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INHALANT ANAESTHETICS
USED IN VETERINARY PRACTICE
ASHISH KUMAR
BVN20008
DEFINITION
 The Inhalant Anaesthetics are gas or volatile liquids that produce
general anaesthesia when inhaled.
 These are absorbed from alveoli to blood stream and blood is
carried to the brain.
 Primarily eliminated through LUNGS.
Example:- Nitrous Oxide, Cyclopropane, Isoflurane
CLASSIFICATION
 Gaseous agents
Nitrous Oxide, Cyclopropane, Carbon Dioxide
 Volatile liquids
Ethyl ether, Methoxyflurane, Isoflurane, Sevoflurane
PROPERTIES OF IDEAL
ANAESTHETIC
 Non irritant
 Non inflammable
 Non explosive
 Minimal metabolism in the body
 Low blood gas solubility
 Adequate muscle relaxant action
 Rapid induction and recovery
INHALANT ANAESTHETIC
MACHINE
Ventilator
consistent supply of oxygen and anesthetic gases
Flow meter
measure and regulates the flow rate of gases
Soda lime
absorb and neutralize exhaled CO2
APL valve
allow excess gas to escape
Vaporizer
convert liquid anaesthetic in to gas and mixes it with
O2
MINIMAL ALVEOLAR
CONCENTRATION ( MAC )
 The alveolar concentration of anaesthetic that is needed to prevent
movement in 50% of subjects in response to surgical stimulus
 It is the measure of potency of inhalation anaesthetics
 The anaesthetic potency of inhaled anaesthetic is inversely related to
MAC
 Potency =1/MAC i.e. an agent having low anaesthetic potency will have
high MAC value and vice versa
FACTORS AFFECTING MAC
 Hypothermia
 Hyponatremia
 Hypotension
 Pregnancy
 Geriatric age
 Hyperthermia
 Hypernatremia
 CNS stimulating drugs
Decrease MAC
Increase MAC
INHALANT MAC in DOGS MAC in CATS
Nitrous oxide 188% 255%
Cyclopropane 17.5% 19.7%
Isoflurane 1.28% 1.63%
Sevoflurane 2.4% 2.6%
Methoxyflurane 0.24% 0.23%
BLOOD-GAS PARTITION COEFFICIENT
 Also called as OSTWALDS COFFICIENT
 It is the ratio of concentration of compound in one solvent to the
concentration in solvent at equilibrium
 Higher partition coefficient = Higher lipophilicity= higher solubility
 Higher solubility = slower onset
 MAC and blood gas partition coefficient are inversely related
OIL-GAS PARTITION
COEFFICIENT
 A measure of fat solubility, determines the potency of an anesthetic
and also influence the kinetics of its distribution in the body
 High lipid solubility delays recovery from anaesthesia
METHODS OF ADMINISTRATION
There are mainly four methods of administration.
1. Open insufflation
2. Semi open system without Nonrebreathing valves
3. Semi open system with Nonrebreathing valves
4. Semi closed and Closed system
1. Open Insufflation
 The anesthetic gas or vapor, together with air and/or oxygen is delivered to the mouth
or trachea by a mask or catheter
2. Semi-Open System without Non-Rebreathing Valves
Ayers T- tube
 This simple non-rebreathing system has no valve and very little resistance which make
it useful for very small patients. It also has very little dead space.
