Inhalational GA

Inhalational agents are critical for the maintenance of general anaesthesia. Potency is measured by Minimum Alveolar Concentration (MAC), defined as the concentration that prevents movement in 50% of patients in response to painful stimuli.


Clinical Profiles of Common Agents

Agent Key Clinical Profile
N2O Low potency; possesses analgesic properties; carries risks of diffusion hypoxia and expansion of air-filled spaces.
Halothane Associated with “Halothane hepatitis” and cardiac sensitization to catecholamines.
Enflurane Associated with seizure-like EEG changes; now largely obsolete.
Isoflurane Stable with a pungent odor; causes coronary vasodilation, posing a “coronary steal” risk.
Desflurane Rapid onset/offset due to low solubility; pungent (causes airway irritation); associated with sympathetic surge.
Sevoflurane Fast-acting and non-irritating; excellent for pediatric inhalational induction.


High-Yield Clinical Pearls

  • Malignant Hyperthermia (MH): All halogenated volatile agents are potential triggers for MH, a hypermetabolic state managed with dantrolene.
  • Blood-Gas Solubility: Agents with lower solubility, such as Desflurane and Sevoflurane, result in a faster wash-in and wash-out.
  • Nitrous Oxide (N2O) Contraindications: It is contraindicated in patients with bowel obstruction, pneumothorax, or middle ear surgery because it diffuses rapidly into air-filled spaces.

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