Thanks for watching the video guys! Take a look at my other related video on the 2nd gas effect and diffusion hypoxia: ua-cam.com/video/ijulFNSUfvs/v-deo.html
Hi, thank you so much for this wonderful video. In regards to Isoflurane, some sources say that it does not cause sensitization of the heart and no arrhythmias. Please clarify for us. Thank you.
It can increase HR slightly, especially at higher concentrations. Because of this, cardiac output is typically maintained because stroke volume goes down, but heart rate slightly increases, maintaining, cardiac output. Desflurane has a greater incidence of tachycardia with higher concentrations over isoflurane.
No information on Sevoflurane? Halothane is rarely used anymore in the US, mostly in other countries and Methoxyflurane is used even less. Banned in most places due to the nephrotoxicity affects it causes.
Sevo is very similar to des and iso. Doesn’t cause increased HR. Can be used for inhaled induction with peds. Strong bronchodilator. Can breakdown to compound A.
FYI, with modern anesthesia machines, you can’t use any other gas other than nitrous oxide as a second gas effect, because safety mechanisms built into the vaporizers do not allow more than one gas to be turned on at a time. This is to protect against inadvertent double gas administration. Nitrous oxide is not nearly as potent and also does not use a vaporizer therefore can be co-administered with a volatile anesthetic gas.
Seems weird to be talking about administering halothane and have nothing on sevo. Originally, i thought maybe this was made like 30 years ago but it's only 2 years old. Were u taught to use halothane in med school?
Can anyone who reads this help me out. I was given anesthetic gas for both my surgeries in 1971 and 1972. I remember the black mask with the black tubes leading to the mask and back to the anesthesia machine. The odor was pungent and unpleasant and I could hardly take a breath. It smelled like what an auto body shop uses when they clean a auto body part before then priming and spray painting it before mounting it to a vehicle. The odor was like a nail polish remover with a musty smell. I tried to research the archives with each Hospital where my surgeries were and they didn't have them due to it being so long ago. I'd appreciate any feedback from anyone just out of curiosity!!
Most like you were breathing Halothane. Inhaled Inductions are typically reserved for pediatric patients so you were most likely a kid. Halothane is a gas like the others. They all have very strong odors, some worse than others.
If nitrous oxide has a very high solubility that means it reaches the Brain tissue faster where anaesthetic effect take place so why is it having a low potency please help me understand. Thanks for making things clearer .
It has a high MAC(minimum alveolar concentration) and this doesn't necessarily mean it has a high solubility, it only means the minimum concentration required to induce anaesthesia is now 'higher', and would require more of it to induce anaesthesia. The potency has to do with it's lipid solubility, it's ability to readily cross the lipid membranes into tissue.
Nitrous has a low solubility actually. It has a MAC of 103%. So it’s actually slow and not potent. This is why it’s not used alone but rather as a second gas or to decrease primary volatile anesthetic gas concentration.
Hello, does nitrous oxide, given by intubation and in facial area surgeries under general anesthesia, cause an increase in the uterus of female patients? Does it cause bloating and accumulation in the uterus like intestines?
I had gallbladder surgery in 2009 at Columbia Presbyterian Hospital in NYC... I was nervous about the pain... The anesthesiologist assured me I'd feel nothing. I was suspicious, because I'm a natural-born skeptic. I knew they'd eventually be able to knock me out, but my concern was I'd first feel a few minutes of pain.... And it's this worry the doctor assured me was a moot point, as I'd be knocked out very quickly with his gas.... I forget what gas it was.... But.... I took a few deep breaths.... And I distinctly remember saying to him, "See, this isn't working very well......" As I was finishing that sentence... I realized I was wrong, and obviously, the experienced doctor was correct. Surprise, eh! The gas worked exactly as anesthesiologist promised. Within seconds I'd be out cold. I certainly was. But... What gas was it? I know it wasn't N20. That, I can rule out. I asked if they use it. He said, no, Nitrous Oxide wouldn't be nearly strong enough and it's just not used to prep a patient for surgery, e.g. gallbladder surgery. Nitrous is mostly used in, say, Dentistry, or as a first-line agent to merely calm a person, but it's rarely used to knock a person out, or to give sustained pain relief. It just isn't strong enough to do the job. If you had to guess.... Which gas do you think I was given by the anesthesiologist? To put into context my gallbladder surgery scenario... It was Thursday, November 5, 2009. I remember the day. And my surgery was done at Columbia Presbyterian in Manhattan, USA. So.... That can let you know what types of gases were popular and used by the medical field back then, at a place like this hospital..... Additionally, I was a 170lb otherwise perfectly healthy male and I was 32 years old at the time. I mention this in case age, weight, gender and current health, would be a factor in which inhaled gas an anesthesiologist would select. So.... If anyone here has experience with these gases, and general procedures most first-world hospitals would have used in 2009.... and considering the info I gave.... if you had to guess what gas I was given.... What gas would you guess I was administered? (I've always been curious, but not so curious as to call the hospital and find out... I'm sure they don't have time to waste on my simple curiosity, so.... this is the only place I can realistically ask such a question. Anyone?)
