comes from the Greek and Latin words meaning “grave muscular weakness”. —The mortality rate from myasthenic crisis declined from 42% in the early 1960s to 6% by the late 1970s. —Currently, mortality is 4% and is primarily the result of comorbid medical conditions. Myasthenic crisis Is a common life-threatening complication that occurs […]

Myasthenia Gravis

Desflurane structure  is very similar to that of isflourane. actually  the only difference is the substitution of a fluorine atom in isoflurane to  chlorine atom. that tiny  change has profound effects on the physical properties of the drug, For instance, because the vapor pressure of desflurane at 20°C is 681 mm […]


The potency of anesthetic gases is compared using minimal alveolar concentration (MAC), which is the concentration at one atmosphere that abolishes motor response to a painful stimulus in 50% of patients. 1.3 MAC is required to abolish this response in 99% of patients. Other definitions of MAC include the MAC-BAR, […]


Tumor lysis syndrome (TLS) is an oncological emergency due to turnover of high cell mass malignancies resulting in severe metabolic derangement it may occur spontaneously  or after initiation of cancer treatment in patients with bulky, rapidly proliferating, and treatment responsive tumors. Tumor lysis syndrome is typically associated with acute leukemias and highgrade non-Hodgkin […]

Tumor lysis syndrome

Ketamine is the only anesthetic available which has analgesic, hypnotic and amnesic effects. it’s on the WHO list of essential medicines  Ketamine produces dissociative anesthesia. This means that unlike with other anesthetic agents the patient may have their eyes open and make reflex movements during the operation. It has a slower […]


Assesment: ELECTIVE SURGERY Ideally pts with asthma who are scheduled for elective surgery should not have wheezing on the morning of surgery. History 1.frequency of Symptoms 2.amount and purulence of sputum 3.use and effectiveness of medications 4.asthma triggers 5.activity level 6.previous history of surgery and anaesthesia 7.recent upper respiratory infections […]

Asthma Anesthetic considerations

Asthma is —chronic inflammatory disease characterized by ; airway obstruction airway inflammation airway hyper-responsiveness In response to various stimuli. In which airway obstruction is usually reversible (either spontaneously or after treatment) —Stimuli are usually airborne , they include: Pollens Animal dander Dust Pollutants Various chemicals Exercise Strong emotions Viral infection Epidemiology […]


Malignant hyperthermia a biochemical chain reaction response triggered by commonly used general anesthetics and the paralyzing agent Suxamethonium, within the skeletal muscles of susceptible individuals” – Has autosomal dominant inheritance Incidence of 1-5 : 100,000, < 5% mortality rate Triggered by Suxamethonium  and other anesthetic drugs such as all inhalation agents except […]

Malignant hyperthermia

Prior to the advent of mechanical respiration, death was defined as the cessation of circulation and breathing. Brain Death Current Consensus can be summarized in absent Cerebral Function, absent Brainstem Function and apnea. below is what we believe comprehensive article about Brain Death by Dr Hadab Mohamed MD. published on Sudanese neurologists website    […]

Brain Death

—The causes of hyperkalemia can be best understood after a brief review of normal potassium homeostasis. The serum potassium concentration is determined by the relationship between potassium intake, the distribution of potassium between the cells and the extracellular fluid, and urinary potassium excretion. In normal subjects, dietary potassium is largely […]


Suxamethonium or Succinylcholine also known as  diacetylcholine is depolarizing Neuromuscular blocking agent (the only one used in medical practice) All neuromuscular blockers are structurally related to acetylcholine. Neuromuscular blocking agents are quaternary ammonium compounds. Positive charges at these sites in the molecules mimic the quaternary nitrogen atom of the transmitter acetylcholine and […]


to make this easy we will start by defining Hofmann degradation. its a reaction in which a quaternary ammonium salt is reacted with strong base, resulting in elimination of a tertiary amine and formation of an alkene. When multiple alkene products are possible, the least stable (usually the least highly substituted) alkene is favored (Hofmann elimination or Hofmann’s rule). easy right.  okey lets do some decryption here.. […]

Atracurium & Hoffman made easy