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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 (di-isopropyl phenol) was synthesized by Glen and colleagues in the early 1970s, [7] but its first formulations were temporarily withdrawn due to a number of adverse reactions during clinical studies. [1] In 1983, a lipid emulsion formulation of propofol was available, which carried great potential during clinical trials. [8]
They use simple tools to access the sap, which averages 3.1% ABV. This behavior suggests that ethanol does not deter feeding and indicates that the last common ancestor of African apes and humans likely consumed foods containing ethanol. [6] Chimpanzees at Bossou consumed large amounts of ethanol and showed signs of intoxication.
Once they enter the circulatory system, the agents are transported to their biochemical sites of action in the central and autonomic nervous systems. Most general anaesthetics are induced either intravenously or by inhalation. Commonly used intravenous induction agents include propofol, sodium thiopental, etomidate, methohexital, and ketamine.
[4] [6] Alcohol dehydrogenase and aldehyde dehydrogenase are present at their highest concentrations (in liver mitochondria). [98] [107] But these enzymes are widely expressed throughout the body, such as in the stomach and small intestine. [2] Some alcohol undergoes a first pass of metabolism in these areas, before it ever enters the ...
The median lethal dose of alcohol in test animals is a blood alcohol content of 0.45%. This is about six times the level of ordinary intoxication (0.08%), but vomiting or unconsciousness may occur much sooner in people who have a low tolerance for alcohol. [31]
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In a retrospective review of almost 32,000 people, etomidate, when used for the induction of anaesthesia, was associated 2.5-fold increase in the risk of dying compared with those given propofol. [37] People given etomidate also had significantly greater odds of having cardiovascular morbidity and significantly longer hospital stay. [37]