Scientific Foundations of

Anesthesia Practice I

Presented By
Dr. Sey-Sawo
Part-time Lecturer

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 Molecular Theory
• All substances are composed of atoms or
compounds of atoms = molecules.
• Three forms of matter are solids, liquids and
gases.

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 Solids
• The atoms or molecules are
usually arranged in a regular
formation called a lattice.
• Each molecule in the lattice
exerts forces on its neighbors

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 and is continuously in motion, oscillating around a mean
position.

Solids
• If heat is added to a solid, each molecule
vibrates with a greater amplitude and
therefore takes up a greater amount of
space.

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• The molecules move further apart, and
consequently, force exerted on its neighbor is
reduced.
Liquids
• Eventually the forces are not
sufficient to hold the molecules
together in a lattice, although
small groupings remain.
• The lattice breaks down; the
substance melts and turns into a
liquid.

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 Liquids
• In a liquid, the molecules still exert some
influence on each other and the weak forces
of attraction between them are the van der
Waals forces.
• The molecules in a liquid have more
vibrational energy than in a solid and each
molecule can move about through the liquid.

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 Gases
• If heat is added to a liquid,
each molecule gains
further kinetic energy and
eventually some are able to
overcome van der Waals
forces exerted by their
neighbors and are able to
move about in space. This
state is that of a gas or
vapor.

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 Gases
• Gas molecules come
from the surface of the
liquid where the bonds
are weakest (A).
• Gas molecules may also
transfer into the liquid
(B).

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 Gases
• When liquid is inside a
closed container,
molecules of liquid
break away and enter
the space above it to
form a vapor.

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 Saturated Vapor Pressure
• At a constant temperature,
the number of molecules
entering and existing the
liquid space remains constant
(equilibrium state).
• The vapor molecules
bombard the walls of the
container, creating a pressure
called the saturated vapor
pressure.

Volatile Agents
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• Volatile anesthetic agents are
liquids that have an inherent
tendency to change to a vapor at
standard temperature and
pressure.

Volatility and
Vapor Pressure
• The higher the volatility of an
agent, the stronger its tendency to enter the
vapor phase.
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• Increased volatility corresponds to a higher
vapor pressure.
Vapor Pressures of Anesthetics at
o
20 C
• Sevoflurane 170 mmHg
• Enflurane 175 mmHg
• Isoflurane 239 mmHg
• Halothane 243 mmHg
• Desflurane 669 mmHg
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 Vapor Pressure
• Vapor pressure is independent of
atmospheric pressure. It is a function of
temperature:
• Heat increases vapor pressure; more molecules
enter the gas phase than the liquid phase.
• Cooling decreases vapor pressure; more
molecules enter the liquid phase than the gas
phase.

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 Vapor Pressure
• Passing a carrier gas
(N2O/O2/Air) over the
liquid shifts the
equilibrium toward the
vapor phase.

Pressure
• Pressure is a force per unit
area.
• For gases it is the force
exerted by atoms and
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 molecules when they collide with each other within a
certain area or with the walls of a closed container.

Units of Pressure
• 1 mm Hg = 1.36 cm H2O
• 1 atmosphere = 760 mm Hg = 14.7 psi
• 1 psi = 54 mm Hg
• ATMOSPHERIC PRESSURE of gases at sea level
is 760 mm Hg or 1034 cm H2O.

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• NB: pounds per square inch
Pressure
• Gases for anesthesia may be compressed in a
close container. The sum of molecular forces
exerted by the gas is called the cylinder
pressure.
• A full E-cylinder tank of oxygen (O2) measures
approximately 2200 psi.

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• A full tank of nitrous oxide (N2O) measures
approximately 745 psi.

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 Bourdon Gauges
• Measures cylinder or
pipeline pressures of
anesthetic gases.
• Based on an aneroid type
of measurement (without
mercury).

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 Bourdon Gauges
• Measure the pressure
relative to atmospheric
pressure not absolute
pressure.
• When the gauge
pressure is zero, the
pressure in the cylinder is
the same as atmospheric.

