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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).
Most propofol is conjugated in the liver with pharmacologically inactive metabolites. [33] Although it has a long terminal elimination half-life of 4 to 30 hours, plasma concentrations remain low after the typical induction dose.
Inaccurate timing of last meal can also increase the risk for aspiration of food, and lead to serious complications. [ 6 ] An important aspect of pre-anaesthetic evaluation is an assessment of the patient's airway , involving inspection of the mouth opening and visualisation of the soft tissues of the pharynx . [ 19 ]
After the completion of his study, he became a practicing animal surgeon. [ 4 ] In 1973, while working at ICI Pharmaceuticals in Alderly Park , Cheshire, England, Glen studied large series of compounds to identify those with desirable anesthetic and hypnotic properties, synthesizing propofol .
In the past, alcohol was believed to be a non-specific pharmacological agent affecting many neurotransmitter systems in the brain, [25] but progress has been made over the last few decades. [26] [21] It appears that it affects ion channels, in particular ligand-gated ion channels, to mediate its effects in the CNS.
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Sodium thiopental is an ultra-short-acting barbiturate and has been used commonly in the induction phase of general anesthesia.Its use has been largely replaced with that of propofol, but may retain some popularity as an induction agent for rapid-sequence induction and intubation, such as in obstetrics. [12]
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