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Intravenous anesthetic agents are titrated at safe doses to maintain stage III surgical anesthesia (unconsciousness, amnesia, immobility, and absence of response to noxious stimulation). [10] The use of TIVA is advantageous in cases where volatile anesthesia is of high risk or is impossible, such as cases involving morbidly obese patients.
Methylnaltrexone (MNTX, brand name Relistor), used in form of methylnaltrexone bromide (INN, USAN, BAN), is a medication that acts as a peripherally acting μ-opioid receptor antagonist that acts to reverse some of the side effects of opioid drugs such as constipation without significantly affecting pain relief or precipitating withdrawals.
[7] [8] The intravenous solution usually begins working within a minute and lasts half an hour to an hour. [5] Large doses may be required to treat some poisonings. [6] Common side effects include dry mouth, abnormally large pupils, urinary retention, constipation, and a fast heart rate. [6]
Adverse effects include a transient increase in serum glucose level, and poor wound healing (controversial). Medications include dexamethasone. Butyrophenones are typically administered as a single injection at the end of surgery. Adverse effects include prolongation of the QT interval on EKG. Medications include droperidol and haloperidol.
Side effects include muscle spasms and restlessness. Amisulpride (Barhemsys), administered by intravenous injection. Domperidone (Motilium) Droperidol; Olanzapine (Zyprexa) Haloperidol (limited in usefulness by extra-pyramidal and sedative side-effects) Alizapride; Prochlorperazine (Compazine, Stemzine, Buccastem, Stemetil, Phenotil)
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).
It is given by intravenous (IV) injection. [3] The most common side effects include nausea, vomiting, dizziness, headache, constipation, itchy skin and low oxygen levels in blood. [4] It was approved for medical use in the United States in August 2020. [4]
Calcium gluconate side effects include nausea, constipation, and upset stomach. Rapid intravenous injections of calcium gluconate may cause hypercalcemia, which can result in vasodilation, cardiac arrhythmias, decreased blood pressure, and bradycardia. Extravasation of calcium gluconate can lead to cellulitis.