How Anesthesia Works. Stuff You Should Know, 17 Mar. 2015, www.stuffyoushouldknow.com/podcasts/how-anesthesia-works.htm.

Mentor Introduction

Beth Stratton
-Certified Registered Nurse
Anesthetist

BSN & MSNA

Employed at Clear Lake

Regional Hospital
 Clear Lake Regional Hospital. Clear Lake Regional Medical Center, clearlakermc.com/.

Clear Lake Regional Hospital

Located on Medical Center Blvd

Operating rooms feature advances in technology such as the Da Vinci Surgical

System

Family and friends are able to track loved ones as they progress from pre-op to
recovery

Surgeons utilize minimal invasive surgical techniques including laparoscopy

and robotics
 ISM & Course
Requirements
The Independent Student Mentorship class is a rigorous
academic course where students are able to mentor with a
professional in a chosen career.

Students enrolled in the course are required to complete an in

depth study of a career of their liking. They must attend their
mentorship site and document a minimum of 3 hours a week.
With the information gathered during the mentorship sessions,
students must complete an online portfolio showcasing
assignments done, as well as a journal entry documenting their
mentorship experiences. The end result of the course will consist
of a mid-term presentation, and a well developed final product
and presentation.
Clear Springs High School. Clear Springs High School, clearspringsathletics.net/.
 Project Topic

Tips to Prep for Surgery and Ease Recovery in Pictures. WebMD, WebMD, www.webmd.com/healthy-aging/ss/slideshow-surgery-prep.

My inhalational anesthetics project will consist of researching the

functions, effects, and determinants for three various types of gases
for anesthesia. It will be based on multiple age groups and patient
cases which will thus enrich the analysis.

I settled on this topic due to my interest in anesthesia being a

catalyst for surgical procedures where certain parts of the body
require sedatives to prevent discomfort. Similarly, my mother
played a big role in my decision for this research regarding the
respiratory field due to her career as an RT, where she continually
encountered intriguing cases while working at the hospital.
 Artifacts
Anesthesia: loss of sensation with or without
loss of consciousness
Propofol: is a short-acting medication that
results in a decreased level of consciousness
and lack of memory for events. Its uses
include the starting and maintenance of
general anesthesia, sedation for mechanically
ventilated adults, and procedural sedation.
 Key Point 1: History behind
inhalational anesthetics
Boyle, Dalton, & Charles outlined the basic properties of gases

Joseph Priestley & Carl Scheele (1742-1786) performed first investigation on gas
inhalation

On December 10th, 1844 Professor Colton presented his exhibit featuring inhalation of
nitrous oxide at union hall in Connecticut

In 1847 Chloroform was suggested as an alternative agent

Between 1950-1993 compounds such as Isoflurane, Sevoflurane, and Desflurane were

introduced

Eger defined the concept of Minimum Alveolar Concentration which states the
alveolar concentration of an inhaled anesthetic at 1atm, produces immobility in 50%
of the subjects exposed

This is the best estimate of anesthetic potency of an inhalational anesthetic

 Key Point 2: What are Inhalational Anesthetics?

Inhalational anesthetics are chemical compounds

possessing general anesthetic properties that can be
delivered via inhalation. These include:
isoflurane, sevoflurane and desflurane

2 Free CEUs for RT- Waste Anesthetic Gas Exposure. Totally Free CEUs, 19 Oct. 2013, freeceus.wordpress.com/2013/10/19/2-free-ceus-for-rt-waste-anesthetic-gas-exposure/.
 Research: Characteristics of Anesthetic
Agents

Although inhalational anesthetics affect various receptors, the receptors that

interact with anesthesia are vague.

Features include low solubility in tissues and blood, potency, resistance to

metabolism, low irritation to respiratory system, and protection for the individual

An Ideal anesthetic allows high absorption of oxygen & production of anesthesia

If 50% of subjects are paralyzed with an anesthetic at one atmosphere then it is

considered potent

Solubility is considered as a ratio of blood:gas

Desflurane tissue solubility is approximately half that of sevoflurane; sevoflurane

is half as soluble as isoflurane; and isoflurane is half as soluble as halothane.
(Eger 1)
 Research Cont.

