Figure 255

The effect of two concentrations of N2O on the alveolar tension of anesthetic with time.

blockade provided by the halogenated hydrocarbons is incomplete, neuromuscular blocking agents, such as suc-cinylcholine or the curariform drugs, must be used to provide paralysis adequate for surgical access. Fourth, the anesthetic plan is also designed to minimize any undesirable cardiovascular and respiratory responses to these drugs. This includes using drug combinations that minimize the dose of the halogenated hydrocarbon. For example, N2O 25 to 40%, which by itself produces minimal cardiovascular depression, is frequently used with about half of the MAC of a particular halogenated hydrocarbon; this tends to preserve cardiovascular stability. Since MACs are additive, unconsciousness is adequate when a combination of inhalational agents is used.

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