Halotano 0.75% Concentración Alveolar Mínima = Potencia = ED50
Isoflurano 1.2%
Menor concentración alveolar necesitada, mayor potencia
Sevoflurano 2%
Desflurano tiene el gas; ↓ MAC = ↑ Potencia
6%
Óxido Nitroso 105%
Halotano 2.4 Solubilidad sanguínea
Isoflurano 1.4 Solubilidad = Blood / Gas (Q = B/G)
Sevoflurano 0.65
Determina la velocidad de acción del fármaco;
Desflurano 0.42
Óxido Nitroso
↑Q = ↓Velocidad
0.47
Mecanismos de acción
- Hidrocarburos halogenados: Aumentan sensibilidad de receptores inhibidores - GABA.
- Halotano: necrosis hepática, arritmias (estimula receptores ß1), hipertermia maligna (Tx:
Dantroleno). hepatoxicidad. Utilizado para inducción.
- Isoflurano: no utilizado para inducción, ↓PA
Hipertermia Maligna
- Sevoflurano: anestesia pediátrica, nefrotóxico. ↓PA Autosomico dominante
- Desflurano: no utilizado para inducción, ↓PA Tx: Dantroleno (antagonista
receptor rianidina)
- Enflurano: utilizado para mantenimiento, seizures. ↓PA
- Metoxiflurano: nefrotoxicidad
- Oxido Nitroso & ketamina: Disminuyen receptores de neurotransmisores exitatorios - Glutamato
(NMDA), glicina, nicotina.
- N2O: se utiliza en conjunto con hidrocarburo halogenado debido a ↑MAC. Puede resultar en
hipoxia por difusión.
ANESTESIA LOCAL
- Bloquean canales de Na+ en la membrana neuronal desde el interior de la célula.
- Orden de bloqueo: Dolor → Temperatura → Tacto → Presión.
- Puede administrarse con Epinefrina para provocar vasoconstricción = aumentar la acción local,
disminuir sangrado y disminuir efectos sistémicos.
1
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