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 Bourdon Gauge
• American Society for Testing and Measuring
(ASTM) sets standards for Bourdon gauges:
• 38-mm diameter;
• Lowest pressure between 6 and 9 o’clock position;
• Name and color of the gas marked on the gauge.

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 Volume
• Volume is the space occupied by an aggregate or
collection of atoms and molecules.
• Volume for gases is measured in milliliters (mL) and
liters (L).

Ideal Gas Laws

• Boyle’s Law:
pressure and
volume.
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• Charles’s Law: volume and temperature.
• Gay-Lussac’s Law: pressure and temperature.

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 Boyle’s Law
• Describes the relationship
of pressure and volume of
gases at a given
temperature.
• At any given temperature,
the volume varies
inversely with the
pressure. If the volume of
a gas is halved, the
pressure is doubled.

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 Boyle’s Law:
Clinical Application
• If a pressurized cylinder of gas is opened and slowly
emptied so that temperature remains constant, the
volume of gas released can be estimated from
Boyle’s law.
• A full E cylinder of O2 (a small volume of gas under
high pressure) will release into the atmosphere
more than 600 liters (a large volume at low
pressure).

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 Boyle’s Law

P 1 V1 = P2 V2
• An O2 E cylinder contains ~ 4.5L at 2200 psi
when it is sealed. If you open the cylinder to 1
atm (760 mmHg), the volume will expand to
673 mL.
• 2200 psi x 4.5 L = 14.7 psi x ? L

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 Boyle’s Law:
• x = 673 L
Clinical Application
• Squeezing the bag on a
bag mask resuscitation
device increases the
pressure and reduces
the volume.

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 Boyle’s Law:
Clinical Application
• During inspiration when
breathing spontaneously,
intrapulmonary pressure falls
and volume increases.
• During expiration,
intrapulmonary pressure
increases and volume
decreases.

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 Boyle’s Law:
Clinical Application

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 Charles’s Gas Law
• The volume of any gas is
directly proportional to
the absolute temperature
(Kelvin = 273 + oC) at a
constant pressure.
• When temperature
increases, the volume
of a gas increases.

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 Charles’s Law
• If you take a helium
balloon outside on a
cold day, it will appear
to deflate and become
soft.
• If you bring it back
inside if will become
firm again.

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 Charles’s Law:
Clinical Applications
• The inflatable cuff on an
endotracheal tube and
laryngeal mask airway (LMA)
expands when placed into an
autoclave for sterilization.

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 Charles’s Gas Law

V1/T1 = V2/T2
• At 15oC, a gas occupies a volume of 273 mL. At
30oC, what volume will that gas occupy?
273 mL/15oC = x/30oC
x = 546 mL

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 Gay-Lussac’s Gas Law
• The pressure of a gas varies
directly with the absolute
temperature when the
volume is kept constant.
• When the temperature of
gas in a container at a
constant volume increases,
pressure increases.
• When the pressure of gas in
a container at a constant volume decreases, pressure
decreases.

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 Gay-Lussac’s Gas Law
• This law shows that
gases expand when
heated and so become
less dense.
• It means that warm air
tends to rise and this
causes convection
currents.

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 Gay-Lussac’s Gas Law

P1/T1 = P2/T2
• A full cylinder of oxygen is placed on an
anesthetic gas machine at room temperature
(20oC). The room is accidentally heated to
40oC. What is the gauge pressure of oxygen at
40oC?

