SlideShare a Scribd company logo
1 of 72
EFFECTS OF ANESTHETICS ON CEREBRAL BLOOD FLOW & CMRO2 PRESENTER Dr Unnikrishnan P  COORDINATOR Dr Linnette Morris MODERATORS Dr Ushakumari Dr Chitra
Why this session…? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Keep the terms close to your heart…. ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
CBV-CBF ,[object Object],[object Object],[object Object]
CBV AND AUTOREGULATION ,[object Object],[object Object],[object Object],[object Object]
Epileptogenesis -concerns ,[object Object],[object Object]
INTRAVENOUS ANESTHETICS ,[object Object]
I V ANESTHETICS  ,[object Object],[object Object],[object Object],[object Object],[object Object]
BARBITURATES ,[object Object],[object Object],[object Object],[object Object]
Barbiturates…. ,[object Object],[object Object],[object Object],[object Object],[object Object],Suppression of CMR Free radical scavenging CBF redistribution effects Decrease ATP consumption
Barbiturates …. ,[object Object],[object Object],[object Object]
ABOUT METHOHEXITAL ,[object Object],[object Object],[object Object]
PROPOFOL ,[object Object],[object Object],[object Object],[object Object],[object Object]
Propofol and seizure incidence  ,[object Object],[object Object],[object Object],[object Object],[object Object]
Propofol & brain protection
Etomidate  ,[object Object],[object Object],[object Object],[object Object]
ETOMIDATE continued ,[object Object],[object Object],[object Object],[object Object]
NARCOTICS ,[object Object],[object Object],[object Object],[object Object]
MORPHINE ,[object Object],[object Object],[object Object]
FENTANYL & ALFENTANYL ,[object Object],[object Object],[object Object],[object Object],[object Object]
Fentanyl  ,[object Object],[object Object],[object Object],[object Object]
SUFENTANYL  ,[object Object],[object Object],[object Object],[object Object]
REMIFENTANYL ,[object Object],[object Object]
Benzodiazepines  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
FLUMAZENIL # true or false # ,[object Object],[object Object],[object Object],[object Object]
DROPERIDOL ,[object Object],[object Object],[object Object]
KETAMINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
LIDOCAINE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
INHALED ANAESTHETICS
VOLATILE AGENTS….
EFFECTS @ DIFFERENT MACs
Beyond 1 MAC what happens? ,[object Object],[object Object],[object Object],[object Object],[object Object]
Volatile agents  Also…… ,[object Object],[object Object]
Continued  (general properties) volatile agents ,[object Object],[object Object],[object Object],[object Object]
HALOTHANE ,[object Object],[object Object],[object Object],[object Object]
Halothane….. continued ,[object Object],[object Object],[object Object],[object Object]
ENFLURANE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
ISOFLURANE ,[object Object],[object Object],[object Object],[object Object],[object Object]
