inhalation anesthesia was the first anesthetic modality employed and has been used for more than 200 years to make it viable we have to transformed inhalation anesthetic that is marketed in liquid form and steam and in this video lesson we will see how this is possible rotate the vignette he [Music] o Hello crew of the ship all right in this video lesson of the anesthesia course at basic we will talk a little about the anesthesia machine and the anesthetic circuits the first inhalation anesthesia historically accepted was carried out by William Thomas Green motorcycle back in 1846
we already we talked about it there in the anesthesiology history video class at that occasion boot used a kind of glass bubble with a sponge inside and drink with at and with the aid of a bellows He is vaporizing that at and providing for the patient so we can say that this container was considered the first anesthesia machine in history since then, everything from bizarre anesthetic masks to equipment very efficient all with the sole purpose of providing anesthetic for the currently we have specific equipment that facilitates E if it is this and using mainly security
in anesthetic procedure but for this to be possible we have to keep patent airway to all General anesthetics are inhaled to enter venous promote pressure of the protective reflexes this can generate airway obstruction so it is very important that our patient is intubated we can do this with appropriate endotracheal tubes for each patient I suggest you take a look at this playlist here that has several incubation techniques for different species We can also use the super gothic probe basically we have two types the laryngeal mask EA vegel a video as well interesting of the company
that manufactures you can see it in this Card here independent of the probe used we have to make sure there was this patent this can be done by observing the curve of the capnographer you don't have capnograph the other way is much simpler is to put a gauze at the entrance of the probe and see if there is air flow passing through it but some species in fifth BA and for that it is impossible as per example the anteaters and the statuses in this case we use face masks that even these animals fit well The
problem is that we are not sure that the airways are totally unobstructed and also the leakage of anesthetic between the mask and the animal polluting the operating room so just use in mask and last case and in the veterinary the main diluting gases of inhaled anesthetics are medical oxygen and compressed air they are color-standardized so always here in Brazil we will see the green oxygen cylinder and the air cylinder yellow tablet on the market there are several sizes of oxygen cylinders each one with its volume but the internal pressure is usually between 150 and 200
kilogram force per square centimeter obviously we can't put this cylinder directly on the equipment and for that we use a valve pressure reducing valve this valve will release pressure to the system that will be between 3 and 6 and 7 kilogram-force per square centimeter you came to watch the video checklist list of anesthesia that there is a step by step of how this reducing valve works And also how the we can calculate the useful volume of oxygen in each cylinder another possibility for us to supply oxygen is to use concentrators is that nowadays they are
being used well in practice they work until very well they can generate 5 liters of oxygen per minute for a concentration of ninety-five percent this gives us an anesthetic in small animals quietly The problem is that the pressure it generates is insufficient for people, for example, to use the fan of an equipment simpler anesthesia in some parts of the anesthesia machine are common for any patient be it man dog cat horse bird snake little matter see which with an anesthesia machine adequately supplied with oxygen and compressed air we started to supply these gases in an
adequate amount for the system So as we can see here we have the rotameters that are scaled in ml and flow meters that are scaled in liters per minute in this case we will release the necessary amount of oxygen and air compressed into the system so that it is feasible to anesthesia these flowmeters and rotameters and a metal sphere a kind of ballerina that indicate for folks what is the gas flow being administered after that the flow of gas goes to the vaporizer basically we have two types this first here is a vaporizer calibrated the
rest because it shows us this is where vaporization is. That is the concentration of anesthetic that is leaving in the mixture after the vaporizer it has some advantages like for example it maintains the administered concentration independent of the temperature flow and of atmospheric pressure on the other hand It can only be used for that anesthetic gas indicated in that case that vaporizer can only be used I keep flower year the other type of vaporizer that practically none place in the world uses in Brazil still has this business is the Universal vaporizer a we can see
here that it is basically a glass dome we you can even see the anesthetic and see it with the stuff it's bubbling up we don't can you specify What is the concentration of anesthetic that we are sending for the patient, this vaporizer is dangerous because we don’t have a damn thing notion of how much is giving to the patient we even jokes that we say that it is the percent eye just so we have the maximum idea that we can vaporize from calibrated non-vaporized isoflurane is five percent at Universal can reach thirty percent after that
we we have a mixture of gases that will bring the patient anesthetic oxygen and depending on the situation compressed air and after that we have the anesthetic circuits that there must be adjusted for each patient didactically I will separate them here in Us reinalatoria circuits and not Bora reinalatoria there and as its name says this circuit makes the gas flow always unidirectional so we can see in this animation here that the fresh gas that comes from the anesthesia machine goes through the inspiratory valve follows The trachea corrugated and reaches the patient on inspiration and exhalation