3. SEMI-OPEN SYSTEM WITH
NONREBREATHING VALVE
Stephen Slater Valve
 Inspired and expired gases are separated by a valve as
close to the animal as possible
 Rebreathing is minimal and the animal breathes only
the anesthetic mixture delivered
4. Semi-Closed and Closed System
 Gases are partly exhaled to the atmosphere and
partly rebreathed. So relatively high fresh gas
flow thus required
NITROUS OXIDE
 Rapid onset and recovery due to its low blood-gas solubility
coefficient
 Minimal cardiovascular depression
 Non-irritating to respiratory tract suitable for paediatric and
small animal cases
 It enchases the uptake of other anaesthetic gases (second gas
effect) leading to quicker induction when used with agent like
isoflurane
 Nitrous oxide must be administrated with oxygen (usually at
least 30% oxygen)
Adverse Effect
 Chronic exposure to nitrous oxide can interfere with
vitamin B12 metabolism, leading to megaloblastic
anemia
 Contraindicated in pneumothorax, bowel obstruction
 Risk of hypoxia when discontinuing
CYCLOPROPANE
 Potent anesthetic effective at low concentration
 Rapid induction and recovery
 Increases heart rate and cardiac output
 Minimal respiratory depression, less impact on respiration
compared to other agents
 For induction 20-30% in oxygen and for maintenance 5-15% in
oxygen
Adverse Effect
 Risk of excitement during induction or recovery
 Explosiveness
 Cardiac arrhythmias
 Can exacerbate ischemia in patients with heart disease
ISOFLURANE
 Minimal cardiac depression, safer for patients with heart
condition
 Low metabolic rate
 Compatible with wide range of species
 Minimal accumulation so suitable for prolonged anaesthesia
 3-5% isoflurane in oxygen for mask induction
Adverse Effect
 Respiratory depression
 Hypotension
 Malignant hyperthermia
 Pungent odor can cause coughing and breath-holding during induction
SEVOFLURANE
 Rapid induction and recovery (low blood-gas
coefficient)
 Non-Irritating: Non pungent, making it suitable for
mask induction, especially in small animal
 For induction in dog and cat 4-6% sevoflurane in
oxygen and for horses 5-7% sevoflurane in oxygen
 Good muscle relaxation without significant additional
agents
Adverse Effect
 Dose-Dependent Hypotension
 Postoperative agitation
 Nephrotoxicity risk
 Malignant hyperthermia
METHOXYFLURANE
 Potent analgesic
 Used as an emergency analgesic
 Vapour is pleasant and of fruity aroma
 Mild cardiovascular effect
Adverse Effect
 Very slow onset and offset
 Nephrotoxicity
 Concurrent use of oxytetracycline and methoxyflurane results in
fatal renal toxicity
DESFLURANE
 Ideal for short procedure due to its low blood-gas partition coefficient
 Effective at low concentration
 Minimal hepatic metabolism, reducing the risk of liver toxicity
 Cardiovascular stability
 Concentration of desflurane maintained between 3-6% for induction
and 1.5-3% for maintenance
Adverse effect
 Respiratory irritation, can cause coughing airway irritation and
increased secretions especially during induction and emergence
 Tachycardia and hypertension
 Environmental impact
REFERENCE
 VETERINARY ANESTHESIA BY WILLIAM V. LUMB, E. WYNN JONES
 VETERINARY ANAESTHESIA 8th
EDITION BY L. W. HALL, K. W. CLARKE
 ESSENTIAL OF VETERINARY PHARMACOLOGY AND THERAPEUTICS 2nd
EDITION BY HARPAL SINGH SANDHU
THANKYOU

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INHALANT_ANAESTHETICS_USED_IN_VETRINARY_PRACTICE.pptx

  • 1. INHALANT ANAESTHETICS USED IN VETERINARY PRACTICE ASHISH KUMAR BVN20008
  • 2. DEFINITION The Inhalant Anaesthetics are gas or volatile liquids that produce general anaesthesia when inhaled. These are absorbed from alveoli to blood stream and blood is carried to the brain. Primarily eliminated through LUNGS. Example:- Nitrous Oxide, Cyclopropane, Isoflurane
  • 3. CLASSIFICATION Gaseous agents Nitrous Oxide, Cyclopropane, Carbon Dioxide Volatile liquids Ethyl ether, Methoxyflurane, Isoflurane, Sevoflurane
  • 4. PROPERTIES OF IDEAL ANAESTHETIC Non irritant Non inflammable Non explosive Minimal metabolism in the body Low blood gas solubility Adequate muscle relaxant action Rapid induction and recovery
  • 5. INHALANT ANAESTHETIC MACHINE Ventilator consistent supply of oxygen and anesthetic gases Flow meter measure and regulates the flow rate of gases Soda lime absorb and neutralize exhaled CO2 APL valve allow excess gas to escape Vaporizer convert liquid anaesthetic in to gas and mixes it with O2
  • 6. MINIMAL ALVEOLAR CONCENTRATION ( MAC ) The alveolar concentration of anaesthetic that is needed to prevent movement in 50% of subjects in response to surgical stimulus It is the measure of potency of inhalation anaesthetics The anaesthetic potency of inhaled anaesthetic is inversely related to MAC Potency =1/MAC i.e. an agent having low anaesthetic potency will have high MAC value and vice versa
  • 7. FACTORS AFFECTING MAC Hypothermia Hyponatremia Hypotension Pregnancy Geriatric age Hyperthermia Hypernatremia CNS stimulating drugs Decrease MAC Increase MAC
  • 8. INHALANT MAC in DOGS MAC in CATS Nitrous oxide 188% 255% Cyclopropane 17.5% 19.7% Isoflurane 1.28% 1.63% Sevoflurane 2.4% 2.6% Methoxyflurane 0.24% 0.23%
  • 9. BLOOD-GAS PARTITION COEFFICIENT Also called as OSTWALDS COFFICIENT It is the ratio of concentration of compound in one solvent to the concentration in solvent at equilibrium Higher partition coefficient = Higher lipophilicity= higher solubility Higher solubility = slower onset MAC and blood gas partition coefficient are inversely related
  • 10. OIL-GAS PARTITION COEFFICIENT A measure of fat solubility, determines the potency of an anesthetic and also influence the kinetics of its distribution in the body High lipid solubility delays recovery from anaesthesia
  • 11. METHODS OF ADMINISTRATION There are mainly four methods of administration. 1. Open insufflation 2. Semi open system without Nonrebreathing valves 3. Semi open system with Nonrebreathing valves 4. Semi closed and Closed system
  • 12. 1. Open Insufflation The anesthetic gas or vapor, together with air and/or oxygen is delivered to the mouth or trachea by a mask or catheter
  • 13. 2. Semi-Open System without Non-Rebreathing Valves Ayers T- tube This simple non-rebreathing system has no valve and very little resistance which make it useful for very small patients. It also has very little dead space.
