Carbon Monoxide in the Anesthesia Circuit Definition Carbon monoxide present in the anesthesia breathing circuit Etiology Carbon monoxide is produced by degradation of volatile anesthetic agents in the presence of desiccated CO 2 absorbents The amount of carbon monoxide produced…
Case Synopsis A 54-year-old man, American Society of Anesthesiologists (ASA) physical status 2, undergoes general anesthesia for a laparoscopic ventral hernia repair. His baseline blood pressure is 120/70 mm Hg. After an uneventful intravenous induction and tracheal intubation, the sevoflurane…
Case Synopsis A 25-year-old man with no significant medical history presents for tonsillectomy. After induction of anesthesia and tracheal intubation, anesthesia was maintained using a mixture of O 2 /N 2 O/isoflurane at a total fresh gas flow (FGF) of…
Case Synopsis A 75-year-old woman with perforated diverticulitis is undergoing a laparoscopic hemicolectomy under general anesthesia. The patient’s abdomen has been insufflated with CO 2 to a pressure of 15 to 20 mm Hg for 45 minutes. The end-tidal CO…
Introduction Myasthenia gravis (MG) is an autoimmune disorder affecting the neuromuscular junction for which patients commonly undergo surgical thymectomy as definitive treatment. It is therefore of great significance to the thoracic anesthesiologist. It is a chronic disorder characterized by fluctuating…
Introduction During anesthesia for a thoracic surgical procedure, many alterations in physiology occur, including changes in oxygenation and ventilation. Whether the patient is receiving monitored anesthesia care (MAC), regional anesthesia, or general anesthesia, it is essential that the anesthesiologist monitor…
Acknowledgments We would like to thank the following individuals for their feedback on the Cybersecurity section: Anura Fernando, Julian Goldman, MD, Andy Levi, Ben Ransford, PhD, and Yi Zhang, PhD. Perspective Failure of the anesthesia delivery system alone is a…
Overview Until the early twentieth century, animal life was defined by the presence of spontaneous ventilation. Absence of breathing implied death or impending death, although experiments with resuscitation and artificial ventilation had occurred since the eighteenth century. The defining characteristics…
Overview The gases of interest to the anesthesia caregiver include oxygen (O 2 ), carbon dioxide (CO 2 ), nitrous oxide (N 2 O), and the potent volatile inhaled anesthetic agents of which desflurane, sevoflurane, and isoflurane are in common…
Overview Under normal physiologic conditions, the upper airway adds heat and moisture to inspired air to prevent drying of lower airway secretions, plugging, and mucosal injury. When dry medical gases bypass the upper airway via an endotracheal tube, the normal…