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General anaesthetic

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partition coefficients. Anesthetics that are highly soluble require many molecules of drug to raise the partial pressure within a given tissue, as opposed to minimally soluble anesthetics which require relatively few. Generally, inhalational anesthetics that are minimally soluble reach equilibrium more quickly. Inhalational anesthetics that have a high fat:blood partition coefficient, however, reach equilibrium more slowly, due to the minimal vascularization of fat tissue, which serves as a large, slowly-filling reservoir for the drug.
698: 3682: 2220: 3703: 2230: 507:. This process is accelerated with intravenous anesthetics, so much so that it is negligible to consider during their use. The four stages of anesthesia are described using Guedel's signs, signifying the depth of anesthesia. These stages describe effects of anesthesia mainly on cognition, muscular activity, and respiration. 729:, tissue solubility, blood flow to the lungs, and patient respiratory rate and inspiratory volume. For gases that have minimal tissue solubility, termination of anesthesia generally occurs as rapidly as the onset of anesthesia. For gases that have high tissue solubility, however, termination of anesthesia is generally 708:
within the various tissues is equivalent to the partial pressure of the drug within the lungs. Healthcare providers can control the rate of anesthesia induction and final tissue concentrations of the anesthetic by varying the partial pressure of the inspired anesthetic. A higher drug partial pressure
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in the liver, and existing drug concentration in fat. When large quantities of an anesthetic drug have already been dissolved in the body's fat stores, this can slow its redistribution out of the brain and spinal cord, prolonging its CNS effects. For this reason, the half-lives of these infused drugs
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Stage II is often characterized by the receiver being delirious and confused, with severe amnesia. Irregularities in the patterns of respiration are common at this stage of anesthesia. Nausea and vomiting are also indicators of Stage II anesthesia. Struggling and panic can sometimes occur as a result
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capacity for its anti-depressant effects. This drug, however, also alters arousal and is often used in parallel with other general anesthetics to help maintain a state of general anesthesia. Administration of ketamine alone leads to a dissociative state, in which a patient may experience auditory and
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channels (i.e. TREK-1 and TASK channels). In the case of TREK-1, activation was shown through an anesthetic perturbation to membrane lipid clusters and activation of phospholipase D2; direct binding of anesthetics to purified reconstituted TREK-1 had no effect on conductance. The effects of certain
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Aside from the clinically advantageous effects of general anesthetics, there are a number of other physiological consequences mediated by this class of drug. Notably, a reduction in blood pressure can be facilitated by a variety of mechanisms, including reduced cardiac contractility and dilation of
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of a gaseous drug is indicative of its relative solubility in various tissues. This metric is the relative drug concentration between two tissues, when their partial pressures are equal (gas:blood, fat:blood, etc.). Inhalational anesthetics vary widely with respect to their tissue solubilities and
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Normal breathing resumes at the beginnings of Stage III. Nearing the end of the stage, breathing ceases completely. Indicators for stage III anesthesia include loss of the eyelash reflex as well as regular breathing. Depth of stage III anesthesia can often be gauged by eye movement and pupil size.
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agonists are primarily utilized for their analgesic effects. These drugs, however, can also elicit sedation. This effect is mediated by opioid actions on both opioid and acetylcholine receptors. While these drugs can lead to decreased arousal, they do not elicit a loss of consciousness. For this
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Induction and maintenance of general anesthesia, and the control of the various physiological side effects is typically achieved through a combinatorial drug approach. Individual general anesthetics vary with respect to their specific physiological and cognitive effects. While general anesthesia
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is used in the UK as "field anaesthesia", for instance in road traffic incidents or similar situations where an operation must be conducted at the scene or when there is not enough time to move to an operating room, while preferring other anaesthetics where conditions allow their use. It is more
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channel family comprises six subfamilies, which includes 15 unique members. 13 of these channels (excluding TWIK-1 and TWIK-2 homomers) are affected by general anesthetics. While it has not been determined that general anesthetics bind directly to these channels, nor is it clear how these drugs
104: 96:—or mixable—in water, and as gases they dissolve in oils better than in water). It is possible to deliver anaesthesia solely by inhalation or injection, but most commonly the two forms are combined, with an injection given to induce anaesthesia and a gas used to maintain it. 588:. The net effect is decreased respiration, which must be managed by healthcare providers, while the patient is under general anesthesia. The reflexes that function to alleviate airway obstructions are also dampened (e.g. gag and cough). Compounded with a reduction in 249:
induction may be facilitated by one general anesthetic, others may be used in parallel or subsequently to achieve and maintain the desired anesthetic state. The drug approach utilized is dependent upon the procedure and the needs of the healthcare providers.
