30 o Anesthesio

after which the endotracheal tube is inserted under direct vision with the aid of a laryngoscope and McGill forceps, ifneeded. Several milliliters oflidocaine 4% so' lution may be instilled into the larynx prior to placing the endotracheal tube, which has been lubricated with anesthetic ointment. The tube cuff is inflated and the tube secured with tape. For the duration of the procedure, muscle relaxation is maintaine4 y!!! any of the ,"u"tut curare-like drugs, as above. Additional monir^'inc rievices are attached., and the patient's position Position a toring devices chanled as necessary. The circulator may be requir-ed tftu anestheiist by providing easy access to the to ^.Jirt equipment, giving additional premeasured drugs, maniiuiating tf,e trichea, and so on, at the instruction of thl anestf,etist. A wide variety of drugs and inhalation agents are available; see Table 4-1.
Toble Agenl
Niirous

Generol lnformotion

.3]

I6le 4-l lgEnt ffurone Glhrone)

Generol Aneslhelics (Continued)

Adminislrolion

Poule of

Form

Commanls

lnholotion

Voloflle liquld Ropid inductlon; occosionolly used for mointenonce; ropid recoveryj moy couse hypotension; moy couse convulsions in children'

Dedurone

(Srprone)

lnholotion

Volotileliquid Very ropid onset ond recoveryj pungent

odor, lncreosed posloperolive nouseo

boflurone
(Forane)

lnholotion

Volotileliquid Mointenonce; good

musculor reloxotion; cotdiovosculor stobiltty, useful in

4-l

Generol Aneslhelics

cordioc potients Commenls

Most commonly.used; not used olone tor. deep onesthesio; used to Potentiole

Adminislration

noule ol

Form

Kelomine Introvenor I,s; gtoble liquld (Ketoject, lntromus-

Kelolor)

culor'

lnholotion

Compressed
g9s-

oxide

lnduction; short-octin g onesthetic; long-octing onolgeslc; good for children; moy couse hqllucinotions if given in lorger
doses. Ropid induction; short

ihe effects of other

ogents

Propofol
(Diprovon)

lntrovenous Stoble liquid

lntrovenous Stobleliquid Thlopentol (Pentothol)

Ropid induction; short durotioni respirotory depreqsonl; con

couse loryngosposm ond hypotension Metho-. hexiiol

(Brevitol)

lntrovenous Siobleliquid

Ropid; ultro-short-

octing; for induction; mointenonce; fost recove!"Y; hieeoughs

Slow, smooth induc-

durotion; con be used os continuous infusion wiih cleor heoded, ropid recovery; respkotory depressonf, l;onsient hypolension, poin on injection

Holothone
(Fluothone)

Inholotion Volotileliquid

tionj mointenonce; moy couse brodycordio; increosed

sensitivity if used wiih

epinephrine; good with burn potients ond children; moY couse liver domoge

' To supplement the use of anesthetic agents, numerous additional drugs may be administered intravenously to balance the anesthesia, These drugs include various narcotics or morphine, miperidinel fentanyl and other muscle felaxants, amnestics,and neuroleptics.