Pharmacological action

The agent for inhalation general anesthesia has an analgesic and muscle relaxant effect and has a wide range of therapeutic effects. General anesthesia when using ether is relatively safe and easily manageable. Skeletal muscles relax well. It has a direct negative inotropic effect (a decrease in myocardial contractility is compensated by an increase in the concentration of catecholamines in the blood). Causes a temporary (up to 24 hours) decrease in liver and kidney function, reduces intestinal motility (stimulation of the sympathoadrenal system), reduces blood volume and plasma (by about 10%). Unlike fluorothane, trichlorethylene and cyclopropane, ether does not increase the sensitivity of the myocardium to epinephrine and norepinephrine.

The period of induction of anesthesia is long (12-20 minutes). Awakening occurs 20-40 minutes after stopping the supply of ether, and the complete depression of consciousness disappears after a few hours.

Pharmacokinetics

When administered by inhalation, the ether is absorbed into the blood and penetrates the brain. The relatively low solubility of ester in the blood causes a gradual increase in its concentration in the alveoli in the initial stage of anesthesia and a gradual decrease when its entry into the body ceases. Almost all of the ether is excreted unchanged from the body through the respiratory tract (a small part is excreted by the kidneys). The smell of ether in the exhaled air can persist for more than 24 hours.

Application

Indications

Inhalation general anesthesia using open (drip), semi-open, semi-closed and closed systems (mainly for short-term surgical interventions).

Maintaining general anesthesia during combined general anesthesia with the use of psychoactive drugs and peripheral muscle relaxants.

Contraindications

Hypersensitivity, acute respiratory diseases, intracranial hypertension, arterial hypertension; CHF, liver and/or renal failure, cachexia, diabetes mellitus, acidosis.

The need for electrocoagulation or the use of an electric knife during surgery.

Side effect

Cough, psychomotor agitation, increased blood pressure, tachycardia, hypersecretion of the bronchial glands; nausea and vomiting.

In the postoperative period - vomiting, depression of the respiratory center; bronchopneumonia, bronchitis, laryngitis, tracheitis, pulmonary edema (toxic origin), intestinal paresis, decreased bile secretion, metabolic acidosis, decreased glomerular filtration and diuresis.

Dosage regimen

With a semi-open system: 2-4 vol.% of ether in the inhaled mixture supports analgesia and loss of consciousness, 5-8% - superficial general anesthesia, 10-12% - deep general anesthesia. Concentrations of up to 20-25% may be required to euthanize a patient.

Overdose

Symptoms: in case of acute inhalation intoxication - headache, nausea, lower back pain, agitation, inappropriate behavior; then - asthenia, drowsiness, loss of consciousness. Breathing is rare and shallow, cyanosis, acrocyanosis, tachycardia, threadlike pulse, severe mydriasis, decreased blood pressure, cardiac arrest.

In case of chronic intoxication - loss of appetite, nausea (rarely vomiting), constipation, apathy, pale skin, headache, dizziness, ethanol intolerance.

Treatment. Immediately stop the supply of ether and remove the victim from the area of ​​exposure to the toxic compound to fresh air or a well-ventilated area. Inhalations of moistened oxygen, alkaline oil inhalations, for persistent cough - ethylmorphine, codeine. 20-30 ml of a 40% dextrose solution with 5 ml of a 5% ascorbic acid solution, analeptics, and, if necessary, sedative drugs are administered intravenously. In case of respiratory depression - mechanical ventilation (the possibility of developing toxic pulmonary edema must be taken into account), in case of cardiac arrest - indirect cardiac massage.

If ether accidentally enters the gastrointestinal tract, induce vomiting, rinse the stomach (8-10 liters of water or 2% sodium bicarbonate solution), give finely crushed activated carbon (2-3 tablespoons) to drink, then induce repeated vomiting, and after 10- Give a saline laxative for 15 minutes. In the future - symptomatic treatment.

Interaction

Enhances the effect of non-depolarizing muscle relaxants, anxiolytics, antipsychotic, sedative and hypnotic drugs.

The minimum alveolar concentration decreases with simultaneous use of dinitrogen oxide.

