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Propofol is usually the selected sedative-hypnotic agent to maintain general anesthesia through TIVA because of its rapid onset and offset, beneficial properties and few adverse effects. [33] Its rapid onset of action is due to its high lipid-solubility , rapid redistribution from the brain to other parts of the body, and rapid clearance (20 to ...
[60] Although propofol is widely used in the adult ICU setting, the side effects associated with medication seem to be more concerning in children. In the 1990s, multiple reported deaths of children in ICUs associated with propofol sedation prompted the FDA to issue a warning. [61] As a respiratory depressant, propofol frequently produces apnea.
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.
Effects are seen within 2–5 minutes, and last 30–60 minutes. [7] [3] Its main effect is anxiolysis, helping to reduce feelings of anxiety, and amnestic effects, helping the patient to forget memories associated with the procedure. It provides no analgesia, so it was commonly used with fentanyl for effective PSA prior to propofol and etomidate.
Sedation is typically used in minor surgical procedures such as endoscopy, vasectomy, or dentistry and for reconstructive surgery, some cosmetic surgeries, removal of wisdom teeth, or for high-anxiety patients. [2] Sedation methods in dentistry include inhalation sedation (using nitrous oxide), oral sedation, and intravenous (IV) sedation ...
General anesthesia is usually considered safe; however, there are reported cases of patients with distortion of taste and/or smell due to local anesthetics, stroke, nerve damage, or as a side effect of general anesthesia. [46] [47] At the end of surgery, administration of anaesthetic agents is discontinued.
Amnesia – induced through an altered state of consciousness – may be adequate or preferred over total unconsciousness. The physiological stability of the patient has to be maintained while all this is achieved. [1] [7] [8] Balanced anesthesia is employed in a range of surgical procedures to optimize patient safety and comfort. [6]
General anesthetics elicit a state of general anesthesia. It remains somewhat controversial regarding how this state should be defined. [2] General anesthetics, however, typically elicit several key reversible effects: immobility, analgesia, amnesia, unconsciousness, and reduced autonomic responsiveness to noxious stimuli. [2] [3] [4]