia. Remifentanil is synergistic with other anesthetics and doses of thiopental, propofol, isoflurane, and midazolam have been... 

Which of the following adjuvants to anesthesia has the potential to cause hyperkalemia, postoperative muscle pain, muscle fasciculation, and prolonged apnea and paralysis in genetically sensitive patients ... 

Etomidate is a carboxylated imidazole that can be used for induction of anesthesia in patients with limited cardiovascular reserve. Its major advantage over other intravenous anesthetics is that it causes minimal cardiovascular and respiratory depression. Etomidate produces a rapid loss of consciousness, with minimal hypotension even in elderly patients with poor cardiovascular reserve. The heart rate is usually unchanged, and the incidence of apnea is low. The drug has no analgesic effects, and coadministration of opioid analgesics is required to decrease cardiac responses during tracheal intubation and to lessen spontaneous muscle movements. Following an induction dose, initial recovery from etomidate is less rapid (< 10 minutes) compared with recovery from propofol. 

Effects on respiration are similar to those of thiopental at usual anesthetic doses. However, propofol causes a marked decrease in systemic blood pressure during induction of anesthesia, primarily through decreased peripheral resistance. In addition, propofol has greater negative inotropic effects on the heart than etomidate and thiopental. Apnea and pain at the site of injection are common adverse effects of bolus administration. Muscle movements, hypotonus, and (rarely) tremors have also been reported following its use. Clinical infections due to bacterial contamination of the propofol emulsion have led to the addition of antimicrobial adjuvants (eg, ethylenediaminetetraacetic acid and metabisulfite). 

Echothiophate Treatment of open-angle glaucoma when succinylcholine is used as skeletal muscle relaxant during surgery requiring general anesthesia Prolonged apnea... 

Preterm infants can become apneic during the immediate postoperative period, even if the ventilatory response to CO2 is not depressed after halothane anesthesia (12). In a prospective study in 167 preterm infants after inguinal herniorrhaphy with halothane/nitrous oxide anesthesia, only one had an episode of apnea up to 2 days postoperatively however, the authors recommended careful monitoring until complete recovery from anesthesia has occurred (13). 

A 68-year-old man developed total spinal anesthesia after the administration of 20 ml of ropivacaine 1% without a prior test dose via an epidural catheter, which was inadvertently placed intrathecally (83). Initial aspiration of both the Touhy needle and the catheter failed to identify the intrathecal position of the catheter. The patient noted weakness in his right leg immediately after the end of the injection. This was followed by weakness in his right arm, asystole, apnea, and loss of consciousness. Ventricular escape beats were noted and sinus rhythm returned after mask ventilation with 100% oxygen and the administration of atropine 1 mg and ephedrine 50 mg. He was able to open his eyes, but remained apneic and was therefore intubated and ventilated. Cardiovascular stabihty was maintained with incremental boluses of ephedrine to a total of 60 mg. He regained consciousness and was successfully extubated 145 minutes later. AH sensory and motor deficits had resolved within 8 hours and no neurological deficit or transient neurological symptoms were detected 5 days later. 

There is a potential risk that spinal anesthesia will cause apnea in premature infants. However, spinal anesthesia with a sound technique has been used safely in high-risk infants. Tetracaine was used in 142 such cases only two infants had serious adverse effects, one with unexplained but treatable apnea and one in whom too high a block resulted in respiratory arrest (196). 

Inadvertent spinal anesthesia and subsequent nervous system toxicity, for example with transient paralysis or apnea, are the main complications of stellate ganglion block (SEDA-22, 140). It has been suggested that ultrasound guidance when performing the block might improve safety (357). The use of very small test doses and an anterior approach to the stellate ganglion are recommended preventive measures. 

In patients with chronic pulmonary disease, polymyxin-induced neuromuscular block can result in fatal apnea. Finally, after anesthesia involving muscle relaxants the polymyxins can cause relapse of muscle weakness and inadequate ventilation (16). 

Overall, about 10% of patients have unpleasant but usually transient adverse reactions. Xenon is a narcotic gas, more potent than nitrous oxide, and inhalation of 71% xenon is sufficient for anesthesia in 50% of patients. Lower concentrations of xenon are currently used, but some euphoric or dysphoric effects are still observed and can cause temporary exacerbation of neuropsychiatric symptoms. Mild nausea can also occur, and patients should have an empty stomach before the scan to reduce the risk of vomiting and possible aspiration. Very rarely, apnea can occur and can be... 

Ketamine (Ketalar) Dissociative (disconnected from surroundings) anesthesia, analgesia. Less hypotension than others. T heart rate, blood pressure, myocardial O2 consumption, and cerebral blood flow. Low risk of apnea following induction. Bronchodilation (useful in asthmatic patients). 

Respiratory The risk of postoperative spells of apnea in preterm infants has promoted the use of spinal anesthesia, because of improved safety. However, high spinal anesthesia has been associated with respiratory failure in a preterm infant [33" ]. The authors concluded that the cephalad spread of spinal anesthesia is less... 

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