Special instructions

Anesthesia ether should only be used by personnel trained to administer general anesthesia.

Inhalation ether general anesthesia should not be performed deeper than level III (1-2) of the surgical stage.

When high concentrations of ether (10-25%) are given during induction of general anesthesia, irritation of the mucous membranes of the respiratory tract, laryngospasm and salivation may occur due to the irritating effect (at present, induction of ether anesthesia is rarely used).

To reduce the evoked reflex reactions and reduce hypersecretion, atropine is pre-administered.

Ether vapors are highly flammable; with oxygen, air, dinitrogen oxide form explosive mixtures in certain concentrations.

The maximum permissible concentration of ether vapor in the air of the working area is 300 mg/cub.m.

When performing general ether anesthesia in a closed system, measures must be taken to prevent the possibility of explosion.

In order to reduce agitation, ether general anesthesia is often used after induction of anesthesia with barbiturates. Sometimes induction of anesthesia is started with dinitrogen oxide, and ether is used to maintain general anesthesia.

The use of muscle relaxants makes it possible to enhance muscle relaxation and significantly reduce the amount of ether required for anesthesia - up to 2-4 vol.% (to maintain general anesthesia with a semi-open system).

The muscle relaxant effect of ester is not eliminated by anticholinesterase drugs.

For general anesthesia, ether can be used only from bottles opened immediately before surgery (when exposed to light, air, elevated temperature and moisture, harmful products are formed in the ether - peroxides, aldehydes, ketones, which cause severe irritation of the respiratory tract).

Frequent inhalation of ether vapors causes drug dependence.

Release forms

One of the types of ether for anesthesia is stabilized ether (lat. Aether pro narcosi stabilisatum ). Adding a stabilizer (antioxidant) extends the shelf life of the drug. Available in hermetically sealed orange glass bottles of 100 and 150 ml with metal foil placed under the stopper. After every 6 months of storage, ether for anesthesia is checked for compliance with the requirements of the State Pharmacopoeia.

In addition to ether for anesthesia, medical ether is also produced (lat. Aether medicinalis). This drug is less purified than the previous one and is unsuitable for anesthesia. Used topically in dental practice, externally (for rubbing), as well as for preparing tinctures and extracts. Sometimes prescribed orally for vomiting. Higher doses for adults orally: single dose - 0.33 ml (20 drops), daily - 1 ml (60 drops).

Storage

List B. Store in a cool, dark place, away from sources of fire.

Notes

Diethyl ether(ethyl ether, sulfuric ether). In terms of chemical properties, it is a typical aliphatic ether. Widely used as a solvent. First obtained in the Middle Ages.

Story

It is possible that diethyl ether was first obtained in the 9th century by the alchemist Jabir ibn Hayyan or the alchemist Raymond Lull in 1275. It is reliably known that it was synthesized in 1540 by Valerius Cordus, who called it “sweet oil of vitriol” (lat. oleum dulce vitrioli), since it was obtained by distilling a mixture of ethyl alcohol and sulfuric acid, which was then called “oil of vitriol.” Cordus also noted its anesthetic properties.

The name "ether" was given to this substance in 1729 Frobenius .

Synthesis

It is obtained by the action of acid catalysts on ethyl alcohol when heated, for example by distilling a mixture of ethyl alcohol and sulfuric acid at a temperature of about 140-150 °C. It is also obtained as a by-product in the production of ethyl alcohol by hydration of ethylene in the presence of phosphoric acid or 96-98% sulfuric acid at 65-75 ° C and a pressure of 2.5 MPa. The main part of diethyl ether is formed at the stage of hydrolysis of ethyl sulfates (95-100 °C, 0.2 MPa)

Properties

  • Colorless, transparent, very mobile, volatile liquid with a peculiar odor and pungent taste.
  • Solubility in water 6.5% at 20 °C. Forms an azeotropic mixture with water (bp 34.15 °C; 98.74% diethyl ether). Mixes with ethanol, benzene, essential and fatty oils in all proportions.
  • Highly flammable, including vapors; In a certain ratio with oxygen or air, ether vapors for anesthesia are explosive.
  • Decomposes when exposed to light, heat, air and moisture to form toxic aldehydes, peroxides and ketones, which are irritating to the respiratory tract.
  • The resulting peroxides are unstable and explosive; they can cause spontaneous ignition of diethyl ether during storage and explosion during its distillation to dryness.