Inhalational anesthetics are packed in a way that CO2 is removed

Inhalational anesthetics can damage tissue due to their metabolic

degradation properties

Some children and young adults receiving sevoflurane have described

agitation and seizures

The various gases tend to have strong odors leading to irritation in the
respiratory system

Inhaled anesthetics differ in their circulatory stimulatory effects during

induction of anesthesia, but only limited differences are usually seen
during maintenance of anesthesia. (Eger 1)
Key Point 3: What are the Factors which Determine
the Type of Anesthesia Used on a Patient?

Almost, if not all surgeries require some type of anesthesia

Inhalational anesthetics are crucial during general surgery as doctors want

to provide a painless procedure, however several considerations such as age,
weight, and health must be accounted for.

For infants, sevoflurane is the preferred method

For adults, several factors such as age and weight have to be considered
 Key Point 3: Cont.

Fat solubility plays a large role in type of anesthetic used

Food and drug consumption may also be the determinants for

anesthesia as it is likely patients can regurgitate food while
recreational drugs may excite the nervous system or heart.
 Research: Age and Anesthesia

The Massachusetts General Hospital analyzed electroencephalogram

signatures to see how various anesthetics affected the brains electrical signals

Dosages for anesthetics vary according to age and activity in the respiratory
and cardiovascular systems

The sites most affected by anesthetics are the central nervous system and brain

The influence of anesthetics in the brain activity of children can eventually

lead to cerebral issues

Anesthesia induced consciousness in teenagers blocked communication

between the cerebral cortex and the thalamus
 Research: Cont.

The synchronization between the cortex and thalamus occurred at slightly lower
frequencies in older patients, who were more likely than younger patients to experience
a state called burst suppression that reflects profoundly deep anesthesia at lower doses.
(McGreevey 1)

Children under the age of one have not yet developed their cortex and thalamus
synchronization

Anesthesia induced signals were high until the age of 6 and then dropped to the average
adult level at 20 years old

Brain waves either decay or develop according to age

 Key Point 4- The Effects of Inhalational Anesthesia on
Various Patients

Sevoflurane is often used to induce unconsciousness in patients undergoing

surgery, it affects the visual and association cortex.

As a result of sevoflurane, researchers speculate more oxygenated blood to

the brain results in memory loss

Side effects include: coughing, dizziness, drowsiness, increase in saliva,

nausea, shivering and vomiting.

Tips to Prep for Surgery and Ease Recovery in Pictures. WebMD, WebMD, www.webmd.com/healthy-aging/ss/slideshow-surgery-prep.
 Key Point 4 Cont.

Anesthesia disrupts the link-ages between cortical and thalamic neurons

anesthetic agents can cause significant cardiac depression and hemodynamic

instability

Anesthesia affects the cardiovascular system in multiple ways: loss of blood

and other volume shifts, release of various substances into the circulation,
hypothermia, sudden changes in cardiac preload and afterload, myocardial
ischemia, and effects of drugs or blood products given for surgical reasons.
 Research: General Anesthesia: Uses, Risks
and Side Effects

General anesthetics are given as gases or IV

Patients under anesthesia do not feel pain but may induce amnesia

There are 4 stages for anesthesia

Stage 1 is called induction, and it is where the patient loses consciousness

In stage 2 excited activity happens

In stage 3 the muscles relax

Stage 4 is considered overdose

 Research Cont.

General anesthetics are preferred if the procedure will be time consuming

Unintended intraoperative awareness refers to rare cases where patients

report a state of awareness during an operation, after the point at which the
anesthetic should have removed all sensation. (Newman 1)

Pre-surgical evaluation must be done to the patient in order to determine the

quantity and type of anesthetic necessary

General anesthetics affect various parts of the central nervous system

 Key Point 5: Linkage between inhalational
anesthetics and dementia

A significant endpoint of general anesthesia is the loss of

memory

Recent experiments on human cells show that anesthesia

can increase the buildup of the proteins thought to underlie
Alzheimers disease
 Current Event: Capturing Anesthetic Gas Could
Cut Environmental Harm
Summary

