Inhalational Agents

Objectives:

  • Define Minimum Alveolar Concentration and Oil:Gas Partition Coefficient and how these relate to potency
  • Define Blood:Gas Partition Coefficient and how it relates to speed of onset/offset
  • Recall the MAC and pertinent pharmacokinetic and pharmacological properties of IsofluraneSevoflurane and Desflurane
  • Understand the principles of the Second Gas EffectConcentration Effect and Diffusion Hypoxia in the context of Nitrous Oxide
  • Compare and contrast the properties of these volatile agents and their clinical uses in anaesthetic practice
  • Use this knowledge and understanding to select an appropriate inhalational anaesthetic for use at induction and for maintenance anaesthesia in various clinical scenarios

Isoflurane

Sevoflurane

Desflurane

4
Created on By Anaestheasier

Volatile Anaesthetics

1 / 16

Which of these agents is not a vapour at 37oC?

2 / 16

Which of the following is not an effect of Sevoflurane?

3 / 16

A 56-year old male with a background of hypertension and NIDDM is undergoing a tympanoplasty, expected to last around 6 hours. He has a BMI of 40. Due to the duration of the anaesthetic and his obesity, your consultant opts to maintain anaesthesia with Desflurane. Which of the following properties of Desflurane confers its fast offset?

4 / 16

Which of the following agents is most irritant to the respiratory tract?

5 / 16

You are anaesthetising a 4-year-old boy with autism for a dental extraction. He is otherwise well with no past medical history of note and no allergies. Which of the following agents would be most appropriate to use alone for a gas induction?

6 / 16

Minimum Alveolar Concentration is inversely proportional to the Oil:Gas Coefficient (and, therefore, potency) and is defined by…

7 / 16

Which of these volatile agents is the most potent?

8 / 16

Which of the following agents have intrinsic analgesic activity?

9 / 16

You are assisting your consultant on a long and complex anterior resection for bowel cancer. The patient is a 55-year-old female with BMI 45. Your consultant has chosen to use Desflurane to expedite her emergence from anaesthesia at the end of the procedure and reduce the accumulation of the anaesthesic in the adipose tissue. Which which of the following properties of Desflurane confers this specific advantage?

10 / 16

Which of the following agents has been found to form nephrotoxic Compound A in its reaction with soda lime?

11 / 16

You are anaesthetising for a diagnostic laparoscopy of a 31-year-old female ASA1. You are aiming for a MAC of 1 with Sevoflurane as maintenance. What should the end-tidal concentration of Sevoflurane be?

12 / 16

A 23-year-old male ASA1 is anaesthetised for a scrotal exploration. Anaesthesia is maintained with 70% Nitrous Oxide and 30% Oxygen with Sevoflurane at end-tidal concentration of 1.8. At the end of the operation, Sevoflurane is switched off and Nitrous Oxide is also switched off and replaced with air. He then begins to desaturate. Correct ET tube position is confirmed and his ventilation remains unchanged. Which of the following statements is incorrect regarding this phenomenon?

13 / 16

Which statement is true regarding the Blood:Gas partition coefficient?

14 / 16

Which statement is incorrect regarding the Oil:Gas partition coefficient?

15 / 16

The Minimum Alveolar Concentration for Sevoflurane is:

16 / 16

Which of the following statements is incorrect regarding Nitrous Oxide?

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