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General Anaesthesia (measurement of anaesthetic potency (factors…

- - - - λb/g > 1
      - more agent in blood, less in gas phase
      - slower recovery
      - accumulates in fat (reservoir) causing
        a hangover through slow release
    - - λo/g < 1
      - less agent in blood, more in gas phase
      - quicker to reach equilibrium alveolar levels (same in the brain)
      - quicker onset and offset
- - - - eyes roll and become fixed
      - corneal and laryngeal reflexes are lost
      - pupil dilation and loosing of light reflex
      - intercostal paralysis and shallow abdominal respiration
- - - - Halothane
      - Enflurane
      - Isoflurane
      - Nitrous oxide
    - - Ether
      - Cyclopropane
      - Methoxyflurane
      - Chloroform
    - - low safety margin - overdose is leathal
      - cardiovascular system
        
        cardiac arrhythmias
        
        blood pressure lowered
        
        respiratory depression
        
        present in Halothane, and that's why
        it was replaced by Isoflurane
      - nausea/hangover
      - Halothane - liver damage
  - - - fast onset, slow recovery
      - high lipid solubility
      - cardiovascular and respiratory depression
    - - fast onset and recofery
      - cardiovascular and respiratory depression
      - administered by continuous slow intravenous infusion
      - irritant at the site of injection
      - needs a vehicle (soya oil) to increase its bioavailability
    - - fast onset and recovery
      - excitation effect during induction - increase nausea
      - adrenocortical suppression
    - - Phencyclidine (Ketamine analogue)
      - cause hallucinations (less in children)
      - used in pediatric surgery and as pediatric sedative after trauma
      - widely used in veterinary practice
      - produce incomplete anaesthesia
        
        dissociation from surrounding, light sleep
        
        used when cooperation is needed
      - very good analgesic effects
      - lethal overdose is rare
      - also orally active
      - very slow recovery
    - - epidural anaesthesia
        
        only give pain control below site of epidural
      - Bupivacaine
        
        long duration
      - Fentanyl
        
        narcotic analgesic
      - clinical uses
        
        Childbirth
        
        minor surgeries
        
        when cooperation is needed
        
        pain control (post operative)
  - - - analgesic, anxiolytic, anti-emetic, anti-muscarinic
    - - I.v. anaesthetic e.g. propofol
    - - inhalation anaesthetic
      - level of anaesthesia can be constantly titrated
    - - reduce plane of anaesthesia needed
    - - for surface analgesia
      - lignocaine
- - - - Na pump
      - axonal conductino
      - response to transmitter
      - transmitter release