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Monday, December 15, 2008

Sevoflurane is not pungent and does not irritates respiratory tract

Question 22
Which of the following statement is wrong
a.       Sevoflurane has rapid onset and recovery
b.      Sevoflurane is pungent and irritates respiratory tract
c.       Desflurane has lower Blood Gas Partition Co Efficient than Sevoflurane
d.      Sevoflurane has lower MAC than Desflurane
Answer
b)      Sevoflurane is pungent and irritates respiratory tract
Reference
Katsung Page 403
QTDF :
Anaesthesia Books / Katsung
Quality
Thinker
Discussion
Anaesthetic
Blood : Gas Partition Co-efficient
Brain : Blood Partition Co-efficient
Minimal Alveolar Conc
(MAC) (%)2
Remarks
Nitrous Oxide
0.47
1.1
> 100
Incomplete Anaesthetic. Rapid Onset and Recovery
Desflurane
0.42
1.3
6-7
Low Volatality. Poor Induction Agent. Rapid Recovery
Sevoflurane
0.69
1.7
2.0
Rapid Onset and Recovery. Unstable in Soda Lime
Isoflurane
1.40
2.6
1.4
Medium Rate of Onset and Recovery
Enflurane
1.80
1.4
1.7
Medium Rate of Onset and Recovery
Halothane
2.30
2.9
0.75
Medium Rate of Onset and Recovery
Methoxyflurane
12
2.0
0.16
Slow Onset and recovery
Explanation
a.       Sevoflurane (2,2,2-trifluoro-1-[trifluoromethyl]ethyl fluoromethyl ether), also called fluoromethyl hexafluoroisopropyl ether, has rapid onset and recovery
b.      Sevoflurane is a sweet-smelling, non-flammable, highly fluorinated methyl isopropyl ether which does not irriate the respiratory tract
c.       Desflurane has lower Blood Gas Partition Co Efficient (0.42) than Sevoflurane (0.67)
d.      Sevoflurane has lower MAC(2) than Desflurane(6-7)
Comments
Gas
Cylinder Colour
Pin Index
Pressure at 15oC
In Other Countires
In USA
Lbf/in2
Bar
Oxygen(O2)
Black body with white shoulder
Green
2-5
1987
137
Nitrous Oxide (N2O)               
French Blue
Blue
3-5
638
44
Cyclopropane               
Orange
Orange
3-6
73
5
Carbon Di Oxide(CO2)
Grey
Grey
1-6
725
50
Halothane bottle
Amber
Ethylene bottle
Red
Helium (He)
Brown
Brown
1987
137
Entonoc     
Blue body with white shoulder
Blue / Green
7
1987
137
Air
Grey body with B & White shoulder
Yellow
1-5
1987
137
O2/Helium
Black
Green / Brown
4-6,2-4
1987
137
O2/CO2
Black
Green / Grey
2-6,1-6
1987
137
Nitrogen
1-4
Tips
Few agents are in bottles rather than in cylinders
Gases
Bottle Colour
Halothane
Amber
Ethylene
Red
Sometimes the supply is through pipes and we have a few details here also
Gas
Hose Colour
Socket Colour
Pressure
Oxygen(O2)
White
White
4 Bar
Nitrous Oxide (N2O)               
Blue
Blue
4 Bar
Air
Black
Black
7 Bar
Suction
Yellow
Yellow
The boiling points of the Anaesthetic agents also are worth remembering
Gas
Boiling Point
Ethylene Chloride
12.5 oC
Desflurane
23 oC
Ether
34.6 oC
Isoflurane
45.5 oC
Halothane
50 oC
Enflurane
56.5 oC
Sevoflurane
58.5 oC
Tricholoroethylene
86 oC
Nitrous Oxide
89 oC
Methoxyflurane
104 oC

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