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in the lungs will drive diffusion more rapidly throughout the body and yield a higher maximum tissue concentration. Respiratory rate and inspiratory volume will also affect the promptness of anesthesia onset, as will the extent of pulmonary blood flow.
486:, analgesia, and unresponsiveness). They are no longer used in the context, because patients experiencing neuroleptic anesthesia were frequently aware of the medical procedures being performed, but could not move or express emotion. Such drugs include 633:
molecules. These characteristics facilitate their rapid preferential distribution into the brain and spinal cord, which are both highly vascularized and lipophilic. It is here where the actions of these drugs lead to general anesthesia induction.
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in animals. Clinical definitions are also extended to include an induced coma that causes lack of awareness to painful stimuli, sufficient to facilitate surgical applications in clinical and veterinary practice. General anaesthetics do not act as
61:. General anaesthetics are a structurally diverse group of compounds whose mechanisms encompass multiple biological targets involved in the control of neuronal pathways. The precise workings are the subject of some debate and ongoing research. 733:. As with intravenous anesthetic infusions, prolonged delivery of highly soluble anesthetic gases generally results in longer drug half-lives, slowed elimination from the brain and spinal cord, and delayed termination of anesthesia. 353:. Additionally, the perception of pain is dissociated from the perception of noxious stimuli. Ketamine appears to bind preferentially to the NMDA receptors on GABAergic interneurons, which may partially explain its effects. 127:. An anaesthesia machine allows composing a mixture of oxygen, anaesthetics and ambient air, delivering it to the patient and monitoring patient and machine parameters. Liquid anaesthetics are vapourised in the machine. 472:
sleep. It is used in parallel with other general anesthetics to help maintain a state of general anesthesia, in an off-label capacity. Notably, patients are easily aroused from this non-REM sleep state.
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neurons and function as inhibitory CNS receptors. General anesthetics that agonize them are typically used to induce a state of sedation and/or unconsciousness. Such drugs include
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mechanisms are triggered in response to cold. (On the other hand, the threshold at which thermoregulatory mechanisms are triggered in response to heat is typically increased.)
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Induction of anesthesia is facilitated by diffusion of an inhaled anesthetic drug into the brain and spinal cord. Diffusion throughout the body proceeds until the drug's
260:. The relative roles of different receptors is still under debate, but evidence exists for particular targets being involved with certain anaesthetics and drug effects. 3733: 1145: 3691: 386:
s have been found to be affected by general anesthetics (esp. halogenated inhalation anesthetics) and are currently under investigation as potential targets. The K
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while under general anesthesia. Healthcare providers closely monitor individuals under general anesthesia and utilize a number of devices, such as an
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increases the heat lost via peripheral blood flow. By and large, these drugs reduce the internal body temperature threshold at which autonomic
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Inhaled anesthetics are eliminated via expiration, following diffusion into the lungs. This process is dependent largely upon the anesthetic
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reason, they are often used in parallel with other general anesthetics to help maintain a state of general anesthesia. Such drugs include
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channel activation. This drug-elicited channel activation has been shown to be dependent upon specific amino-acids within certain K
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Injectable anaesthetics are used for the induction and maintenance of a state of unconsciousness. Anaesthetists prefer to use
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Franks, Nicholas P. (May 2008). "General anaesthesia: from molecular targets to neuronal pathways of sleep and arousal".
