Medical Anaesthetics

1. Give a general introduction to your topic (include lots of chemistry, equations,

substances, visuals of processes)

What is Anesthesia?

● Anesthesia is a medical treatment that allows medical professionals to perform

different types of procedures such as surgeries, screenings or diagnosis without
causing any pain to the patient.
● Anesthesia can be classified into four types: Regional, general and local, and ID
sedations anesthetics.

General Anesthesia: It affects the whole body; making the patient unconscious
and unable to move. It is often used to operate on internal organs or invasive
procedures such as brain, heart or back surgery. It is the most commonly used.
General anesthesia is a mix of intravenous and inhaled anesthetics

Local and Regional Anesthesia: Local and regional anesthesia only affects a
certain part of the body, allowing complete consciousness and mobility of the
patient. It is often used in dentistry or eye surgeries; as well as ease the pain in
childbirth.

Intravenous Anesthesia (IV sedation): Intravenous anesthesia is

when certain sedatives and anesthetics are injected through the veins and the
bloodstream. IV anesthesia doesn’t usually put you into a deep sleep like general
anesthesia does. The most commonly intravenous anesthetics used in surgical
procedures are : Propofol, Etomidate and Ketamine.

How does it work?

General anesthesia blocks nerve transmission to pain centers in the central nervous system by
binding to and inhibiting the function of an ion channel in the cell membrane of nerve cells
known as the sodium channel.
Voltage-gated sodium channels (VGSCs) are the basic ion channels for neuronal excitability,
which are crucial for the resting potential and the generation and propagation of action potentials
in neurons. (Conduct Sodium ions Na+ through cell membrane).

General anesthesia:
General anesthesia causes brain circuits to change their movement patterns into particular ways;
blocking communication between neurons, which results in a loss of consciousness. The loss of
consciousness due to anesthetics is often compared to a reversible comma.

A commonly used anesthetic, called isoflurane (used for animals) weakens the transmission of
neural electrical signals in the synapse; Although this commonly used anesthetic does not block
all the signals, it blocks the high frequency signals that block functions such as movement or
cognition, and it has the lowest effect on lower frequency impulses that control essential
functions for living, such as breathing.
Isoflurane (C3H2ClF5O) reduced the amount of excitatory neurotransmitters released; thus,
making the patient not feel pain.

*Researchers have not been able to explain how isoflurane reduces the amount of vesicles
being released in the synapse.*

How are general anesthetics made?

https://www.youtube.com/watch?v=B_tTymvDWXk

What is it made of?

General anesthetics are mixtures of inhalable gasses such as nitrous oxide N2O (laughing gas)
and various derivatives of isoflurane, sevoflurane and desflurane. Some other anesthesia is made
of propofol and sometimes Fentanyl (C22H28N2O)
2. What are the benefits and dangers (risks) associated with this process? Address the pros
and cons. Long and short term effects?
CONS
- Allergic reaction to the medicines (rare)
● It is estimated that 1 out of 10000 to even 1 out of 20000
people will have and allergic reaction to any anesthesia
- Heart or lung problems.
- Severe agitation that requires additional medicine.
- Inhaling food or liquids from your stomach into your lungs
- Injury to nerves.
- Dental injury (local anesthetic)
- Stroke.
● Generally not high (approximate 0.1–1.9%) in non-cardiac,
non-neurologic, and non-major surgery. It may occur in up
to 10% of patients undergoing high-risk cardiac or brain
surgery
- Awareness during surgery and being unable to move (rare).
● 1 or 2 out of 1000 people experience this feeling
Pros
- Makes it possible to have procedures that would be too painful or
stressful to have while awake.
- Allows your health care provider to control your breathing and
your blood pressure. This can prevent problems during the
procedure.
- Can be given quickly in an emergency.
- Can be reversed quickly when a procedure is over.
- Can be continued for a long period of time.

Side Effects:
- Nausea and vomiting
● This is a very common side effect that can occur within the
first few hours or days after surgery and can be triggered by
a number of factors, such as the medication, motion, and
the type of surgery.
● Higher chances of this side effect can occur if proper
precautions aren't taken properly. (ex. Not allowed to eat or
drink past a certain time before your surgery)
- Sore throat
● The tube that is placed in your throat to help you breathe
while you’re unconscious can leave you with a sore throat
after it’s removed.
- Cognitive dysfunction
● Confusion when regaining consciousness after surgery is
common, but for some people, (older patients) the
confusion can come and go for about a week.
- Muscle aches
 ● The medications used to relax your muscles so a breathing
tube can be inserted can cause soreness.
- Chills and shivering (hypothermia) (mild case)
● This occurs in up to half of patients as they regain
consciousness after surgery

3. Propose ways to lessen the harmfulness of the substance(s) or this process.

- Follow proper instructions (pre operation and post operation)
- Speak with an anesthesiologist beforehand to talk about your medical history.
This will help you take more precautions to prevent any detrimental illnesses and
severe side effects

4. Identify alternative substances or processes that could be used for the same purpose

5. What are the STSE connections of your subject? (*STSE = Science, Technology, Society
and the Environment)
Science - Chemical labs and research

