Anaes Vivas · Volatile & inhalational agents
Clinical viva — selecting the inhaled agent
A clinical viva on agent selection — by induction (inhalational vs intravenous), by the need for rapid emergence (obese, long case), by the contraindications (MH, raised ICP, pneumothorax, ischaemic heart disease), and by the environmental cost.
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Study tools
Target exams
ANZCAFRCAABAEDAIC
Prompt
The examiner asks you to talk through how you choose between sevoflurane, desflurane, isoflurane, nitrous oxide and a total intravenous technique for a range of patients.
Stimulus
Talk through how you choose the maintenance agent for: a needle-phobic child needing an inhalational induction; an obese man having a long operation; a patient with known ischaemic heart disease; a patient with a pneumothorax; and a patient known to be malignant-hyperthermia-susceptible.
References3ShowHide
- [6]Sulbaek Andersen MP, Nielsen OJ, Sherman JD. Assessing the potential climate impact of anaesthetic gases. The Lancet Planetary Health, 2023.PMID 37438003
- [3]Adam MP, et al. Nonsyndromic Malignant Hyperthermia Susceptibility. GeneReviews, 1993.PMID 20301325
- [7]Bersten AD, Soni N (eds) Oh's Intensive Care Manual. 8th edition, Elsevier, 2018.