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During administration of an anesthetic, the receiver goes through different stages of behavior ultimately leading to
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While most research focuses on the intoxicating effects of ethanol, it can also produce a general anesthesia. Since
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of an anesthetic drug following a prolonged infusion, however, depends upon both drug redistribution kinetics,
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Pavel, Mahmud Arif; Petersen, E. Nicholas; Wang, Hao; Lerner, Richard A.; Hansen, Scott B. (16 June 2020).
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No respiration occurs in stage IV. This is shortly followed by circulatory failure and depression of the
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the vasculature. This drop in blood pressure may activate a reflexive increase in heart rate, due to a
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Many compounds have been used for inhalation anaesthesia, but only a few are still in widespread use.
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of the drug utilized by healthcare providers during general anesthesia induction and/or maintenance.
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properties. Previously, they were used in parallel with opioids to elicit neuroleptic anesthesia (
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It is postulated that general anaesthetics exert their action by the activation of inhibitory
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Benzodiazepines are sedatives and are used in combinations with other general anaesthetics.
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Steinberg, E. A.; Wafford, K. A.; Brickley, S. G.; Franks, N. P.; Wisden, W. (2015-05-01).
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are particularly well supported as playing a role in the induction of general anesthesia.
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Below are several key targets of general anesthetics that likely mediate their effects:
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tone, which increases the frequency of regurgitation, patients are especially prone to
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Metabolism of inhaled anesthetics is generally not a major route of drug elimination.
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General anesthetics are frequently administered as volatile liquids or gases.
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Intravenously delivered general anesthetics are typically small and highly
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Anesthetics typically affect respiration. Inhalational anesthetics elicit
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followed by amnesia and a sense of confusion moving into the next stage.
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Brown, Emery N.; Purdon, Patrick L.; Van Dort, Christa J. (2011-06-21).
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General anaesthetics can be administered either as gases or vapours (
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Patients under general anesthesia are at greater risk of developing
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antagonist, is used primarily for its analgesic effects and in an
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studies have shown that certain general anesthetics result in K
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American Society of Anesthesia Technologists & Technicians
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in neurons. Opening of these channels therefore facilitates a
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Goodman & Gilman's pharmacological basis of therapeutics
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of various inhalational general anesthetics and impacts the
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modulate the potassium conductance that contributes to the
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Helsinki Declaration for Patient Safety in Anaesthesiology
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Effects of early-life exposures to anesthesia on the brain
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Eger II EI, Saidman LJ, Westhorpe RN (14 September 2013).
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Bindra, Ashish; Bindu, Barkha; Rath, Girija (2017-07-01).
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Association of Anaesthetists of Great Britain and Ireland
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Wong, SM; Fong, E; Tauck, DL; Kendig, JJ (25 June 1997).
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European Society of Anaesthesiology and Intensive Care
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Katzung, Bertram G.; Trevor, Anthony J. (2014-12-23).
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Anatomical Therapeutic Chemical Classification System
611:, eliciting nausea and vomiting following treatment. 162:. Researchers are also actively exploring the use of 150:. Older, less popular volatile anaesthetics include 3632: 3604: 3560: 3369: 3304: 3267: 3215: 3128: 3072: 3032: 2989: 2873: 2809: 2721: 2618: 2590: 2557: 2498: 2465: 2417: 2389: 2380: 2287: 2191:
Australian and New Zealand College of Anaesthetists
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frequently used in the operative setting in the US.