@@edwardherrera846 Thanks. I did quick research and found there are two realistic possibilities: Isoflurane, as the first guy mentioned and Seveflurane, as you mention. Although reading Wikipedia... I also see there are many, many similar gases. But yes, it was likely one of these two. Thanks for replying.
Thanks for watching the video guys! Take a look at my other related video on the 2nd gas effect and diffusion hypoxia: ua-cam.com/video/ijulFNSUfvs/v-deo.html
Link for IV? Anesthesia
God bless you. you are a very smart and intelligent person with clear concepts
Hi, thank you so much for this wonderful video. In regards to Isoflurane, some sources say that it does not cause sensitization of the heart and no arrhythmias. Please clarify for us. Thank you.
It can increase HR slightly, especially at higher concentrations. Because of this, cardiac output is typically maintained because stroke volume goes down, but heart rate slightly increases, maintaining, cardiac output. Desflurane has a greater incidence of tachycardia with higher concentrations over isoflurane.
Great lecture... learned alot!
Nice teaching 👍 impressed
I wish I can explain like this
No information on Sevoflurane? Halothane is rarely used anymore in the US, mostly in other countries and Methoxyflurane is used even less. Banned in most places due to the nephrotoxicity affects it causes.
Sevo is very similar to des and iso. Doesn’t cause increased HR. Can be used for inhaled induction with peds. Strong bronchodilator. Can breakdown to compound A.
Hey thank you man it was so effective
shiwa Hashimi very glad to hear this!
FYI, with modern anesthesia machines, you can’t use any other gas other than nitrous oxide as a second gas effect, because safety mechanisms built into the vaporizers do not allow more than one gas to be turned on at a time. This is to protect against inadvertent double gas administration. Nitrous oxide is not nearly as potent and also does not use a vaporizer therefore can be co-administered with a volatile anesthetic gas.
great video man, hope to see that iv anesthetic video!!
Super simple to understand 👍🏼
will you be doing any videos on cardiac pathology?
Yes I’m thinking of one on aortic coarctation and maybe some others!
Nice, thanks!
Seems weird to be talking about administering halothane and have nothing on sevo. Originally, i thought maybe this was made like 30 years ago but it's only 2 years old. Were u taught to use halothane in med school?
Can anyone who reads this help me out. I was given anesthetic gas for both my surgeries in 1971 and 1972. I remember the black mask with the black tubes leading to the mask and back to the anesthesia machine. The odor was pungent and unpleasant and I could hardly take a breath. It smelled like what an auto body shop uses when they clean a auto body part before then priming and spray painting it before mounting it to a vehicle. The odor was like a nail polish remover with a musty smell. I tried to research the archives with each Hospital where my surgeries were and they didn't have them due to it being so long ago. I'd appreciate any feedback from anyone just out of curiosity!!
Most like you were breathing Halothane. Inhaled Inductions are typically reserved for pediatric patients so you were most likely a kid. Halothane is a gas like the others. They all have very strong odors, some worse than others.
What is MOA on Inhaled Anesthetics?
If nitrous oxide has a very high solubility that means it reaches the Brain tissue faster where anaesthetic effect take place so why is it having a low potency please help me understand. Thanks for making things clearer .