This article pertains to environmental pollution as a result of inhalational

anesthetics. It is stated that operation rooms are the main sources for
environmental waste at a hospital. Thus, U. Melbourne advocates the
importance of pursing ways to diminish the amount of harm to the
environment. Several research projects have led to the development of a
polymer which can recycle inhalational anesthetics and in turn reduce the
negative effects to the atmosphere as well as surgery costs. Melbourne
proceeds to shed light onto the benefits of creating such technology that
can potentially develop safer anesthetic gases like xenon which has no
known negative impacts. Nonetheless, xenon is very rare and expensive,
and additional solutions must be considered. A team of researchers have
recently developed branches of polymers able to fit into specific anesthetic
gases. They managed to capture two common inhalational anesthetics,
sevoflurane and isoflurane; therefore, creating a pathway for new ways to
protect the planet.
 Product

A trifold presentation that incorporates hypothetical

patient cases of a child, adult, elderly person who
required inhalational anesthetics during surgery. It will
display the factors and effects taken into consideration,
as well as a overall comparison between all three.
 Conclusion
Throughout my experience being mentored, I attained a greater
sense of understanding and appreciation for the team in the
operation room, but more specifically the anesthesia department
who is able to provide comfort to the patient. At the same time,
my mentor familiarized me with gas anesthetics and the
numerous people who require them during their procedures.
 Thank You

I would like to thank my mentor, Mrs. Stratton because

she was excellent at explaining and it is hard to find
someone who is so passionate towards their job; the
evaluators who took time out of their day to be here;
my instructor, Mrs. Click, who made sure we had a
professional project; and my parents, for providing me
with support and guidance throughout the course of
my mentorship.

A Little Thank You. Skipton Properties, 5 July 2017, www.skiptonproperties.com/blog/a-little-thank-you/.

 Works Cited/References
Alzheimer's. Why Do Older People Develop Dementia after Surgery? Alzheimer's Society, Alzheimer's Society, 12 Jan. 2017,
www.alzheimers.org.uk/info/20053/research_projects/708/why_do_older_people_develop_dementia_after_surgery.

Chapter 8. Inhalation Anesthetics. Chapter 8. Inhalation Anesthetics | Morgan & Mikhail's Clinical Anesthesiology, 5e | AccessAnesthesiology | McGraw-Hill Medical,
accessanesthesiology.mhmedical.com/content.aspx?bookid=564ionid=42800539.

Khan, Khurram Saleem, et al. Pharmacology of Anaesthetic Agents II: Inhalation Anaesthetic Agents | Continuing Education in Anaesthesia Critical Care & Pain | Oxford
Academic.
OUP Academic, Oxford University Press, 25 Sept. 2013, academic.oup.com/bjaed/article/14/3/106/340726.

Operating Room. Operating & Surgery Room | St. Mary's Health System | Maine,
www.stmarysmaine.com/departments-services/surgical-services/operating-room.

Salim. 4 Easy Tricks To Create An Epic Presentation. Goalcast, 4 Oct. 2016,

www.goalcast.com/2015/11/03/4-easy-tricks-to-create-an-epic-presentation/.

SmartBeautyNews. Anesthesia 101: What You Need to Know Before Your Next Cosmetic Procedure.
SmartBeautyGuide, 11 July 2015, www.smartbeautyguide.com/news/safety/anesthesia-101-cosmetic-procedure/.

Study: Surgery, Anesthesia Not Linked to Cognitive Impairment. UPI, UPI, 1 Mar. 2016,
www.upi.com/Health_News/2016/03/01/Study-Surgery-anesthesia-not-linked-to-cognitive-impairment/7421456857606/.

What Is Anesthesia? | Strategy Anesthesia. Pain Management Anesthesia Services:

Strategy Anesthesia, 17 Aug. 2017, strategyanesthesia.com/what-is-anesthesia/.

What You Should Know About the Different Types of Anesthesia. Johns Hopkins Medicine Health Library,
www.hopkinsmedicine.org/healthlibrary/conditions/surgical_care/types_of_anesthesia_and_your_anesthesiologist_85,P01391.