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TIVA is maintained by intravenous infusion devices and assisted by electroencephalography (EEG) monitoring. These techniques facilitate the use of propofol, etomidate, ketamine, and other intravenous anesthetic agents. During or after TIVA, patients may be subjected to an elevated risk of anesthesia awareness, hyperalgesia and neurotoxicity. [2]
To determine the depth of anesthesia, the anesthetist relies on a series of physical signs of the patient. In 1847, John Snow (1813–1858) [1] and Francis Plomley [2] attempted to describe various stages of general anesthesia, but Guedel in 1937 described a detailed system which was generally accepted. [3] [4] [5]
Anesthesia is a combination of the endpoints (discussed above) that are reached by drugs acting on different but overlapping sites in the central nervous system. General anesthesia (as opposed to sedation or regional anesthesia) has three main goals: lack of movement , unconsciousness, and blunting of the stress response. In the early days of ...
Ketamine is also used to manage pain among large animals. It is the primary intravenous anesthetic agent used in equine surgery, often in conjunction with detomidine and thiopental, or sometimes guaifenesin. [174] Ketamine appears not to produce sedation or anesthesia in snails. Instead, it appears to have an excitatory effect. [175]
Inhalational anaesthesia may be chosen when intravenous access is difficult to obtain (e.g., children), when difficulty maintaining the airway is anticipated, or when the patient prefers it. Sevoflurane is the most commonly used agent for inhalational induction, because it is less irritating to the tracheobronchial tree than other agents.
The Meyer-Overton correlation for anaesthetics. A nonspecific mechanism of general anaesthetic action was first proposed by Emil Harless and Ernst von Bibra in 1847. [9] They suggested that general anaesthetics may act by dissolving in the fatty fraction of brain cells and removing fatty constituents from them, thus changing activity of brain cells and inducing anaesthesia.
Leaves of the coca plant (Erythroxylum novogranatense var. Novogranatense), from which cocaine, a naturally occurring local anesthetic, is derived. [1] [2]An anesthetic (American English) or anaesthetic (British English; see spelling differences) is a drug used to induce anesthesia — in other words, to result in a temporary loss of sensation or awareness.
[1] [7] One survey of anesthesiologists who practice intravenous regional anesthesia found that 98% used adjuvant benzodiazepines and/or opioids, with benzodiazepines always being given systemically (to the whole body and brain), whereas opioids can be given either systemically or locally (only into the limb being anesthetized). Most providers ...