Depth of inhalation anesthesia can be regulated by adjusting the vaporizer to maintain patient's end-tidal % at 1.2-1.5 xMAC. End-expiration (end-tidal) concentration approximates alveolar and brain concentrations. Typically the inspired concentration is about 0.2% higher than the expired concentration. The inspired concentration may be the same as the concentration leaving the vaporizer or it may be less, especially in a circle circuit with low oxygen flow and a large dog. I shall use this information in case discussions to more accurately explain patient assessment and treatment.Īn anesthetic gas analyzer measures inspired and expired anesthetic gas concentrations by aspirating gas from a T-port interposed between the endotracheal tube and the delivery circuit. The monitor is able to fairly accurately determine the concentration of inhalation agent in the patient thus providing information on depth of anesthesia. This monitor is expensive and at present is only available for use in large practices or universities. Measurement of alveolar anesthetic gas concentration using an anesthetic gas analyzer. With the addition of Domitor, or as the blood levels of ketamine decrease, the eyeball will rotate. Ketamine maintains muscle tone, thus the eyeball is usually centrally placed in the orbit. If the eyeball is rotated and you can see white of the eye, then severe CNS depression is not present. Most surgical procedures can be performed when the eyeball is rotated in the orbit. In deep anesthesia all the muscles become relaxed and the eyeball returns to the central position. As anesthetic depth increases, the muscles surrounding the eyeball relax at different rates and the eye rotates exposing the sclera or white of the eye. In light anesthesia the eyeball is centrally placed in the orbit. Common recommendations are to monitor several systems and to monitor several parameters of each system and make frequent comparisons of serial recordings.Įyeball movements can be a useful guide to depth of anesthesia with thiopental, propofol, and/or inhalation anesthesia. Monitoring the patient adequately is the basis of safe clinical anesthesia. To emphasis the importance of monitoring from induction to the recovery period.To indicate appropriate treatment for different abnormalities. To discuss examples of anesthetized patients to illustrate evaluation of cardiopulmonary status.To describe the data obtained, normal values, and significance of values outside normal range.To describe the function of commonly available monitors.
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