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Remifentanil is relatively context insensitive whilst fentanyl and thiopentone are examples of drugs which have significant context-sensitive changes in their half-life. [1] The Context-Sensitive Half-Time describes the time required for the plasma drug concentration to decline by 50% after terminating an infusion of a particular duration. [2]
0.05 (3–6 min context-sensitive half-life; 7–18 min elimination half-life) Instantaneously (from 5 to 15 sec) 15 minutes; rapid offset of effects necessitates continuous infusion for maintenance of anesthesia Protonitazene: 200 50 μg Ocfentanil: 125–250 40–80 μg Ro4-1539: 240–480 20–40 μg Isotonitazene: 500 20 μg Sufentanil: 500 ...
Remifentanil's short context-sensitive half-life makes it ideal for intense pain of short duration. As such, it has been used for analgesia in labor successfully; however, it is not as effective as epidural analgesia. [10] In combination with propofol, remifentanil is used for anesthesia of patients undergoing electroconvulsive therapy. [11]
To induce general anesthesia, propofol is the drug used almost exclusively, having largely replaced sodium thiopental. [13]It is often administered as part of an anesthesia maintenance technique called total intravenous anesthesia, using either manually programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion (TCI).
In 1983, a lipid emulsion formulation of propofol was available, which carried great potential during clinical trials. [8] It was licensed for use in Europe in 1986 and received FDA approval in the US in 1989. [1] Propofol is now used worldwide with a well-defined pharmacological profile for a variety of medical uses.
In 1973, while working at Imperial Chemical Industries in Alderly Park, Cheshire, England, Glen studied large series of compounds to identify those with desirable anesthetic and hypnotic properties, synthesizing propofol.
Fospropofol (INN [3]), often used as the disodium salt (trade name Lusedra [4]) is an intravenous sedative-hypnotic agent. It is currently approved for use in sedation of adult patients undergoing diagnostic or therapeutic procedures such as endoscopy .
Ketofol is a combination of ketamine and propofol. Ketamine is frequently used in severely injured people and appears to be safe in this group. [41] It has been widely used for emergency surgery in field conditions in war zones, [42] for example, during the Vietnam War. [43]