History

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History

• 1668 Stirius reported the intravenous
  administration of alcohol.
• 1921 Nakagawa conducted experiments with
  laboratory animals to study IV alcohol combined
  with chloroform or diethyl ether for induction of
  anesthesia.
• 1929 Marin presented first comprehensive study
  use IV alcohol as a general anestetic.
• 1944 Variouse clinical reports concerned with the
  use of IV alcohol.

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Chemistry Physical Properties

• Colorless
• Volatil
• Hydroscopic
• Flamable
• Fluid
• Obtained by the distilation of saccharine liquids
• Freely mix with water and chloroform
• Boils at 780C

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Pharmacokinetics

• When ingested its rapidly absorbed from the GI
  tract.
• Vaporaised absorbed throug the lungs and also
  from subcutaneouse sites if its concentration
  not excesive.
• Complete absorbtionrate 2 6 hours.
• Arterio venouse equlibrium established within 5
  min.
• Total body alcohol saturation occurs within 1
  hour
• Ones absorbed its distributed throughout all
  body tissues.Oxidation begins immediately upon
  absorbtion and continues as long as alcohol
  remains in the body.

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Pharmacodynamics

• CNS more markedly affected than any other system
• Initial stimulatory action
• Primary and continouse CNS depression
• Slowing brain activity (similar as hypoxia and
  hypoglycemia)
• Does not increase mental or physical abilities

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Cardiovascular System

• Exerts only montor effects on the circulation
• BP and CO remain unchanged
• Generalized vasodilatation (especialy affects the
  cutaneous vessels)
• Heat loss

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Clinical Aplications
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Intravenouse Analgesia

• Was studied in control of somatic pain
• 0.9 saline infusion or 1.5 ml/kg body weight of
  absolute alcohol in 10 solution (v/v) in saline
  per 1 hour.
• 0.75ml/kg has same effect as the 0.2 mg/kg of
  morphine with same volume and infusion rate.

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Intravenouse Anesthesia

• Original method of Martin
• 25 alcohol solution at rate of 20 40 ml/min,to
  reach a total dose of 2 to 3 ml/kg within 20 to
  25 min.
• A total dose 2.5 ml/kg induce alcohol coma
• Schenlle Infusion of 300ml of 5 alcohol was
  recommended to produce a blood concentration of
  2.5 to 3.0 ml/kg after Thiopental 50 mg
  itravenously
• An 8 w/v alcohol solution diluting 55 ml of
  absolute alcohol (44mg) in 400 ml of Ringer
  Lactate solution rapidly infused in 4 to 5 min to
  total administered dose of 550 ml, if required

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SideEffects and Complications

• Occasional failure to induce sleep with the rapid
  infusion (small amounts of Barbiturate)
• Hangoverassociated with headaches,nausea,vomitin
  g,thirst
• (chlordiazepoxide should be given)
• Pain during within the rapid infusion of 8w/v
  alcohol solution.(usually subsides within 1 min)
• Erythrocytic lysis may occur (Hartmanns solution
  will prevent this)

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