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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 [6] is a non-barbiturate derivative that is thought to act by stimulating inhibitory GABA receptors and blocking excitatory NMDA receptors. It takes 40 seconds for the effects of propofol to kick in, and effects last six minutes. [3] Propofol has both sedative and amnestic effects, but provides no analgesia.
Total intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first study of TIVA was done in 1872 using chloral hydrate , [ 1 ] and the common anesthetic agent propofol was licensed in 1986.
General anesthesia does not always require the anesthetic machine, tested daily, as basic equipment. Anesthesia machines may differ in appearance, size and degree of sophistication but generally speaking, they consist of sections for: ventilation; Peripheral Nerve Stimulator; space for monitoring equipment; accessories; storage space; worktop
The BIS is an electroencephalogram-derived multivariant scale that, when a drug such a propofol is used, correlates with the metabolic rate of glucose. [15] Both loss of consciousness and awakening from anesthesia are correlated with this scale. [16] The efficacy of BIS index monitoring is not without controversy. [17]
General anaesthesia (UK) or general anesthesia (US) is medically induced loss of consciousness that renders a patient unarousable even by painful stimuli. [5] It is achieved through medications, which can be injected or inhaled, often with an analgesic and neuromuscular blocking agent .
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[9] [10] These features can be desirable for endoscopic procedures such as esophagogastroduodenoscopy, colonoscopy, bronchoscopy, as well as for some surgical procedures done under local or regional anesthesia. Propofol is further metabolised to propofol glucuronide (34.8%) and quinol glucuronide. [11]