In terms of chemical properties, diethyl ether has all the properties characteristic of ethers, for example, it forms unstable oxonium salts with strong acids:

\mathsf((C_2H_5)_2O + HBr \rightarrow [(C_2H_5)_2OH]^+Br^-)

Forms relatively stable complex compounds with Lewis acids: (C 2 H 5) 2 O BF 3

Application

Pharmacology

In medicine it is used as a general anesthetic drug, since its effect on neuronal membranes and the ability to “immobilize” the central nervous system is very specific and completely reversible. It is used in surgical practice for inhalation anesthesia, and in dental practice - topically, for the treatment of carious cavities and root canals of the tooth in preparation for filling.

Due to the slow decomposition of diethyl ether, the established storage periods must be strictly adhered to. For anesthesia, ether can only be used from bottles opened immediately before surgery. After every 6 months of storage, ether for anesthesia is checked for compliance with the requirements. The use of technical ether for these purposes is not permitted.

Technique

  • It is used as a solvent for cellulose nitrates in the production of smokeless powder, natural and synthetic resins, and alkaloids.
  • It is used as an extractant for the separation of plutonium and its fission products during the production and processing of nuclear fuel, and for the separation of uranium from ores.
  • It is used as a fuel component in model aircraft compression engines.
  • When starting gasoline internal combustion engines in harsh winter conditions.

In the USSR, Arctic starting fluid was produced; a small amount was poured into the intake manifold through the carburetor with the air filter removed. For the army, ether was produced in a sealed aluminum casing; before use, the casing was pierced with a bayonet or screwdriver. Abroad, “starting fluid on cold days” is produced in an aerosol can. Ingredients: diethyl ether, industrial oil, propellant.

The engine starting mechanism in this case is mostly diesel: the mixture of ether and air is ignited by compression already at a compression ratio of about 5-6; Engines that have lost compression for various reasons can make several revolutions on ether, but nevertheless do not work on gasoline.

Write a review about the article "Diethyl ether"

Notes

Literature

  • Babayan E. A., Gaevsky A. V., Bardin E. V. “Legal aspects of the circulation of narcotic, psychotropic, potent, toxic substances and precursors” M.: MCFR, 2000 p. 148
  • Gurvich Ya. A. “Handbook of a young apparatchik-chemist” M.: Chemistry, 1991 p. 229
  • Devyatkin V.V., Lyakhova Yu.M. “Chemistry for the curious, or what you won’t learn about in class” Yaroslavl: Academy Holding, 2000 p. 48
  • Rabinovich V. A., Khavin Z. Ya. “A short chemical reference book” L.: Chemistry, 1977 p. 148
  • Hauptmann 3., Organic chemistry, trans. from German, M.: Khimiya, 1979, p. 332-40;
  • Graefe Yu., General organic chemistry, trans. from English, vol. 2, M., 1982, p. 289-353;
  • Remane X., Kirk-Othmer encyclopedia, v. 9, N.Y., 1980, p. 381-92.

Diethyl alcohol structural formula. Diethyl ether (ethyl ether, ethoxyethane, sulfuric ether)

34.6 °C
T. dec. 193.4 °C
Classification
Reg. CAS number 60-29-7
SMILES
Data are based on standard conditions (25 °C, 100 kPa) unless otherwise stated.

