Adjuncts - Disassociative + Inhalants

Review!

Multiple Choice

What is "wind-up" pain?

• Pain that occurs only in the joints of the hip, shoulder, knee, and elbow.

• Pain that intensifies with repeated stimulation of the nervous system.

• A psychological condition unrelated to nerve stimulation.

Review!

Multiple Choice

Do dissociative anesthetics provide good pain control?

• They are only used for sedation, not pain control

• No, they do not affect pain perception.

• Yes, good for somatic, but limited for visceral.

Open Ended

What are our patient's eyes like on Ketamine?
What do we need to do?

Review!

Open Ended

What is one Adverse effect of dissociative anesthetics?

Review!

Multiple Choice

What is the reversal agent for Ketamine?

• Naloxone

• Flumazenil

• There is no specific reversal agent for Ketamine.

• Atropine is used to counteract Ketamine effects.

Multiple Choice

Why might Ketamine be a poor choice for an animal with a history of seizures?

• It can produce seizure-like activity on recovery.

• Ketamine is a common treatment for seizures.

• It actually helps prevent seizures.

Review?

Multiple Choice

Which of the following is the vaporizer on an anesthetic machine?

Knowledge Check!

Multiple Choice

What does "equilibrium" mean?

• A state in which opposing forces or influences are balanced.

• A form of artistic expression in dance and painting.

• A type of chemical reaction.
• A method of cooking food.

Review

Multiple Choice

Which of those anesthetic gases have a higher vapor pressure?

• Isoflurane - concentration 30% at 20°C

• Methoxyflurane -concentration 4% at 20°C

Multiple Choice

What would happen to a person if the contents of a bottle of isoflurane were spilled in an enclosed room?

• The person would experience a mild headache and fatigue, as well as sneezing/coughing.

• The person would feel energized and alert with an increased appetite and improved mood.

• The person could experience respiratory depression, loss of consciousness, and potentially fatal outcomes.

Blood/Gas Partition Coefficient - Page 88

• Defines the solubility of a gas in blood and the rate of induction and recovery.

• It compares the amount of drug in 1 mL of blood to the amount of drug in 1 mL of alveolar gas.

• The lower the blood solubility the more rapid induction and recovery.

🧪 Understanding the Blood-Gas Partition Coefficient: A Sponge vs. Balloon Analogy

Imagine you’re filling two containers with water:

• One is a sponge.

• The other is a balloon.
  

When you pour water into the sponge, it absorbs a lot and holds onto it. It takes time to saturate and even longer to dry out.

When you pour water into the balloon, it fills quickly and releases water easily when squeezed.

🧪 Understanding the Blood-Gas Partition Coefficient: A Sponge vs. Balloon Analogy

Now, think of the sponge as an anesthetic with a high blood-gas partition coefficient — like methoxyflurane. It dissolves well in blood, so it takes longer to build up enough in the brain to cause anesthesia, and longer to leave the body during recovery.

The balloon represents a low blood-gas partition coefficient — like sevoflurane. It doesn’t dissolve much in blood, so it quickly moves from the lungs to the brain and back again, leading to fast induction and recovery.

Key Takeaways:

• High coefficient (sponge) = slow in, slow out (longer onset and recovery). The higher the number, the slower the recovery

• Low coefficient (balloon) = fast in, fast out (quick anesthesia and recovery). The lower the number, the faster the recovery

• It’s all about how much the anesthetic “likes” to stay in the blood vs. moving into the lungs or brain.

Review

Multiple Choice

Looking at the blood/gas partition coefficient of the following inhalant drugs, which would have a more rapid induction and recovery?

• Isoflurane

  Blood/Gas Partition Coefficient: 1.4

• Halothane

  Blood/Gas Partition Coefficient: 2.4

• Desflurane

  Blood/Gas Partition Coefficient: 0.42

• Sevoflurane

  Blood/Gas Partition Coefficient: 0.65

​

Review

Multiple Choice

How would we define "Minimum Alveolar Concentration" ?

• Highest concentration of an anesthetic where 50% of patients respond to a painful stimulus.

• Lowest concentration of an anesthetic where 50% of patients show no response to a painful stimulus.

Review

Multiple Choice

Which tissues in the body get the most blood supply?

• Pancreas, spleen, and lungs
• Skin, muscles, and bones
• Heart, kidneys, liver, and brain
• Stomach, intestines, and gallbladder

Review

Multiple Choice

What effect would increasing the percentage of Isoflurane delivered have on our patient's blood pressue?

• No effect on the patient's blood pressure.

• Decrease the patient's blood pressure.

• Increase the patient's blood pressure.

• Stabilize the patient's blood pressure.

Review

Categorize

Options (18)

Safe for epileptic patients

Not tested on animals

High in sugar content

Can cause hypothermia

Requires significant metabolism in the liver

Can cause hypotension

Dangerous increase in intracradian pressure in head trauma patients

Recommended for head trauma patients

Can be given IV

Requires precision vaporizer

High blood/gas partition coefficient (2.47)

Most patients can be maintained at 1.5-2.5%

Fewest adverse cardiac effects of available inhalants

Not recommended for neonates or geriatric patients

No analgesic effect

Low blood/gas partition coefficient (1.46)

Evaporates quickly at room temperature

Remains a liquid at room temperature

Categorize the following as True or False for Isoflurane

True

False

Review

Categorize

Options (11)

Fewest adverse cardiac effects of available inhalants

More likely to see arrhythmias

Malignant hyperthermia

Replaced by Isoflurane

Expensive!

Lowest blood/gas coefficient - extremely fast induction and recovery.

Pungent! Not good for masking.

2nd most common inhalant after isoflurane.

What we use here at Oulton College

Good muscle relaxation

Metabolized by liver and kidneys, more storage in fat

Categorize the facts according to the veterinary inhalants listed below.
Not all categories will have equal number of points!

Isoflurane

Halothane

Sevoflurane

Desflurane