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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).
The dosage is between 0.2 and 0.6 mg/kg (commonly 20 to 50 mg doses). Dose reduction may be required in those with hypotension. [10] Etomidate has minimal cardiovascular side effects, reduces intracerebral pressure (by reducing cerebral blood flow), and does not cause histamine release. [10]
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]
Fospropofol is metabolized in the liver by alkaline phosphatases to propofol, formaldehyde, and phosphate.The hepatic metabolism of this prodrug to an active metabolite means that peak plasma levels of propofol after the administration of a bolus of fospropofol are lower than for an equipotent dose of propofol and also that its clinical effect is more sustained.
[28] [29] Midazolam is superior to diazepam in impairing memory of endoscopy procedures, but propofol has a quicker recovery time and a better memory-impairing effect. [30] It is the most popular benzodiazepine in the intensive care unit (ICU) because of its short elimination half-life , combined with its water solubility and its suitability ...
This is because remifentanil is rapidly eliminated from the blood plasma on termination of the remifentanil infusion; hence the effects of the drug quickly dissipate even after very long infusions. Owing to synergism between remifentanil and hypnotic drugs (such as propofol) the dose of the hypnotic can be substantially reduced. [16]
Ketamine potentiates the sedative effects of propofol [86] and midazolam. [87] Naltrexone potentiates psychotomimetic effects of a low dose of ketamine, [88] while lamotrigine [38] and nimodipine [39] decrease them. Clonidine reduces the increase of salivation, heart rate, and blood pressure during ketamine anesthesia and decreases the ...
Ciprofol (also known as cipepofol, or HSK3486) is a novel 2,6-disubstituted phenol derivative that is used for the intravenous induction of general anesthesia. [1] [2] A short-acting and highly selective γ-aminobutyric acid agonist, [3] ciprofol is 4–6 times more potent than other phenol derivatives such as propofol or fospropofol.