Excerpt characterizing Diethyl Ether

Five minutes later, Denisov entered the booth, climbed onto the bed with dirty feet, angrily smoked a pipe, scattered all his things, put on a whip and a saber and began to leave the dugout. To Rostov’s question, where? he answered angrily and vaguely that there was a matter.
- God and the great sovereign judge me there! - Denisov said, leaving; and Rostov heard the feet of several horses splashing in the mud behind the booth. Rostov didn’t even bother to find out where Denisov went. Having warmed himself up in his coal, he fell asleep and just left the booth in the evening. Denisov has not returned yet. The evening cleared up; Near the neighboring dugout, two officers and a cadet were playing piles, laughingly planting radishes in the loose, dirty soil. Rostov joined them. In the middle of the game, the officers saw carts approaching them: about 15 hussars on thin horses followed them. The carts, escorted by the hussars, drove up to the hitching posts, and a crowd of hussars surrounded them.
“Well, Denisov kept grieving,” said Rostov, “and now the provisions have arrived.”
- And then! - said the officers. - Those are very welcome soldiers! “Denisov rode a little behind the hussars, accompanied by two infantry officers with whom he was talking about something. Rostov went to meet him halfway.
“I’m warning you, captain,” said one of the officers, thin, small in stature and apparently embittered.
“After all, I said that I wouldn’t give it back,” Denisov answered.
- You will answer, captain, this is a riot - take away the transports from your own! We didn't eat for two days.
“But mine didn’t eat for two weeks,” answered Denisov.
- This is robbery, answer me, my dear sir! – the infantry officer repeated, raising his voice.
- Why are you pestering me? A? - Denisov shouted, suddenly getting excited, - I will answer, not you, and you don’t buzz around here while you’re still alive. March! – he shouted at the officers.
- Good! - without timidity and without moving away, the little officer shouted, - to rob, so I tell you...
“To chog” that march at a fast pace, while he’s still intact.” And Denisov turned his horse towards the officer.
“Okay, okay,” the officer said with a threat, and, turning his horse, he rode away at a trot, shaking in the saddle.
“A dog is in trouble, a living dog is in trouble,” Denisov said after him - the highest mockery of a cavalryman at a mounted infantryman, and, approaching Rostov, he burst out laughing.
– He recaptured the infantry, recaptured the transport by force! - he said. - Well, shouldn’t people die of hunger?
The carts that approached the hussars were assigned to an infantry regiment, but, having been informed through Lavrushka that this transport was coming alone, Denisov and the hussars repulsed it by force. The soldiers were given plenty of crackers, even shared with other squadrons.
The next day, the regimental commander called Denisov to him and told him, covering his eyes with open fingers: “I look at it like this, I don’t know anything and I won’t start anything; but I advise you to go to headquarters and there, in the provisions department, settle this matter, and, if possible, sign that you received so much food; otherwise, the demand is written down on the infantry regiment: the matter will arise and may end badly.”
Denisov went straight from the regimental commander to headquarters, with a sincere desire to carry out his advice. In the evening he returned to his dugout in a position in which Rostov had never seen his friend before. Denisov could not speak and was choking. When Rostov asked him what was wrong with him, he only uttered incomprehensible curses and threats in a hoarse and weak voice...
Frightened by Denisov's situation, Rostov asked him to undress, drink water and sent for a doctor.
- To judge me for crime - oh! Give me some more water - let them judge, but I will, I will always beat the scoundrels, and I will tell the sovereign. Give me some ice,” he said.
The regimental doctor who came said that it was necessary to bleed. A deep plate of black blood came out of Denisov’s shaggy hand, and only then was he able to tell everything that happened to him.
“I’m coming,” Denisov said. - “Well, where is your boss here?” Shown. Would you like to wait? “I have work, I came 30 miles away, I don’t have time to wait, report.” Okay, this chief thief comes out: he also decided to teach me: This is robbery! - “Robbery, I say, is committed not by the one who takes provisions to feed his soldiers, but by the one who takes it to put it in his pocket!” So would you like to remain silent? "Fine". Sign, he says, with the commission agent, and your case will be handed over to the command. I come to the commission agent. I enter - at the table... Who?! No, just think!...Who is starving us, - Denisov shouted, hitting the table with the fist of his sore hand, so hard that the table almost fell and the glasses jumped on it, - Telyanin! “What, are you starving us?!” Once, once in the face, deftly it was necessary... “Ah... with this and that and... began to roll. But I was amused, I can say,” Denisov shouted, baring his white teeth joyfully and angrily from under his black mustache. “I would have killed him if they hadn’t taken him away.”
“Why are you shouting, calm down,” Rostov said: “here the blood is starting again.” Wait, I need to bandage it. Denisov was bandaged and put to bed. The next day he woke up cheerful and calm. But at noon, the regimental adjutant with a serious and sad face came to the common dugout of Denisov and Rostov and with regret showed a uniform paper to Major Denisov from the regimental commander, in which inquiries were made about yesterday's incident. The adjutant reported that the matter was about to take a very bad turn, that a military court commission had been appointed and that with the real severity regarding the looting and willfulness of the troops, in a happy case, the matter could end in demotion.
The case was presented by those offended in such a way that, after the transport was recaptured, Major Denisov, without any summons, came to the chief of provisions in a drunken state, called him a thief, threatened him with beatings, and when he was taken out, he rushed into the office and beat up two officials and sprained one's arm.
Denisov, in response to Rostov’s new questions, laughingly said that it seemed like someone else had turned up here, but that it was all nonsense, nonsense, that he didn’t even think of being afraid of any courts, and that if these scoundrels dare to bully him, he would answer them so that they will remember.
Denisov spoke disparagingly about this whole matter; but Rostov knew him too well not to notice that in his soul (hiding it from others) he was afraid of the trial and was tormented by this matter, which, obviously, was supposed to have bad consequences. Every day, papers began to arrive, requests to the court, and on the first of May Denisov was ordered to hand over the squadron to his senior man and appear at the division headquarters for explanations in the case of rioting in the provisions commission. On the eve of this day, Platov made reconnaissance of the enemy with two Cossack regiments and two squadrons of hussars. Denisov, as always, rode ahead of the line, flaunting his courage. One of the bullets fired by the French riflemen hit him in the flesh of his upper leg. Maybe at another time Denisov would not have left the regiment with such a light wound, but now he took advantage of this opportunity, refused to report to the division and went to the hospital.