1164:"Molecular targets underlying general anaesthesia" 562:. Some anesthetics, however, disrupt this reflex. 1344:Journal of Anaesthesiology Clinical Pharmacology 1281:"Studies on the mechanism of general anesthesia" 1285:Proceedings of the National Academy of Sciences 1228:PflĂĽgers Archiv: European Journal of Physiology 584:, an increase in respiratory rate, and reduced 515:The receiver of the anesthesia primarily feels 382:current, which reduces neuronal excitability. K 112:Inhalational anaesthetic substances are either 2698: 2260: 1473: 759:, prior to the development of modern agents, 256:(CNS) receptors, and the inactivation of CNS 27:Compound that induces a loss of consciousness 8: 2713:Major chemical drug groups – based upon the 1853:Intraoperative neurophysiological monitoring 1144:: CS1 maint: multiple names: authors list ( 408:general anesthetics are less pronounced in K 2705: 2691: 2683: 2386: 2267: 2253: 2245: 2156:American Association of Nurse Anesthetists 1480: 1466: 1458: 1086:: CS1 maint: location missing publisher ( 2201:International Anesthesia Research Society 1808:ASA physical status classification system 1406: 1365: 1355: 1314: 1304: 1255: 1195: 918: 1553:Combined spinal and epidural anaesthesia 696: 560:baroreceptor-mediated feedback mechanism 186:. Among the most widely used drugs are: 30:These drugs are not to be confused with 3734:Drugs with unknown mechanisms of action 2186:Association of Veterinary Anaesthetists 1450:from the original on 18 September 2017. 799: 3692:Pharmacological classification systems 3059:Selective estrogen receptor modulators 1137: 1079: 1049: 1047: 1045: 1043: 1041: 1039: 1037: 999: 970: 968: 966: 964: 962: 960: 958: 244:Theories of general anaesthetic action 64:General anesthetics elicit a state of 3339:Non-steroidal anti-inflammatory drugs 2166:American Society of Anesthesiologists 1217: 1215: 1157: 1155: 1107: 1105: 1103: 1101: 1099: 1097: 1035: 1033: 1031: 1029: 1027: 1025: 1023: 1021: 1019: 1017: 956: 954: 952: 950: 948: 946: 944: 942: 940: 938: 872: 870: 868: 866: 864: 862: 860: 858: 856: 854: 123:, and are usually delivered using an 57:and should also not be confused with 7: 2171:Anaesthesia Trauma and Critical Care 603:General anesthetics also affect the 419:counterparts. Cumulatively, TASK-1, 146:today. They are often combined with 2952:Angiotensin II receptor antagonists 2196:Australian Society of Anaesthetists 2104:Physicians' assistant (anaesthesia) 2007:Postoperative residual curarization 895:10.1146/annurev-neuro-060909-153200 763:was used as a general anaesthetic. 2084:Operating department practitioners 25: 2094:Certified anesthesia technologist 2002:Postoperative nausea and vomiting 1517:Procedural sedation and analgesia 1162:Franks, Nicholas P (2006-01-01). 468:leads to sedation that resembles 3701: 3681: 3680: 2228: 2219: 2218: 1635:Transverse abdominis plane block 1433:The Wondrous Story of Anesthesia 1395:European Journal of Pharmacology 674:Inhalational general anesthetics 642:Following distribution into the 3089:Hypothalamic–pituitary hormones 2229: 2135:History of neuraxial anesthesia 2089:Certified anesthesia technician 1911:Double-lumen endobronchial tube 1772:Blood–gas partition coefficient 1605:Intravenous regional anesthesia 1168:British Journal of Pharmacology 1056:Basic and clinical pharmacology 727:blood:gas partition coefficient 620:Intravenous general anesthetics 2381: 2181:Royal College of Anaesthetists 2140:History of tracheal intubation 1787:Minimum alveolar concentration 1724:Anesthesia provision in the US 1114:Rang & Dale's pharmacology 679:Minimal alveolar concentration 541:Stage IV: Medullary Depression 532:Stage III: Surgical Anesthesia 478:antagonists have sedative and 368:Two-pore potassium channels (K 358:Two-pore potassium channels (K 1: 2841:Thrombolytics / fibrinolytics 2130:History of general anesthesia 1642:Total intravenous anaesthesia 1590:Inferior alveolar nerve block 1536:Continuous wound infiltration 1408:10.1016/S0014-2999(97)89174-1 883:Annual Review of Neuroscience 788:History of general anesthesia 3552:Wakefulness-promoting agents 1693:Neuromuscular-blocking drugs 600:, to ensure patient safety. 