Isoflurane  more ,[object Object],[object Object],[object Object]
SEVOFLURANE ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
DESFLURANE ,[object Object],[object Object],[object Object],[object Object]
Summary of volatile agents MAJOR  IMPACT ON CBF/CBV & ICP OCCURS WHEN WE EXCEED 1 MAC BECOMES SIGNIFICANT IF INTRACRANIAL COMPLIANCE IS ABNORMAL HERE, IT IS BETTER TO USE A PREDOMINANTLY INTRAVENOUS TECHNIQUE UNTIL THE POINT OF OPENING OF CRANIUM & DURA  NET VASODILATORY EFFECT OF ISO/DES & SEVO LESS THAN HALO;SO IF ONE IS TO BE USED, PREFER THE FORMER ONES EFFECT OF HYPOCAPNOEA : HALOTHANE  Vs ISO/DES/SEVO ENFLURANE IS EPILEPTOGENIC; SLIGHT RISK WITH SEVOFLURANE CO2 REACTIVITY AND AUTOREGULATION PRESERVED
NITROUS OXIDE ,[object Object],[object Object],[object Object],[object Object],[object Object]
Nitrous oxide… ,[object Object],[object Object],[object Object]
N2O  continued ,[object Object],[object Object]
MUSCLE RELAXANTS
NON DEPOLARIZING RELAXANTS ,[object Object],[object Object],[object Object],[object Object]
Non depolarizing relaxants- histamine release
NDMR continued ,[object Object],[object Object],[object Object],[object Object]
Message…. NDMR use ,[object Object],[object Object],[object Object],[object Object]
SUCCINYL CHOLINE ,[object Object],[object Object],[object Object],[object Object],[object Object],Deep anesthesia Defasciculation with metocurine 0.03 mg/kg “ paralysis with Vecuronium”
Also know ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Textbook of neuroanesthesia & criticalcare/Basil F Matta SURGERY INDUCTION RELAXANT MAINTENANCE SUPRATENTORIAL ICSOL TPS/P’FOL ATRA/VEC/MIVA/ROC P’FOL-FENT /  FENT- LD ISO / N2O- HD ISO VASCULAR Sx TPS/ETO/P’FOL VEC/ATRAC/PAN/? SCOLINE* P’FOL-OPIOID +/- VOL AGENT* ?N2O CAROTID Sx FENT/ETO/TPS/ P’FOL VEC FENT/ISO/N2O POST FOSSA OPIOID/TPS/ P’FOL NDMR VARIES  ?N2O-PC/VAE ?VOL-TRANS PUL,SSEP NSx WITHOUT CRANIOTOMY FENT/TPS/P’FOL NDMR ISO WITH HYPOCAPNOEA Cx SPINE RSI-SCOLINE PED TPS/P’FOL/SEVO SUXA/NDMR N2O+LD ISO/SEV OR P’FOL i/FEN OR AIR+HD VA
. ,[object Object],[object Object]
REFERENCES ,[object Object],[object Object],[object Object],[object Object]
BRAIN PROTECTION ,[object Object]
COMPLETE GLOBAL ISCHEMIA ,[object Object],INDUCTION OF MILD HYPOTHERMIA IN THE RANGE OF 32-32 ^C X 24 HRS  PASSIVE REWARMING OVER 8 HRS CALCIUM CHANNEL BLOCKER NIMODIPINE NORMALIZATION OF pH Rx OF SEIZURES NORMOTENSION
FOCAL [INCOMPLETE] ISCHEMIA ,[object Object]
Thiopentone  ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Propofol  ,[object Object],[object Object],[object Object]
ISOFLURANE/VOLATILE AGENTS ,[object Object],[object Object],[object Object]
ETOMIDATE ,[object Object],[object Object],[object Object],[object Object]
Others  ,[object Object],[object Object],[object Object]
. ,[object Object],[object Object]
REFERENCES ,[object Object],[object Object],[object Object],[object Object]
F ,[object Object]
 