  • 14. 3. SEMI-OPEN SYSTEM WITH NONREBREATHING VALVE Stephen Slater Valve Inspired and expired gases are separated by a valve as close to the animal as possible Rebreathing is minimal and the animal breathes only the anesthetic mixture delivered
  • 15. 4. Semi-Closed and Closed System Gases are partly exhaled to the atmosphere and partly rebreathed. So relatively high fresh gas flow thus required
  • 16. NITROUS OXIDE Rapid onset and recovery due to its low blood-gas solubility coefficient Minimal cardiovascular depression Non-irritating to respiratory tract suitable for paediatric and small animal cases It enchases the uptake of other anaesthetic gases (second gas effect) leading to quicker induction when used with agent like isoflurane Nitrous oxide must be administrated with oxygen (usually at least 30% oxygen)
  • 17. Adverse Effect Chronic exposure to nitrous oxide can interfere with vitamin B12 metabolism, leading to megaloblastic anemia Contraindicated in pneumothorax, bowel obstruction Risk of hypoxia when discontinuing
  • 18. CYCLOPROPANE Potent anesthetic effective at low concentration Rapid induction and recovery Increases heart rate and cardiac output Minimal respiratory depression, less impact on respiration compared to other agents For induction 20-30% in oxygen and for maintenance 5-15% in oxygen
  • 19. Adverse Effect Risk of excitement during induction or recovery Explosiveness Cardiac arrhythmias Can exacerbate ischemia in patients with heart disease
  • 20. ISOFLURANE Minimal cardiac depression, safer for patients with heart condition Low metabolic rate Compatible with wide range of species Minimal accumulation so suitable for prolonged anaesthesia 3-5% isoflurane in oxygen for mask induction
  • 21. Adverse Effect Respiratory depression Hypotension Malignant hyperthermia Pungent odor can cause coughing and breath-holding during induction
  • 22. SEVOFLURANE Rapid induction and recovery (low blood-gas coefficient) Non-Irritating: Non pungent, making it suitable for mask induction, especially in small animal For induction in dog and cat 4-6% sevoflurane in oxygen and for horses 5-7% sevoflurane in oxygen Good muscle relaxation without significant additional agents
  • 23. Adverse Effect Dose-Dependent Hypotension Postoperative agitation Nephrotoxicity risk Malignant hyperthermia
  • 24. METHOXYFLURANE Potent analgesic Used as an emergency analgesic Vapour is pleasant and of fruity aroma Mild cardiovascular effect
  • 25. Adverse Effect Very slow onset and offset Nephrotoxicity Concurrent use of oxytetracycline and methoxyflurane results in fatal renal toxicity
  • 26. DESFLURANE Ideal for short procedure due to its low blood-gas partition coefficient Effective at low concentration Minimal hepatic metabolism, reducing the risk of liver toxicity Cardiovascular stability Concentration of desflurane maintained between 3-6% for induction and 1.5-3% for maintenance
  • 27. Adverse effect Respiratory irritation, can cause coughing airway irritation and increased secretions especially during induction and emergence Tachycardia and hypertension Environmental impact
  • 28. REFERENCE VETERINARY ANESTHESIA BY WILLIAM V. LUMB, E. WYNN JONES VETERINARY ANAESTHESIA 8th EDITION BY L. W. HALL, K. W. CLARKE ESSENTIAL OF VETERINARY PHARMACOLOGY AND THERAPEUTICS 2nd EDITION BY HARPAL SINGH SANDHU