It have heigh MAC
It has a high MAC(minimum alveolar concentration) and this doesn't necessarily mean it has a high solubility, it only means the minimum concentration required to induce anaesthesia is now 'higher', and would require more of it to induce anaesthesia.
The potency has to do with it's lipid solubility, it's ability to readily cross the lipid membranes into tissue.
Nitrous has a low solubility actually. It has a MAC of 103%. So it’s actually slow and not potent. This is why it’s not used alone but rather as a second gas or to decrease primary volatile anesthetic gas concentration.
Where is diethyl ether?
Nice
What are the risk factors for blindness caused by nitrous oxide?
If there is a penetrating eye injury then nitrous can accumulate. Some avoid with bad glaucoma since pressures are already very high.
thanks sir🙏🙏
Hello, does nitrous oxide, given by intubation and in facial area surgeries under general anesthesia, cause an increase in the uterus of female patients? Does it cause bloating and accumulation in the uterus like intestines?
NO
So Sir which inhalational agent will be best for cardiac patient?
www.ncbi.nlm.nih.gov/pmc/articles/PMC4682541/
Sevo is most common for hearts. Heart rate stability. Less cardiac “steal” possibility. Bronchodilation.
thanks ♥♥
What about chloroform?
I am a operation theatre technician in India, but there is not a good salary
I wanted to know how inhaled gases work .,!!!
Check out my video on the 2nd gas effect and diffusion hypoxia to see the way inhaled anesthetics reach the brain to elicit their effects.
We don’t use halothane these days...
I had gallbladder surgery in 2009 at Columbia Presbyterian Hospital in NYC... I was nervous about the pain... The anesthesiologist assured me I'd feel nothing. I was suspicious, because I'm a natural-born skeptic. I knew they'd eventually be able to knock me out, but my concern was I'd first feel a few minutes of pain.... And it's this worry the doctor assured me was a moot point, as I'd be knocked out very quickly with his gas....
I forget what gas it was.... But.... I took a few deep breaths.... And I distinctly remember saying to him, "See, this isn't working very well......" As I was finishing that sentence... I realized I was wrong, and obviously, the experienced doctor was correct. Surprise, eh! The gas worked exactly as anesthesiologist promised. Within seconds I'd be out cold. I certainly was.
But... What gas was it?
I know it wasn't N20. That, I can rule out. I asked if they use it. He said, no, Nitrous Oxide wouldn't be nearly strong enough and it's just not used to prep a patient for surgery, e.g. gallbladder surgery. Nitrous is mostly used in, say, Dentistry, or as a first-line agent to merely calm a person, but it's rarely used to knock a person out, or to give sustained pain relief. It just isn't strong enough to do the job.
If you had to guess.... Which gas do you think I was given by the anesthesiologist?
To put into context my gallbladder surgery scenario... It was Thursday, November 5, 2009. I remember the day. And my surgery was done at Columbia Presbyterian in Manhattan, USA. So.... That can let you know what types of gases were popular and used by the medical field back then, at a place like this hospital..... Additionally, I was a 170lb otherwise perfectly healthy male and I was 32 years old at the time. I mention this in case age, weight, gender and current health, would be a factor in which inhaled gas an anesthesiologist would select.
So.... If anyone here has experience with these gases, and general procedures most first-world hospitals would have used in 2009.... and considering the info I gave.... if you had to guess what gas I was given....
What gas would you guess I was administered?
(I've always been curious, but not so curious as to call the hospital and find out... I'm sure they don't have time to waste on my simple curiosity, so.... this is the only place I can realistically ask such a question. Anyone?)
Isoflurane
Sevoflurane given by the CRNA.
@@edwardherrera846 Thanks. I did quick research and found there are two realistic possibilities: Isoflurane, as the first guy mentioned and Seveflurane, as you mention.
Although reading Wikipedia... I also see there are many, many similar gases. But yes, it was likely one of these two.
Thanks for replying.
07:21 desflurane
this is confusing
Holly Lamovsky let me know if there’s anything I can do to clear it up! Best of luck!
what
@@HollyLamovsky they mean what can they do to help you feel less confused