Anesthetic agents administered through inhalation method. One of oldest anesthesia forms, back to early 19th century.
Inhalation anesthetics used to maintain general anesthesia in surgery. For volatile anesthetics use of vaporizers is recommended due to their liquid nature.
Inhalational anesthetics provide amnesia, immobility, and analgesia effect. It is used in medical procedures/surgeries for pain-free operations.
Inhaled and IV anesthetic are FDA-approved agents for purpose of general anesthesia and sedation in the operation room.
The main uses of inhaled anesthetic agents in ICU are for sedation, bronchospasm, and uncontrolled seizures.
Modern Inhalational Anesthetic agents are:
Halothane
Isoflurane
Sevoflurane
Desflurane
Balanced anesthesia is a combination of anesthetic agents and techniques to achieve ideal sedation level. While combining various agents will give synergistic anesthesia effect.
Development in inhalational and balanced anesthesia will improve safety, efficacy, and patient outcomes.
for Inhalational Anesthesia:
Anesthesia Machine
Breathing Circuit
Endotracheal Tubes or Laryngeal Mask Airway
for Balanced Anesthesia:
Anesthesia Machine
Neuromuscular monitoring device
Breathing Circuit
Detailed assessment of patient’s medical history, any current medications, and allergies should be conducted.

Inhalational anesthesia

Anesthesia mask
For Inhalational Anesthesia:
Step 1: Induction:
Administer with volatile anesthetic agent which is delivered through face anesthesia mask.
Step 2: Maintenance:
Surgeons should adjust the concentration of the inhalational agent to maintain the desired depth of anesthesia.
For Balanced Anesthesia
Step 1: Induction:
Administer with intravenous anesthetic agent to induce rapid onset. It should be followed with muscle relaxants if required.
Step 2: Maintenance:
Surgeons should maintain anesthesia with a combination of inhalational and intravenous agents based on the surgery and patient condition.
Respiratory Complications
Cardiovascular Complications
Malignant Hyperthermia
Neuromuscular complications
Liver Toxicity
Postoperative nausea and vomiting these are commonly noticed adverse effects in inhaled anesthetics.
Malignant hyperthermia is a severe adverse reaction of halothane gas.
Desflurane and isoflurane may irritate the airways of severe asthmatic patients due to pungent odour.
Nitrous oxide should be avoided in craniotomy and intraocular surgeries.

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