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ANESTHESIA STUDENT

Anesthesia notes, Anesthesia pharmacology, Clinical Anesthesia , Physiology in Anesthesia, Comorbidity disease in Anesthesia, Anesthesia complications, Regional Anesthesia, Paediatric Anesthesia, Anesthesia machine, Physics in Anesthesia, Anesthetic considerations

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Paediatric blood pressure

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By Anaesthesia student - February 07, 2023

Lower limit of paediatric systolic blood pressure according to age: 0 - 1 month: > 60 mmHg 1 month - 1 yr: > 70 mmHg 1 yr - 10 yr: > 70 + (2 x age in yrs) > 10 yrs: > 90 mmHg

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Paediatric blood pressure

By Anaesthesia student - February 07, 2023

Lower limit of paediatric systolic blood pressure according to age: 0 - 1 month: > 60 mmHg 1 month - 1 yr: > 70 mmHg 1 yr - 10 yr: > 70 + (2 x age in yrs) > 10 yrs: > 90 mmHg

Basic physiology of Neuromuscular junction

By Salahuddin - July 09, 2022

Macro-anatomy of neuron ⍺ Motor neuron is surrounded by myelin sheath which is formed by the Swann cell. Speed of conduction in ⍺ neuron is faster (50 - 100 m/s) due to myelin insulation and node of Ranvier. In the node of Ranvier, there is a high concentration of voltage-gated sodium channel causing depolarisation and saltatory movement to the next node. The neuromuscular junction commences at the nonmyelinated nerve ending. Extraocular, laryngeal and some facial muscles are innervated by slow conducting Ɣ neuron with multiple innervations. Motor endplate The axon terminal surrounded by Schwann cell cytoplasm contains mitochondria and vesicles. The synaptic vesicles are synthesised in the anterior horn cell of the spinal cord and transported to the motor nerve terminal via the micro-tubular system. The synaptic gap is 50 nm wide and contains a basement lamina of 20 nm consisting of mucopolysaccharides. Ach receptors are arranged in discrete groups on the sho

Clinical effects of Sevoflurane

By Salahuddin - January 05, 2023

Due to the preferable pharmacodynamics, Sevoflurane is the most favoured drug for the induction and maintenance of anaesthesia. Its low blood-gas partition coefficient helps to rapid alteration of the level of anaesthesia. CVS effects: → Mild ↓ cardiac contractility (dose-dependent, equal to isoflurane) → Mild ↓ SVR (dose-dependent, equal to Halothane) → Mild ↓ BP (dose-dependent, most least compared to others) → Minimal effect on HR → May cause prolongation of the QT interval → Not associated with coronary steal → Doesn't sensitize the myocardium → No effect on splanchnic blood flow Respiratory effects: → Non-irritant → Dose-dependent Tidal volume depression (less than Isoflurane, equal to Halothane) → ↑ RR (equal to Isoflurane, more than Halothane) → ↓ MV causing ↑ PaCO2 → Depression of hypoxic and hypercapnic ventilatory drive → Inhibition of hypoxic pulmonary vasoconstriction → Bronchial smooth muscle relaxation and reversal of bronchospasm CNS effects: → Effect on

Blood Gas Partition Coefficient

By Salahuddin - January 05, 2023

It is the ratio of the amount of anaesthetic agents present in the blood compared to gas when two phases are of equal volume and pressure and in equilibrium at 37 degrees Celsius. ⇒ Also called as Ostwald coefficient of blood gas. ⇒ It expresses the solubility of the agent in blood. ⇒ The higher the blood/gas partition coefficient, the more the agent is soluble. It will take longer to raise the agent's partial pressure in the blood. Anaesthesia is related to the partial pressure of the anaesthetic agent at the effect site. ↑ B/G partition coefficient: ↑ Duration Onset time of anaesthesia ↑ Duration of Offset time of anaesthesia ↓ B/G partition coefficient: ↓ Duration of Onset time ↓ Duration of Offset time The blood gas partition coefficient of the volatile agents: Halothane: 2.4 Isoflurane: 1.4 Sevoflurane: 0.6 Desflurane: 0.4 Halothane is present in the blood 2.4 times more than that present in the alveoli. The concentration of anaesthetic agents in the blood com

Liver or Hepatic Anatomy and Physiology for anesthesiology

By Salahuddin - May 26, 2022

The anesthesiologist's most critical aspect of liver anatomy is its blood supply. The liver derives its blood supply from the hepatic artery and portal vein. These two blood vessels receive about 20%–25% (≈1500 mL/min) of cardiac output. The hepatic artery provides approximately 25% of the blood flow to the liver, with the portal vein providing the remaining 75%. The portal vein receives blood specifically from the stomach , intestines , pancreas, and spleen and carries it into the liver through the porta hepatis. While there may be some variations between individuals, the hepatic portal vein is usually formed by the convergence of the superior mesenteric vein and the splenic vein , referred to as the splenic-mesenteric confluence. The hepatic artery arises from the common hepatic artery, a branch of the celiac artery. It runs alongside the portal vein and the common bile duct to form the portal triad. Owing to the difference in oxygen content of portal venous blood compared

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