r ,[object Object]
r ,[object Object]
 
 
 

More Related Content

What's hot

Airway local blocks
Airway local blocksAirway local blocks
Airway local blocksNisar Arain
 
Anaesthesia for posterior fossa surgery
Anaesthesia for posterior fossa surgeryAnaesthesia for posterior fossa surgery
Anaesthesia for posterior fossa surgeryDhritiman Chakrabarti
 
Monitoring depth of anaesthesia
Monitoring depth of anaesthesiaMonitoring depth of anaesthesia
Monitoring depth of anaesthesiadr anurag giri
 
Regional anaesthesia in Pediatrics
Regional anaesthesia in Pediatrics Regional anaesthesia in Pediatrics
Regional anaesthesia in Pediatrics KIMS
 
Hypothermia and anaesthesia implication
Hypothermia and anaesthesia implicationHypothermia and anaesthesia implication
Hypothermia and anaesthesia implicationdrriyas03
 
Pulmonary hypertension and its anesthetic management
Pulmonary hypertension and its anesthetic managementPulmonary hypertension and its anesthetic management
Pulmonary hypertension and its anesthetic managementprateek gupta
 
Anesthesia for neurosurgery (zuhura)
Anesthesia for neurosurgery (zuhura)Anesthesia for neurosurgery (zuhura)
Anesthesia for neurosurgery (zuhura)AnaestHSNZ
 
Ischemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementIschemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementkrishna dhakal
 
anaesthesia in chronic kidney disease
anaesthesia in chronic kidney diseaseanaesthesia in chronic kidney disease
anaesthesia in chronic kidney diseasesarmistha panigrahi
 

What's hot (20)

Postoperative vision loss
Postoperative vision lossPostoperative vision loss
Postoperative vision loss
 
Simple TCI
Simple TCISimple TCI
Simple TCI
 
Airway local blocks
Airway local blocksAirway local blocks
Airway local blocks
 
Anaesthesia for posterior fossa surgery
Anaesthesia for posterior fossa surgeryAnaesthesia for posterior fossa surgery
Anaesthesia for posterior fossa surgery
 
Obesity & anaesthesia
Obesity & anaesthesiaObesity & anaesthesia
Obesity & anaesthesia
 
Geriatric anaesthesia
Geriatric anaesthesiaGeriatric anaesthesia
Geriatric anaesthesia
 
Monitoring depth of anaesthesia
Monitoring depth of anaesthesiaMonitoring depth of anaesthesia
Monitoring depth of anaesthesia
 
Neuraxial block
Neuraxial blockNeuraxial block
Neuraxial block
 
Regional anaesthesia in Pediatrics
Regional anaesthesia in Pediatrics Regional anaesthesia in Pediatrics
Regional anaesthesia in Pediatrics
 
Anaesthesia for supratentorail mass
Anaesthesia for supratentorail massAnaesthesia for supratentorail mass
Anaesthesia for supratentorail mass
 
Meningomyelocele and Anesthesia
Meningomyelocele and AnesthesiaMeningomyelocele and Anesthesia
Meningomyelocele and Anesthesia
 
Upper limb blocks
Upper limb blocks Upper limb blocks
Upper limb blocks
 
Oxygen cascade & therapy
Oxygen cascade & therapyOxygen cascade & therapy
Oxygen cascade & therapy
 
Hypothermia and anaesthesia implication
Hypothermia and anaesthesia implicationHypothermia and anaesthesia implication
Hypothermia and anaesthesia implication
 
Pulmonary hypertension and its anesthetic management
Pulmonary hypertension and its anesthetic managementPulmonary hypertension and its anesthetic management
Pulmonary hypertension and its anesthetic management
 
Anesthesia for neurosurgery (zuhura)
Anesthesia for neurosurgery (zuhura)Anesthesia for neurosurgery (zuhura)
Anesthesia for neurosurgery (zuhura)
 
Ischemic heart disease and anesthetic management
Ischemic heart disease and anesthetic managementIschemic heart disease and anesthetic management
Ischemic heart disease and anesthetic management
 
anaesthesia in chronic kidney disease
anaesthesia in chronic kidney diseaseanaesthesia in chronic kidney disease
anaesthesia in chronic kidney disease
 
Neuromuscular monitoring
Neuromuscular monitoringNeuromuscular monitoring
Neuromuscular monitoring
 
Dexmedetomidine
DexmedetomidineDexmedetomidine
Dexmedetomidine
 

Similar to Effects Of Anesthetics On Cerebral Blood Flow

Effects of anesthetics on cerebral blood flow
Effects of anesthetics on cerebral blood flowEffects of anesthetics on cerebral blood flow
Effects of anesthetics on cerebral blood flowZIKRULLAH MALLICK
 
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomy
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomyCupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomy
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomyanugerah5
 
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)AnzilAR
 
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptx
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptxINTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptx
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptxAnoop886693
 
INTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxINTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxsweetlove26
 
oxygen requrement cmr and cerebral circulation
oxygen requrement cmr and cerebral circulationoxygen requrement cmr and cerebral circulation
oxygen requrement cmr and cerebral circulationBRAJENDRA VERMA
 
INTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxINTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxssuser579a28
 
Intravenous induction agents
Intravenous induction agentsIntravenous induction agents
Intravenous induction agentsDeepali Jamgade
 
Sedative hypnotic notes
Sedative hypnotic notes Sedative hypnotic notes
Sedative hypnotic notes DevenderSaini12
 
Antiasthmatic drugs.pptx
Antiasthmatic drugs.pptxAntiasthmatic drugs.pptx
Antiasthmatic drugs.pptxsapnabohra2
 
Pharmacology of drugs used in hyper reactive airway diseases
Pharmacology of drugs used in hyper reactive airway diseasesPharmacology of drugs used in hyper reactive airway diseases
Pharmacology of drugs used in hyper reactive airway diseasesShekhar Verma
 
Anaesthetic considerations for intraoperative neurophysiological monitoring
Anaesthetic considerations for intraoperative neurophysiological monitoringAnaesthetic considerations for intraoperative neurophysiological monitoring
Anaesthetic considerations for intraoperative neurophysiological monitoringSamir Elkafrawy
 
INTRA VENOUS INDUCING AGENTS
INTRA VENOUS INDUCING AGENTS INTRA VENOUS INDUCING AGENTS
INTRA VENOUS INDUCING AGENTS Agrawal N.K
 
ANS-_Adrenergic_drugs-_Catecholamines.pdf
ANS-_Adrenergic_drugs-_Catecholamines.pdfANS-_Adrenergic_drugs-_Catecholamines.pdf
ANS-_Adrenergic_drugs-_Catecholamines.pdfSanjayaManiDixit
 
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printable
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printableIsofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printable
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printablegishabay
 
Cardiac medications
Cardiac medicationsCardiac medications
Cardiac medicationsjjones51
 

Similar to Effects Of Anesthetics On Cerebral Blood Flow (20)

Effects of anesthetics on cerebral blood flow
Effects of anesthetics on cerebral blood flowEffects of anesthetics on cerebral blood flow
Effects of anesthetics on cerebral blood flow
 
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomy
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomyCupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomy
Cupdf.com cerebral pharmacology-and-anesthesia-for-supratentorial-craniotomy
 
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)
Dr Anzil A R( CEREBRAL PHYSIOLOGY AND ANAESTHESIA DRUGS)
 
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptx
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptxINTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptx
INTRAVENOUS INDUCTION AGENTS IN ANESTHESIA .pptx
 
INTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxINTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptx
 
OPIOIDS ii.pptx
OPIOIDS ii.pptxOPIOIDS ii.pptx
OPIOIDS ii.pptx
 
oxygen requrement cmr and cerebral circulation
oxygen requrement cmr and cerebral circulationoxygen requrement cmr and cerebral circulation
oxygen requrement cmr and cerebral circulation
 
INTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptxINTRAVENOUS INDUCTION AGENTS.pptx
INTRAVENOUS INDUCTION AGENTS.pptx
 
Intravenous induction agents
Intravenous induction agentsIntravenous induction agents
Intravenous induction agents
 
Sedative hypnotic notes
Sedative hypnotic notes Sedative hypnotic notes
Sedative hypnotic notes
 
Anticholinergics
AnticholinergicsAnticholinergics
Anticholinergics
 
Sedative and hypnotic
Sedative and hypnoticSedative and hypnotic
Sedative and hypnotic
 
Antiasthmatic drugs.pptx
Antiasthmatic drugs.pptxAntiasthmatic drugs.pptx
Antiasthmatic drugs.pptx
 
Pharmacology of drugs used in hyper reactive airway diseases
Pharmacology of drugs used in hyper reactive airway diseasesPharmacology of drugs used in hyper reactive airway diseases
Pharmacology of drugs used in hyper reactive airway diseases
 