1 liter

Typical aliphatic ether.
Widely used as a solvent.
First obtained in the Middle Ages.

    Chemical formula C₄H₁₀O

    Melting point-116.3 °C

    Boiling point 34.65 °C

Russian name

Diethyl ether

Latin name of the substance Diethyl ether

Aether diaethylicus (genus. Aetheris diaethylici)

Chemical name
1,1-Hydroxy-bis-ethane

Gross formula

Characteristics of the substance Diethyl ether

Ethyl acetate is a typical aliphatic ether.
Molecular weight = 74.1 grams per mole.
The substance is also called: ethyl, sulfuric ether.
This is a colorless liquid, mobile and very transparent, has a specific smell and taste.
The substance is poorly soluble in water and forms an azeotropic mixture with it.
Mixes freely with benzene, fatty oils, ethyl alcohol.
The compound is volatile and flammable, and is explosive when combined with oxygen or air.
The anesthetic drug contains about 96-98% of the substance, the density of the medical ether is 0.715.
The product boils at 35 degrees Celsius.

Structural formula of Diethyl Ether:

CH3-CH2-O-CH2-CH3

The substance has homologues and isomers.
The isomer of Diethyl Ether is: methylpropyl (CH3-CH2-CH2-O-CH3) And methyl isopropyl ethers .
Propionic acid ethyl ester formula: С5Н10О2.
Chemical formula of acetic acid ethyl ester: CH3-COO-CH2-CH3.

The substance decomposes when exposed to heat, air and light, forming toxic aldehydes, ketones and peroxides.
The compound also has all the chemical properties that are characteristic of ethers and forms oxonium salts and complex compounds.

Preparation of Diethyl Ether

The substance can be synthesized by the action of acid catalysts on ethyl alcohol. For example, Diethyl Ether is obtained by distilling sulfuric acid and ethylene at high temperatures (about 140-150 degrees). The compound can also be formed as a by-product in the hydration of ethylene with acetic or sulfuric acid at appropriate pressure and temperature.

  • The product is widely used in medicine;
  • used as a solvent for cellulose nitrates in the production of smokeless vice, synthetic and natural resins, alkaloids;
  • in the production of fuel for aircraft model engines;
  • used for gasoline internal combustion engines at low temperatures;
  • the substance is used in the reprocessing of nuclear fuel as an extractant to separate plutonium and its fission products, uranium from ore, and so on.

Where and how to buy Diethyl Ether?