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 2200 psi/20oC = x/40oC
x = 4400 psi

Gay-Lussac’s Law:
Clinical Applications
• This law is true of all gases but especially
gases stored in the gaseous form (O2).
• Gases stored in liquid form (N2O) will also
decrease and increase in proportion to

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 temperature but not in the same manner as
described by Gay-Lussac.
Joule-Thompson Effect
• Whenever matter changes phase, an increase
or decrease in the surrounding temperature
occurs depending on whether it is becoming
more solid or gaseous.
• As a liquid vaporizes heat is lost. This is the
latent heat of vaporization.
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 Joule-Thompson Effect:
Clinical Application
• As gas escapes from a N2O cylinder, the liquid
N2O vaporizes and heat is lost (latent heat of
vaporization).
• The result is that the temperature of the
cylinder falls. This is the Joule-Thompson
effect.
Gay-Lussac’s Law:
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 Clinical Applications
• In addition, as the temperature of the
constant-volume cylinder falls
(JouleThompson effect), the pressure of the
gas in the cylinder also decreases (Gay-
Lussac).
Adiabatic Changes in a Gas
• The three ideal gas laws describe the behavior of a
gas when one of the three variables – pressure,

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 temperature or volume – is constant. For these
conditions to apply, heat energy is required to be
added or taken from a gas as the change occurs.
• The state of a gas can also be altered without
allowing the gas to exchange heat energy with its
surroundings. This is an adiabatic change. (An adiabatic
process is one in which no heat is gained or lost by the system)

Adiabatic Processes
• If a cylinder of a compressed gas is opened in a close space
(pipes of the anesthesia machine), the pressure in the
closed space will rise rapidly, and as a result, so will the
temperature, possible to levels that could cause ignition.
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• Because the change occurs so rapidly, the heat cannot be
dissipated (adiabatic).
• Temperature rises because the total amount of heat is
unchanged; there is insufficient time for the heat to be
dissipated. Adiabatic explosion is possible.

Ideal (Universal) Gas Law

• Based on Avogadro’s hypothesis which states an equal
volume of gases under the
same conditions of
temperature and pressure
contain the same number of
molecules.

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 Ideal Gas Law
PV = nRT
• P = pressure
• V = volume
• n = number of moles
• R = universal gas constant (62.4)
• T = temperature in Kelvin

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• A mole is defined as an
amount of a substance in a
system which contains as
many elemental entities of
that system (atoms, molecules,
etc) as there are in 12 g of
Carbon 12.

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 Mole (Unit)
Avogadro’s Number
• One mole of a substance contains 6.022 x 1023
molecules.
• One mole of iron has as many molecules as one
mole of gold.
• One mole of benzene has as many molecules as one
mole of water.

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• One mole of oxygen has as many molecules as one
mole of nitrous oxide.
• What is the quantity of one mole?
• It is the molecular weight of a substance in
grams.
O2 = 32 gm
N2O = 44 gm

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 Mole (Unit)
Calculating Molecular Weight
• O2: Each oxygen atom has an atomic weight of
16; there are two atoms in an oxygen
molecule. An oxygen molecule (O2) = 2 x 16 =
32 gm.

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• N2O = One nitrogen atom has an atomic
weight of 14; 2 x 14 (N2) + 16 (O) = 44 gm.
• 1 mole = 32 gm O2
• 1 mole = 44 gm N2O
• 32 gm O2 = 6.022 x 1023 molecules
23
• 44 gm N2O = 6.022 x 10 molecules

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 Mole (Unit)
Ideal Gas Law
• Avogadro also stated that at a standard
temperature and pressure (0oC and 760 mm
Hg) that one mole of a gas will occupy a
volume of 22.414 liters.

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 Ideal Gas Law:
Clinical Application
• As a cylinder of compressed gas empties, the
pressure in the cylinder falls, because the
amount (number of moles = n) in the tank is
decreasing.
↓PV = ↓nRT
• Volume of a cylinder is constant.

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 Van de Waal’s Relationship
• Explains reality-based deviations from the ideal assumptions
of PV = nRT.
• Ideal molecular gases are assumed to occupy infinitely
smaller volumes and neither attract nor repel each other.
• Real gases do not behave ideally:
(P + n2a/V2)(V-nb) = nRT
• a = a measure of the attraction between particles; b = the
average volume excluded from V by a particle.

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 Van de Waal Forces
• Occur when molecules
interact strongly with
each other electrically.
• Refers generally to
attractive or repulsive
forces between
molecules other than
due to covalent bonds.

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 Questions?

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