Anaesthetic considerations for intraoperative neurophysiological monitoring
Anaesthetic considerations for intraoperative neurophysiological monitoringAnaesthetic considerations for intraoperative neurophysiological monitoring
Anaesthetic considerations for intraoperative neurophysiological monitoring
 
INTRA VENOUS INDUCING AGENTS
INTRA VENOUS INDUCING AGENTS INTRA VENOUS INDUCING AGENTS
INTRA VENOUS INDUCING AGENTS
 
ANS-_Adrenergic_drugs-_Catecholamines.pdf
ANS-_Adrenergic_drugs-_Catecholamines.pdfANS-_Adrenergic_drugs-_Catecholamines.pdf
ANS-_Adrenergic_drugs-_Catecholamines.pdf
 
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printable
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printableIsofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printable
Isofulorane, enfulorane, sevofulorane, desfulorane, n2 o 2017 printable
 
General anaesthesia principles
General anaesthesia principlesGeneral anaesthesia principles
General anaesthesia principles
 
Cardiac medications
Cardiac medicationsCardiac medications
Cardiac medications
 

More from Unnikrishnan Prathapadas

Awake Craniotomy and the neurosurgeon.pptx
Awake Craniotomy and the neurosurgeon.pptxAwake Craniotomy and the neurosurgeon.pptx
Awake Craniotomy and the neurosurgeon.pptxUnnikrishnan Prathapadas
 
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptx
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptxPHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptx
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptxUnnikrishnan Prathapadas
 
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptx
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptxANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptx
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptxUnnikrishnan Prathapadas
 
An introduction to paediatric anaesthesia for undergraduates
An introduction to paediatric anaesthesia for undergraduatesAn introduction to paediatric anaesthesia for undergraduates
An introduction to paediatric anaesthesia for undergraduatesUnnikrishnan Prathapadas
 
Pathophysiology and Epidemiology of Traumatic Brain Injury
Pathophysiology and Epidemiology of Traumatic Brain InjuryPathophysiology and Epidemiology of Traumatic Brain Injury
Pathophysiology and Epidemiology of Traumatic Brain InjuryUnnikrishnan Prathapadas
 

More from Unnikrishnan Prathapadas (20)

ARTERIAL BLOOD GAS ANALYSIS.pptx
ARTERIAL BLOOD GAS ANALYSIS.pptxARTERIAL BLOOD GAS ANALYSIS.pptx
ARTERIAL BLOOD GAS ANALYSIS.pptx
 
BS MAC BS CP50 .pptx
BS MAC BS CP50 .pptxBS MAC BS CP50 .pptx
BS MAC BS CP50 .pptx
 
Awake Craniotomy Anaesthesia.pptx
Awake Craniotomy Anaesthesia.pptxAwake Craniotomy Anaesthesia.pptx
Awake Craniotomy Anaesthesia.pptx
 
Awake Craniotomy and the neurosurgeon.pptx
Awake Craniotomy and the neurosurgeon.pptxAwake Craniotomy and the neurosurgeon.pptx
Awake Craniotomy and the neurosurgeon.pptx
 
TIVA IN NEUROANAESTHESIA.pptx
TIVA IN NEUROANAESTHESIA.pptxTIVA IN NEUROANAESTHESIA.pptx
TIVA IN NEUROANAESTHESIA.pptx
 
SAFE & APPROPRIATE TIVA.pptx
SAFE & APPROPRIATE TIVA.pptxSAFE & APPROPRIATE TIVA.pptx
SAFE & APPROPRIATE TIVA.pptx
 
ARTERIAL BLOOD GAS ANALYSIS FINAL.pptx
ARTERIAL BLOOD GAS ANALYSIS FINAL.pptxARTERIAL BLOOD GAS ANALYSIS FINAL.pptx
ARTERIAL BLOOD GAS ANALYSIS FINAL.pptx
 
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptx
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptxPHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptx
PHYSIOLOGICAL CHANGES IN AGING IN CNS1.pptx
 