Buy Diethyl Ether 1 liter, as well as laboratory glassware and reagents wholesale and retail in Moscow
You can in our online store.
We have a fairly wide range of this type of product at affordable prices.
You can also buy from us.
The office and warehouse are located on the same territory, which significantly speeds up the order processing process.

Esters are products of substitution of the hydrogen atom of the hydroxyl group of alcohols or phenols with the carbon radical R: R1-O-R2. Diethyl ether - formula H3C-O-CH3. Esters are characterized by hydrocarbon chain isomerism and metamerism. The first is due to the branching of the hydrocarbon chain. Metamerism is a type of isomerism in which two or more ethers have the same molecular formula, but different molecular structures due to different radicals on both sides of the oxygen “bridge.”

Diethyl ether: preparation

Esters are obtained synthetically (they are not found in nature in a free state). In order to synthesize esters, several methods can be used: using mineral acids, the interaction of alcoholates with halogen alkyls. Dimethyl and methyl ethyl ethers have a gaseous state, the next few representatives are solutions, and the higher ones are solids. Esters are poorly soluble in water, but well in water, and the middle representatives (diethyl ether, propyl and dipropyl ethers) are excellent organic solvents. they vary depending on Diethyl ether mixes well with alcohol, chloroform, benzene, essential oils, and also with fatty oils. If the storage conditions of ether are violated, toxic and explosive compounds - hydroperoxides - are formed in it.

Diethyl ether is used in medicine. It is used for inhalation anesthesia. This type of anesthesia is characterized by a pronounced stage of excitation (cardiac activity increases, vascular tone increases, catecholamine excretion is activated, the concentration of glucose, pyruvic and lactate acids in the blood increases, the secretory and motor functions of the digestive tract are inhibited). You should know that when using this type of ether, anesthesia occurs slowly, and very often you will observe strong agitation and motor activity. In general, anesthesia has a multifaceted effect on the human body (muscle-relaxing, analgesic and narcotic).

The local effect of the ether manifests itself in the form of irritation of nerve endings, as a result of which the patient feels a cooling effect. In this regard, it is sometimes used internally to regulate motor function and subcutaneously to reflexively stimulate breathing and improve blood circulation. When inhaled, ether vapors irritate the respiratory tract, which first causes a reflex inhibition of breathing, after which it activates the secretion of the bronchial glands. For the first time, diethyl ether was used for inhalation anesthesia by the outstanding Russian surgeon N.I. Pirogov, the founder of military field surgery, during the Crimean War (1853-1856).

Diethyl ether is easily absorbed by the mucous membrane of the respiratory tract, but complete anesthesia occurs a little later compared to chloroform. The narcotic effect occurs only when inhaling 5-8% of the mixture of ether vapors, and complete anesthesia occurs within 30 minutes when inhaling 10% of the mixture. The narcotic effect of the drug manifests itself in a concentration of 110 to 150 mg per 100 ml of blood, paralysis of the respiratory center occurs at 200 mg/100 ml of blood. The overall toxicity of the ether is insignificant. Awakening after anesthesia occurs 20-40 minutes after stopping the inhalation of ether, but the body returns to a normal state only after a few hours. The ether is released through the respiratory tract and through the kidneys. Approximately 50% of its total amount is excreted from the body in the first 30-60 minutes after the end of anesthesia. It should be said that some products of diethyl ether hydrolysis can be localized in triglycerides and other lipids for up to several days.

Gross formula

C4H10O

Pharmacological group of the substance Diethyl ether

Nosological classification (ICD-10)

CAS code

60-29-7

Characteristics of the substance Diethyl ether

Colorless, transparent, very mobile, volatile liquid with a peculiar odor and pungent taste. Anesthesia ether contains 96-98% diethyl ether. The density of anesthesia ether is 0.713-0.714, medical ether 0.714 - 0.717, boiling point 34-35 °C and 34-36 °C, respectively. When 1 ml of anesthesia ether is evaporated, 230 ml of steam is formed; the vapor density of the ether for anesthesia is 2.6, the relative molecular weight is 74. It decomposes under the influence of light, heat, air and moisture to form toxic aldehydes, peroxides and ketones that irritate the respiratory tract. Solubility in water 1:12. Mixes with alcohol, benzene, essential and fatty oils in all proportions. Highly flammable, incl. couples; in a certain ratio with oxygen, air and dinitrogen oxide, ether vapors for anesthesia are explosive.

