anesthesiologist is unable to ventilate the patien - proteus

[ArchivalUser]

prot: plz post the answ!!! r u playing here with us? or r u a med teacher or some like that and try to have some idea abut the q? some one said u cud be a researcher and r doing a kind of reasearch here!!!? : (...hope u r not slept though!!

[ArchivalUser]

Nitrous oxide -E ?

[ArchivalUser]

i feel flank pain when i see his post....i hope he is not got renal colic tonight...he is not around!!!

[ArchivalUser]

answer please

[ArchivalUser]

Choice (E) is the correct answer. Nitrous oxide or laughing gas is often used in combination with volatile anesthetics to achieve general anesthesia. By itself, nitrous oxide has a low potency and relatively poor blood solubility. It has a blood:gas partition coefficient of 0.46. However, nitrous oxide is approximately 30 times more blood soluble than nitrogen gas. The blood:gas partition coefficient of nitrogen gas is 0.015. What this means is that nitrous oxide can diffuse out of solution 30 times faster than nitrogen gas can be reabsorbed into the blood stream. In a patient undergoing anesthesia with a known pneumothorax, nitrous oxide is contraindicated, because nitrous oxide will diffuse into the pneumothorax space faster than nitrogen gas can be reabsorbed into the blood. The net result is expansion of the pneumothorax. In the clinical scenario, the patient developed a tension pneumothorax resulting in hemodynamic comprise that necessitated a needle thoracostomy and chest tube placement. In a patient with a known ileus, nitrous oxide can cause bowel dilation. Nitrous oxide can also diffuse into an endotracheal tube cuff and potentially cause tracheal trauma. Air emboli can expand with the use of nitrous oxide, as well. Essentially, any closed gas space will expand with the use of nitrous oxide during surgery, so the risks must always be assessed before its use. Epoprostenol (Choice A) and nitric oxide (Choice B) are vasodilators and are often used to treat pulmonary hypertension and improve V/Q mismatching. Desflurane (Choice C) and sevoflurane (Choice D) are both volatile general anesthetics. Milrinone (Choice E) is a phosphodiesterase inhibitor that increases intracellular calcium concentration, resulting in increased myocardial inotropy with no effect on chronotropy. In addition, milrinone causes systemic vasodilation resulting in a decrease in afterload. It is sometimes used in congestive heart failure to increase cardiac output by increasing contractility and decreasing afterload.