OBSTETRIC HAEMORRHAGE.pptx
OBSTETRIC HAEMORRHAGE.pptxOBSTETRIC HAEMORRHAGE.pptx
OBSTETRIC HAEMORRHAGE.pptx
 
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptx
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptxANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptx
ANAESTHESIA GAS CYLINDERS & PIPELINE GAS SUPPLY (2).pptx
 
Sodium Imbalances in NEURO ICU.pptx
Sodium Imbalances in NEURO ICU.pptxSodium Imbalances in NEURO ICU.pptx
Sodium Imbalances in NEURO ICU.pptx
 
Delirium in Intensive Care Unit
Delirium in Intensive Care UnitDelirium in Intensive Care Unit
Delirium in Intensive Care Unit
 
NON OPERATING ROOM ANAESTHESIA
NON OPERATING ROOM ANAESTHESIANON OPERATING ROOM ANAESTHESIA
NON OPERATING ROOM ANAESTHESIA
 
DVT AND PE
DVT AND PEDVT AND PE
DVT AND PE
 
Introduction to anesthesia
Introduction to anesthesiaIntroduction to anesthesia
Introduction to anesthesia
 
An introduction to paediatric anaesthesia for undergraduates
An introduction to paediatric anaesthesia for undergraduatesAn introduction to paediatric anaesthesia for undergraduates
An introduction to paediatric anaesthesia for undergraduates
 
TRIGEMINAL NEURALGIA
TRIGEMINAL NEURALGIATRIGEMINAL NEURALGIA
TRIGEMINAL NEURALGIA
 
Intensive fcare for spinal cord injury
Intensive fcare for spinal cord injuryIntensive fcare for spinal cord injury
Intensive fcare for spinal cord injury
 
Arise,awake doctors
Arise,awake doctorsArise,awake doctors
Arise,awake doctors
 
Pathophysiology and Epidemiology of Traumatic Brain Injury
Pathophysiology and Epidemiology of Traumatic Brain InjuryPathophysiology and Epidemiology of Traumatic Brain Injury
Pathophysiology and Epidemiology of Traumatic Brain Injury
 

Recently uploaded

Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...tanya dube
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...parulsinha
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...hotbabesbook
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...aartirawatdelhi
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...Taniya Sharma
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Ishani Gupta
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...parulsinha
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...narwatsonia7
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Dipal Arora
 
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...perfect solution
 
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeCall Girls Delhi
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426jennyeacort
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadGENUINE ESCORT AGENCY
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableDipal Arora
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableDipal Arora
 

Recently uploaded (20)

Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
Premium Bangalore Call Girls Jigani Dail 6378878445 Escort Service For Hot Ma...
 
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
(Low Rate RASHMI ) Rate Of Call Girls Jaipur ❣ 8445551418 ❣ Elite Models & Ce...
 
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
Night 7k to 12k Chennai City Center Call Girls 👉👉 7427069034⭐⭐ 100% Genuine E...
 
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
Night 7k to 12k Navi Mumbai Call Girl Photo 👉 BOOK NOW 9833363713 👈 ♀️ night ...
 
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
(👑VVIP ISHAAN ) Russian Call Girls Service Navi Mumbai🖕9920874524🖕Independent...
 
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
Mumbai ] (Call Girls) in Mumbai 10k @ I'm VIP Independent Escorts Girls 98333...
 
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Coimbatore Just Call 9907093804 Top Class Call Girl Service Available
 
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...Russian Call Girls Service  Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
Russian Call Girls Service Jaipur {8445551418} ❤️PALLAVI VIP Jaipur Call Gir...
 
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...Top Rated Bangalore Call Girls Richmond Circle ⟟  9332606886 ⟟ Call Me For Ge...
Top Rated Bangalore Call Girls Richmond Circle ⟟ 9332606886 ⟟ Call Me For Ge...
 
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
Call Girls Bhubaneswar Just Call 9907093804 Top Class Call Girl Service Avail...
 