he goes through corrugated trachea passes through the expiratory valve and returns to the system it is clear to us that the gas breathed is reused, that is great because we save oxygen and anesthetic and also reduce pollution In addition, as time goes by, we start to supply patient a mixture of more humid and warmer gases Adriano the animal Marina expected start and your two so this detail is very important in the circuit circulated flying as we can see here and there's a container called kanist that has soda lime inside it substance retains CO2 And with
that it is possible for us to re use the gas inspired by soda soda indispensable in the circular circuit to fly and obviously it has an expiration date the more we use the anesthesia machine but the Soda lime absorbs CO2 and releases oxygen. It is formed by white tablets that as time goes by they turn bluish or violet in color here we can see a canister with new lime and another with refined pants after anesthesia for one equine that lasted 5 hours this indicator warns us that we should throw the soda lime out and replace
with a new one so as i told you take care is excellent because we can save oxygen anesthetic and reduce pollution The problem is that we are unable to use this equipment to all animals And what the problem with this equipment is mechanical resistance that is basically done by soda lime and valves unidirectional so very small patients They have no expiratory force and inspiratory enough to get the gas to circulate in that system suitably good being very simplistic because the business is more complicated than it looks like we separated our impatient patients over 5 kg
in less than 5 kg in theory patients over 5 kg already have strength enough expiratory and inspiratory to circulate in the system which is really theoretical because if we take for example that grandma pinscher that was supposed to be two kilos and has 5 kg will not work and in some books suggest that patients weighing less than 10 kg must be kept on Systems not reinalatoria I think this a lot but anyway for these patients there bordering between 5 6 7 kg what we can do the following we put these patients in the circuit circulated
flying and checks a capnograph to see if the animal is reigning bid two if he has reign bid two we exchange the system does not re-report ah it's true you don't have a capnographer right ah my old man Then it complicates the situation in this case so I suggest you put the patient there around 567 kg in the non-reinalatorial circuit but gives a way to buy a capillary It was quick there ok and unreported circuits are derived from human pediatric anesthesia they are extremely simple basically a corrugated trachea with reservoir balloon They don't have a
canister, they don't have pants on the die and they also don't have unidirectional valves this helps a lot because the mechanical resistance is practically zero on the other hand environmental pollution increases a lot and obviously we cannot reuse the gas inspired by your own lot of circuits don't report with different names is a real zone I will show you here the two main non-reporting circuits that we use it at the veterinary clinic we have the baraka circuit and and no, not in this place, so as we can see here the gas flow fresh reaches Nessa
Hose near the patient's mouth and when the patient breathing this gas gains the corrugated trachea we can also see a exit which is an exhaust outlet that is close to the balloon another possibility is we place the fresh gas flow hose next to the balloon and the outlet of gases next to the patient another not widely used circuit is the well circuit it has an internal hose that takes the fresh gas up to the mouth of the patient and when the patient exhales the inspired gas it passes through a trachea corrugated that is covering this
hose in this case Theoretically the gas inspired gains heat and humidity But it doesn't happen if the flow of fresh gas is too high we still have the other non-king circuit models in the can and used in the veterinary and so A Choosing between one and the other is basically the taste of the anesthetist but they have difference yes some advantages and disadvantages I suggest anyone who has interest of one consulted in the material here of the description to find out best of the subject ok we still have two very important pieces that are present
in both the flying circuit and the non-reporting circuits is the first of these is the reservoir balloon this generates a lot of doubt that say that I easily use the reservoir balloon the distensible part of circuit so it must have at least the tidal volume of the animal so while the animal is exhaling the balloon inflates and when the animal is inhaling the balloon retract we keep a ratio between one and three times the tidal volume of the patient with that the balloon will not be so inflated also will not stick bar the other important
piece the exhaust valve also known as pop valve off even if we use the circular valve circuit the minimum gas flow fresh must be kept this generates a surplus that must be relieved in escape valve if we are working on non-circuits all fresh gas must escape through the exhaust valve exhaust is partially is obviously that this can generate pollution in the room so we must filter this anesthetic and purging the gas from the room we have some commercial coal-based filters activated that are very interesting can filter the anesthetic and not polluting the atmosphere The problem
is that unfortunately it is not the reality of most veterinary surgical centers as a conclusion of this video class we have that the use of inhaled anesthetics requires that we have devices and adequate circuits to make the procedure feasible, it is essential that the patient to be intubated To ensure the procedure is safe the probe endotracheal should be adequate for each patient we must prioritize the calibrated vaporizers as they allow greater precision in the procedure circuits must be suitable for the patient being circular circuit valve most used for patients over 5 kilos is a report
for minors and a good 5 kg Guys I hope you have like this video lesson remember that this lesson is part of the anesthesia lesson inhalation that we will leave just to discuss the inhalation agents we thank everyone there who has commented praised criticized suggested something that makes our videos and our channel always evolve a big hug and see you soon on Lula's side here can be video in this are completely obstructed if when Oi Rai Good night to close we see in ours is not so What's up
