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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).
Propofol infusion syndrome (PRIS) is a rare syndrome which affects patients undergoing long-term treatment with high doses of the anaesthetic and sedative drug propofol. It can lead to cardiac failure , rhabdomyolysis , metabolic acidosis , and kidney failure , and is often fatal.
Induced coma usually results in significant systemic adverse effects. The patient is likely to completely lose respiratory drive and require mechanical ventilation; gut motility is reduced; hypotension can complicate efforts to maintain cerebral perfusion pressure and often requires the use of vasopressor drugs. Hypokalemia often results.
Opioid is a commonly administered adjuvant agent as the analgesic component of TIVA. However, when used with propofol, it might exacerbate the adverse hypotensive effects. [48] Other potential adverse effects include respiratory depression, bradycardia, delirium and potential for acute tolerance. [50]
Sodium thiopental is an ultra-short-acting barbiturate and has been used commonly in the induction phase of general anesthesia.Its use has been largely replaced with that of propofol, but may retain some popularity as an induction agent for rapid-sequence induction and intubation, such as in obstetrics. [12]
Propofol [6] is a non-barbiturate derivative that is thought to act by stimulating inhibitory GABA receptors and blocking excitatory NMDA receptors. It takes 40 seconds for the effects of propofol to kick in, and effects last six minutes. [3] Propofol has both sedative and amnestic effects, but provides no analgesia.
Propofol, an anesthetic medication, confers its own antiemetic properties. Weibel, Rücker, Eberhart et al's 2020 Cochrane review demonstrated that combination therapy is more effective than single anti-emetic, and that dexamethasone and ondansetron (a commonly used combination) are two of the most effective anti-emetics for PONV.
Etomidate will be classed as a controlled drug on 14 February 2025 by the Dangerous Drugs Ordinance (Cap. 134), which states that illegal possession or smoking, inhaling, ingesting and injecting space oil is liable to a maximum penalty of imprisonment of seven years and a fine of HK$1,000,000, while trafficking or illegal importing etomidate is ...