Pharmacology

Pharmacological action- anesthesia.

Non-specifically interacts with neuronal membranes, mainly with bilayer lipid membranes of axons of the brain, medulla oblongata and spinal cord, reversibly changes their ultrastructure and functions. Depresses the central nervous system: blocks synaptic transmission of excitation (mainly afferent impulses), functionally disintegrates cortical-subcortical interactions while maintaining the activity of bulbar centers. Causes clearly defined “classical” stages of anesthesia - analgesia, excitement, surgical anesthesia with 3 levels (superficial, medium, deep) and characteristic signs: lack of consciousness and all types of sensitivity, inhibition of reflex reactions and relaxation of skeletal muscles.

In the case of premedication and against the background of other inhalational or non-inhalational general anesthetics, the classic picture of anesthesia changes significantly. At the analgesic stage, it reduces the functional activity of cortical neurons and causes an amnestic effect. In the stage of excitation, it inhibits the cerebral cortex, turns off subordination mechanisms that control the state of subcortical structures (mainly the midbrain). An increase in the activity of subcortical formations is manifested by psychomotor agitation, variability of breathing, blood pressure, pulse, etc.). This stage is more pronounced in adults than in children, less (or absent) during premedication and basic anesthesia. Irritates mucous membranes, incl. oral cavity, increases the secretion of the salivary glands (hypersalivation). Through the receptor zones of the trigeminal, laryngeal and vagus nerves, it increases bronchial secretion; causes cough, laryngospasm, spasm of the bronchi (changed during deep anesthesia by their expansion), respiratory disorders (reflex stimulation or inhibition, up to apnea) and cardiac activity (tachycardia or bradycardia, cardiac arrest), hypertension. When saliva or mucus saturated with ether enters the stomach, it irritates its mucous membrane, reflexively stimulates the vomiting center, causing nausea and vomiting (in the beginning of anesthesia and upon awakening).

During the stage of surgical anesthesia, it significantly inhibits interneuronal transmission in the brain and spinal cord. Increases the activity of parts of the hypothalamus that regulate the functions of the pituitary-adrenal cortex system and the sympathetic nervous system, increases the secretion of glucocorticoids and catecholamines. Increases the release of adrenaline from the adrenal medulla, causes hyperglycemia, vasospasm of internal organs, increases blood pressure, heart rate and heart rate (does not sensitize the myocardium to catecholamines). Activation of the sympathetic nervous system neutralizes the inhibitory effect on vascular tone, blood pressure and cardiac function. Increases capillary bleeding, inhibits intestinal motility (at the beginning of anesthesia). Relaxes skeletal muscles, because disrupts the central regulation of muscle tone and blocks the propagation of local potential on the postsynaptic membrane of skeletal muscle.

In high concentrations, it directly inhibits the respiratory and vasomotor centers (impaired pulmonary ventilation, hypotension) and has a direct cardiodepressive effect. Causes cooling of the lung tissue, which, in combination with the accumulation of mucus in the bronchi (due to the irritating effect), contributes to the development of pneumonia, more often in young children. Disturbs metabolism (loss of glycogen reserves, fatty infiltration), and liver function, incl. detoxification. Induces microsomal enzymes of the cytochrome P450 system. Inhibits renal function and reduces diuresis due to the release of antidiuretic hormone and constriction of renal vessels. It is characterized by a small breadth of anesthetic action (therapeutic index does not exceed 1.5), relatively low organ toxicity (heart, liver, kidneys).

Ether anesthesia is characterized by good controllability and manageability. With the mask method, the effect develops slowly, the stage of surgical anesthesia occurs in 15-20 minutes (faster in young children). Awakening is gradual - (20-40 minutes). And in the subsequent period, depression of the central nervous system, drowsiness and analgesia persist for a long time (brain functions are completely restored after a few hours). Against the background of barbiturates and muscle relaxants, there is usually no stage of excitation (induction of anesthesia is not accompanied by suffocation, fear and other unpleasant sensations), muscle relaxation is potentiated and the severity of post-anesthesia depression is reduced.