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Haridwar Just Call 8250077686 Top Class Call Girl Service Available
 
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
College Call Girls in Haridwar 9667172968 Short 4000 Night 10000 Best call gi...
 
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Aurangabad Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Tirupati Just Call 8250077686 Top Class Call Girl Service Available
 
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any TimeTop Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
Top Quality Call Girl Service Kalyanpur 6378878445 Available Call Girls Any Time
 
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Varanasi Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
Call Girls in Delhi Triveni Complex Escort Service(🔝))/WhatsApp 97111⇛47426
 
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In AhmedabadO898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
O898O367676 Call Girls In Ahmedabad Escort Service Available 24×7 In Ahmedabad
 
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service AvailableCall Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
Call Girls Kochi Just Call 8250077686 Top Class Call Girl Service Available
 
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service AvailableCall Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
Call Girls Cuttack Just Call 9907093804 Top Class Call Girl Service Available
 

Effects Of Anesthetics On Cerebral Blood Flow

  • 1. EFFECTS OF ANESTHETICS ON CEREBRAL BLOOD FLOW & CMRO2 PRESENTER Dr Unnikrishnan P COORDINATOR Dr Linnette Morris MODERATORS Dr Ushakumari Dr Chitra
  • 2.
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11.
  • 12.
  • 13.
  • 14.
  • 15. Propofol & brain protection
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21.
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 32.
  • 33.
  • 34.
  • 35.
  • 36.
  • 37.
  • 38.
  • 39.
  • 40.
  • 41.
  • 42. Summary of volatile agents MAJOR IMPACT ON CBF/CBV & ICP OCCURS WHEN WE EXCEED 1 MAC BECOMES SIGNIFICANT IF INTRACRANIAL COMPLIANCE IS ABNORMAL HERE, IT IS BETTER TO USE A PREDOMINANTLY INTRAVENOUS TECHNIQUE UNTIL THE POINT OF OPENING OF CRANIUM & DURA NET VASODILATORY EFFECT OF ISO/DES & SEVO LESS THAN HALO;SO IF ONE IS TO BE USED, PREFER THE FORMER ONES EFFECT OF HYPOCAPNOEA : HALOTHANE Vs ISO/DES/SEVO ENFLURANE IS EPILEPTOGENIC; SLIGHT RISK WITH SEVOFLURANE CO2 REACTIVITY AND AUTOREGULATION PRESERVED
  • 43.
  • 44.
  • 45.
  • 47.
  • 48. Non depolarizing relaxants- histamine release
  • 49.
  • 50.
  • 51.
  • 52.
  • 53. Textbook of neuroanesthesia & criticalcare/Basil F Matta SURGERY INDUCTION RELAXANT MAINTENANCE SUPRATENTORIAL ICSOL TPS/P’FOL ATRA/VEC/MIVA/ROC P’FOL-FENT / FENT- LD ISO / N2O- HD ISO VASCULAR Sx TPS/ETO/P’FOL VEC/ATRAC/PAN/? SCOLINE* P’FOL-OPIOID +/- VOL AGENT* ?N2O CAROTID Sx FENT/ETO/TPS/ P’FOL VEC FENT/ISO/N2O POST FOSSA OPIOID/TPS/ P’FOL NDMR VARIES ?N2O-PC/VAE ?VOL-TRANS PUL,SSEP NSx WITHOUT CRANIOTOMY FENT/TPS/P’FOL NDMR ISO WITH HYPOCAPNOEA Cx SPINE RSI-SCOLINE PED TPS/P’FOL/SEVO SUXA/NDMR N2O+LD ISO/SEV OR P’FOL i/FEN OR AIR+HD VA
  • 54.
  • 55.
  • 56.
  • 57.
  • 58.
  • 59.
  • 60.
  • 61.
  • 62.
  • 63.
  • 64.
  • 65.
  • 66.
  • 67.  
  • 68.
  • 69.
  • 70.  
  • 71.  
  • 72.