Technology - The technology that goes into anesthetics (Modern day anaesthesiology is
dependent on lots of technology. “Certain chips are inserted into the nerves which can then be
stimulated and monitored to deliver the anesthetic, thus reducing the neuropathic pain in these
patients.”
- Perioperative, Ultrasound is used to see the anesthesia being delivered into lines
- Softwares, AI, and robotic systems help predict any complications with anesthesia before
surgery.
- These technologies can’t replace anaesthesiologists, but rather are used as support and
typically have to be handled manually
- Robots are used to help precisely deliver the anesthetic
- Non-invasive monitoring that uses patches to monitor your body
- “The EEG and saturation machines will give a real-time status which informs the
anesthesiologist on how much anesthesia should be administered.”
-

Society - Economy, helps save lives

Environment -

6. What are the connections between your topic and two of the units studied in class?

_ Solutions and Concentrations

- Chemical bonding (polarity)

Solutions: https://aneskey.com/pharmacokinetics-of-inhalation-anesthetics/
The blood/gas solubility coefficient of an anesthetic is an indicator of the speed of uptake and
elimination.

MAC: Minimum alveolar concentration.

Alveoli; Air sacs at the end of bronchioles where air gas exchange takes place.

-The solubility of isoflurane along with other drugs is related to the blood and gas coefficients.
Low solubility drugs such as nitrous gas and desflurane achieve a much faster lung concentration
than those with a higher solubility; therefore, achieving a faster anesthetic effect on the patient.

Fa/f1= alveolar concentration

after inhalation.
The partition coefficient (P) is defined as the ratio of the equilibrium concentrations of a
dissolved substance in a two-phase system consisting of two largely immiscible solvents.

The lower gas/blood solubility, the faster the rise in lung and blood concentrations.
- Chemical bonds (intermolecular and intramolecular)

7. Include 1 discussion question for the class

8. Include a hands-on activity for the class that connects with your topic

References
Anesthesia. (2022, July 21). National Institute of General Medical Sciences. Retrieved January 3,

2023, from https://www.nigms.nih.gov/education/fact-sheets/Pages/anesthesia.aspx

How does anesthesia work? (2005, February 7). Scientific American. Retrieved January 3, 2023,

from https://www.scientificamerican.com/article/how-does-anesthesia-work/

Medical Milestones: Discovery of Anesthesia & Timeline. (2015, November 11). Scott Harrah.

Retrieved January, 3, 2023

https://www.umhs-sk.org/blog/medical-milestones-discovery-anesthesia-timeline

Risks and Benefits of General Anesthesia. (2022). Baptisthealth.net. Retrieved January, 3, 2023

https://baptisthealth.net/patient-resources/preparing-for-surgery/planning-for-procedure-o

r-surgery/risks-and-benefits-of-general-anesthesia

Can You Be Allergic to an Anesthetic? (May 23, 2022). Kelly Elterman, Sophie Vergnaud.

Retrieved January, 4, 2023,

https://www.goodrx.com/conditions/anesthesia/allergic-to-anesthesia

https://hms.harvard.edu/news-events/publications-archive/brain/anesthesia-brain#:~:text=patients

%20waken%20quickly.-,Anesthetic%20drugs%20cause%20brain%20circuits%20to%20c

hange%20their%20oscillation%20patterns,%E2%80%9D%E2%80%94that%20differs%2

0from%20sleep.
Awareness Under General Anesthesia (January 11, 2011). Petra Bischoff, Ingrid Rundshagen.

Retrieved January 4, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3026393/

Perioperative stroke: pathophysiology and management (February 1, 2018). Sang-Bae Ko.

Retrieved January 4, 2023.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5809704/#:~:text=Its%20incidence%20i

s%20generally%20not,operatively%20after%20recovery%20from%20anesthesia.

https://neurosciencenews.com/general-anesthesia-mechanism-16259/

National Center for Biotechnology Information (2023). PubChem. Retrieved January 7, 2023

from https://pubchem.ncbi.nlm.nih.gov/compound/Propofol.

DIPRIVAN® (propofol) injectable emulsion, USP (April 2017). Retrieved January 7, 2023 from

https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/019627s066lbl.pdf

https://patents.google.com/patent/US5416244A/en

https://www.cdc.gov/niosh/topics/healthcarehsps/gases.html#:~:text=One%20of%20the%20prin

cipal%20goals,produce%20surgical%20levels%20of%20anesthesia.

https://pubmed.ncbi.nlm.nih.gov/11420572/

Effects of Anesthesia, American Society Of Anesthesiologists Retrieved January 14, 2023 from

https://www.asahq.org/madeforthismoment/anesthesia-101/effects-of-anesthesia/
he production of isoflurane requires several steps. First 2-2-2-trifluoroethyl difluoromethyl ether (CF3 --CH2 --O--CF2

H) is chlorinated with chlorine gas.

The no unpurified mixture reaction will produce the following impurities: CF3 --CCl2 --O--CF2 H, CF3 --CH2 --O--CF2 Cl

and CF3 --CHCl--O--CF2 Cl. In order to prevent these impurities to exceed the acceptable levels, i.e 10% by

weight, only 60% of the starting material (2-2-2-trifluoroethyl difluoromethyl) has to be consumed.

*Continued chlorination will produce excessive amounts of the by-product (1-1-1-2-2-2-trifluoroethyl

difluoromethyl ).