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Anaesthesia
Inducing an unconscious state where the patient is :
-Unaware
-Pain-free
-Immobile
-Memory-free
Anaesthesia
Induce it Vascular system
(Syringe )
Maintain it Pulmonary system
(Anesthesia machine )
+
Anaesthesia )for adults(
= +
Anesthesia Ventilator Vaporizer
Anesthesia oversimplification
Vaporizers
Flow controller
Pressure gages
O2 flush
Drawers
Flow meters
Vent. monitor
Ventilator
CO2 removal
AGSS
Anaesthesia / Main parts
Main parts
Ventilator
During anesthesia muscles relax)including lung diaphragm(
Lung diaphragm: the muscle who establish positive and negative pressures in order to inhale and exhale air.
Why ventilator?
Ventilator job: to push gas )containing O2, N2O…etc( into the lungs.
OVER simplification!
We can control: volume of gas, speed, frequency, pattern, pressure inside the lung …etc.
Why ventilator?
Manual or via ventilator
Ventilation during anaesthesia
Ventilator
1 -Gas driven
2- Electrically driven, electronically controlled
b( Electronically controlled
a( Pneumatically controlled
Ventilator types:
Ventilation via Ventilator
Piston motor
ValveValve
Bellow
Electrical ventilator
Piston motor
ValveValve
Bellow
Piston down )gas in(
Electrical ventilator principle
Piston motor
ValveValve
Bellow
Piston up )gas out(
Electrical ventilator principle
Electrical ventilator / real look
Used sometimes at the end of anesthesia or incase of ventilator failure
Drawing for illustration )valves within ventilation part(
valvevalve
Elastic bag )rubber, silicon…etc(
Ventilation via bag )manual(
valvevalve
Elastic bag )rubber, silicon…etc(
Fresh gas from machine
Ventilation via bag )manual(
valvevalve
Fresh gas to patient
Force by hand
Elastic bag )rubber, silicon…etc(
Ventilation via bag )manual(
Main parts
Vaporizer
Vaporizer job: to load the gas with anesthetic agent.
OVER simplification!
We can control: type and dose of anesthetic agent.
Vaporizer oversimplification
Halothane, Enflurane, Isoflurane, Sevoflurane & Desflurane
Each one has its own properties.
Example:Sevoflurane and halothane : easy to inhale Desflurane : very irritating to inhale , shorter duration of action.
Halothane decrease the heart rate and blood pressure Desflurane increase the heart rate and blood pressure
Vaporizer types
Anesthetic agent Lungs Brain Blood
Lungs Brain Blood
During Anesthesia:
After Anesthesia:
((Most important feature ))Reversible effect
Feature of anesthetic gases
Summery: fresh gas will flow through the anesthetic agent chamber and enriched with anesthetic agent vapors
IN OUT
Vaporizer internal construction
Main parts
Flow controllers
Anesthetic gas
O2 N2O Anesthetic agent Medical Air
Relaxes the musclesProduces an
unconscious state To lower N2Oconcentration
O2 concentration must not be lower than 21% of the total inhaled gas )this is achieved by Anti-hypoxic device(
Anesthetic gas content
N2OO2
The device that prevent delivery of O2 lower than 21-25% of fresh gas
Anti-hypoxic device / principle
Main parts
Flow meters
Glass tubes
Function :control the amount
of gas )Oxygen, Nitrous & Air( in the
fresh gas )L/min(
Flow meters
Main parts
AGSS(In the back)
Exhaled gas does contain anesthetic agent.
Doctors and nurses surrounding the patient will be subjected to anesthetic gases as well.
How to prevent this?Suck the exhaled gas outside the operating room.
Inhalation Exhalation
Anesthetic Gas Scavenging System
AGSS wall outlet AGSS Hospital pipeline system
Discharge at the hospital roof
AGSS topology
CO2 removal
CO2 removal
Anesthetic gases:
1( Expensive
2( Unwelcome to the surrounding area
Solution: Return exhalation back to patient!
Inhalation Exhalation
The exhaled gas will be returned back to patient after being passed through ‘Soda lime’ for CO2 removal
Open / Closed / Semi-Closed systems
CO2
Anesthetic agent O2 + N2O
Soda lime
+
Soda lime
The main components of soda lime are
- Calcium hydroxide, Ca)OH(2 )about 75%(
- Water, H2O )about 20%(
- Sodium hydroxide, NaOH )about 3%(
- Potassium hydroxide, KOH )about 1%(
Chemical reaction:
CO2 + H2O → H2CO3
H2CO3 + 2NaOH → Na2CO3 + 2H2O + Heat
Na2CO3 + Ca)OH(2 → CaCO3 + 2NaOH
Ca)OH(2 )heat( → CaO + H2O
Soda lime principle
Systems:
1( Open: no gas is returned to patient
2( Closed: no gas is released from patient
3( Semi-Closed: part of the gas will be released from patient.
Inhalation Exhalation
Open / Closed / Semi-Closed systems
ECG Cardiac system function
NIBP / IBP Vascular system function SpO2 O2 concentration etCO2 CO2 concentration
Agents Anesthetic agent concentration
BIS level of consciousness
Monitored parameters during anesthesia
Provides a direct measure of the effects of anesthetics and sedatives on the brain
EEG signal processing numerical number to show the level of sedation
Safer anesthesia / BIS® monitoring
Anaesthesia / Fabius plus
Anaesthesia / Fabius plus
One of latest equipment data sheet overviewAnaesthesia / Fabius plus
Anaesthesia / Fabius plus
Anaesthesia
Thank you!