Passes well through the BBB, easily diffuses to neurons through interneuronal fluid (low-molecular uncharged compound). It is unevenly distributed in organs: the level in the brain exceeds the concentration in the blood and other organs (the content in the medulla oblongata and spinal cord is approximately 50% higher than in the brain, due to the higher lipid content in the nerve conductors). Concentrations in the blood are: 10-25 mg% (analgesia stage), 25-70 mg% (excitation stage) and 80-110 mg% (surgical anesthesia stage). Passes through the placental barrier and creates high concentrations in the fetus. Deposited in the membranes of hepatocytes. Slightly (10-15%) biotransforms. It is quickly eliminated during the first few minutes, then excretion gradually slows down: 85-90% is excreted unchanged by the lungs, the rest by the kidneys. Medical ether, when applied locally to dental tissue, causes a “drying” effect (evaporates quickly at room temperature), exhibits weak antibacterial and local anesthetic activity (due to the irritant effect). The local irritating effect of ether on the skin can be used for distraction therapy (rubbing).

Application of the substance Diethyl ether

Ether for anesthesia: for inhalation anesthesia (mixed, combined, potentiated), incl. maintaining anesthesia (usually in a mixture with oxygen and dinitrogen oxide, against the background of muscle relaxants, induction of anesthesia with barbiturates, or dinitrogen oxide).

Medical ether: for the treatment of carious cavities and root canals of the tooth (preparation for filling).

Contraindications

Pulmonary tuberculosis, acute respiratory diseases, increased intracranial pressure, cardiovascular diseases with a significant increase in blood pressure, incl. hypertension, cardiac decompensation, severe liver and kidney diseases, general exhaustion, thyrotoxicosis, diabetes mellitus, state of agitation, severe acidosis, operations using electrosurgical instruments, incl. electrocoagulation.

Restrictions on use

Operations on the maxillofacial area (due to explosion hazard); use of mask anesthesia using only ether; childhood, pregnancy, breastfeeding.

Use during pregnancy and breastfeeding

With caution during pregnancy (adequate clinical studies have not been conducted) and during breastfeeding (data on excretion into human milk are not available).

Side effects of the substance Diethyl ether

From the respiratory system: hypersecretion of bronchial glands, cough, laryngo- and bronchospasm, disturbances in pulmonary ventilation, increased or depressed respiration, up to apnea, pneumonia and bronchopneumonia (in the postoperative period), diffusion hypoxia (against the background of impaired function of the lungs and heart or with prolonged use in high concentrations ).

From the cardiovascular system and blood (hematopoiesis, hemostasis): tachycardia or bradycardia, up to cardiac arrest; arrhythmia; hyper- or hypotension; collapse; bleeding

From the gastrointestinal tract: hypersalivation, nausea, vomiting, decreased tone and motility of the gastrointestinal tract, paralytic ileus (with long-term anesthesia), transient jaundice, changes in liver tests.

From the nervous system and sensory organs: agitation, motor activity, rarely - convulsions in children, drowsiness, depression (after surgery).

Others: metabolic acidosis, hypoalbuminemia, hypogammaglobulinemia, decreased urine output, albuminuria.

Interaction

Potentiates the effect of CNS depressants (mutually), the effect of non-depolarizing muscle relaxants, such as tubocurarine, and the hypotensive effect of beta-blockers. Reduces the hypoglycemic effect of insulin and sulfonylurea derivatives, oxytocin and other hormonal stimulants of the uterus. Incompatible with analeptics and psychostimulants. MAO inhibitors inhibit metabolism (increase the anesthetic effect); epinephrine and aminophylline increase the risk of arrhythmias, m-anticholinergics and antihistamines neutralize side effects, muscle relaxants reduce ether consumption by half.

Gross-
formula
?
Classification
Pharm.
group
Anesthetics
ATX N01AA01
ICD-10 Y 56.7 56.7
Dosage forms
liquid for inhalation,
topical liquid
Trade names
ether for anesthesia, stabilized ether for anesthesia, medical ether


CATEGORIES

POPULAR ARTICLES

2024 “kingad.ru” - ultrasound examination of human organs