2028:Critical emergency medicine 809:Nature Reviews Neuroscience 283:are chloride channels that 3750: 3202:Intravenous immunoglobulin 2074:Anesthesiologist assistant 1936:Relative analgesia machine 1357:10.4103/joacp.joacp_334_16 748: 605:chemoreceptor trigger zone 590:lower esophageal sphincter 553:Physiological side effects 462:alpha2 adrenergic receptor 376:resting membrane potential 241: 29: 3676: 2643: 2214: 1982:Local anesthetic toxicity 1240:10.1007/s00424-014-1654-4 609:brainstem vomiting center 332:NMDA receptor antagonists 142:are the most widely used 82:inhalational anaesthetics 3257:Topoisomerase inhibitors 2941:renin–angiotensin system 2935:Calcium channel blockers 1997:Postanesthetic shivering 1863:Neuromuscular monitoring 1754:Rapid sequence induction 1683:Inhalational anesthetics 783:Intraoperative awareness 569:, as the aforementioned 2048:Oral sedation dentistry 2038:Intensive care medicine 1992:Perioperative mortality 1848:Guedel's classification 1595:Intercostal nerve block 1306:10.1073/pnas.2004259117 415:, as compared to their 184:subcutaneous injections 3049:Hormonal contraception 2979:Bile acid sequestrants 2760:Proton-pump inhibitors 2723:gastrointestinal tract 2099:Anaesthetic technician 1987:Malignant hyperthermia 1180:10.1038/sj.bjp.0706441 1006:: CS1 maint: others ( 778:Mechanical ventilation 701: 644:central nervous system 460:Administration of the 254:central nervous system 176:intravenous injections 109: 76:Mode of administration 1921:Laryngeal mask airway 1765:Scientific principles 1734:Dogliotti's principle 1610:Occipital nerve block 1575:Brachial plexus block 1112:M., Dale, M. (2007). 714:partition coefficient 700: 144:volatile anaesthetics 107: 84:), or as injections ( 3658:Radiopharmaceuticals 3446:Antiparkinson agents 2592:Neuroactive steroids 2559:Arylcyclohexylamines 1967:Drug-induced amnesia 1962:Anesthesia awareness 1896:Anesthetic vaporizer 1873:Thyromental distance 1777:Concentration effect 1651:Pharmacologic agents 1620:Pudendal nerve block 523:Stage II: Excitement 499:Stages of anesthesia 397:electrophysiological 258:excitatory receptors 42:General anaesthetics 18:Anesthetics, general 3441:Antimigraine agents 3431:Antidementia agents 3334:Anti-inflammatories 3024:Medicated dressings 2964:Antihyperlipidemics 2791:Diabetes medication 2276:General anesthetics 1891:Anaesthetic machine 1749:Tracheal intubation 1739:Intravenous therapy 1678:General anesthetics 1630:Sciatic nerve block 1585:Femoral nerve block 1580:Fascia iliaca block 1558:Epidural anesthesia 1524:Twilight anesthesia 1297:2020PNAS..11713757P 1291:(24): 13757–13766. 751:Alcohols (medicine) 238:Mechanism of action 166:as an anaesthetic. 125:anaesthesia machine 3294:Immunosuppressants 3164:Antimycobacterials 3120:Antithyroid agents 3104:Mineralocorticoids 2908:Cardiac stimulants 2898:Cardiac glycosides 2890:cardiac therapy / 2786:Anti-obesity drugs 2670:Never to phase III 1977:Emergence delirium 1957:Allergic reactions 1833:Entropy monitoring 1615:Paracervical block 1600:Interpleural block 1563:Spinal anaesthesia 1548:Neuraxial blockade 702: 511:Stage I: Analgesia 110: 66:general anesthesia 3716: 3715: 3619:Ophthalmologicals 3329:Anabolic steroids 3232:Anticancer agents 3195:Ectoparasiticides 2915:Antihypertensives 2863:Antifibrinolytics 2680: 2679: 2639: 2638: 2457:Thiotetrabarbital 2362:Trichloroethylene 2242: 2241: 2079:Nurse anesthetist 1906:Bronchial blocker 1901:Arterial catheter 1792:Second gas effect 1719:Airway management 1688:Local anesthetics 1625:Retrobulbar block 1443:978-1-4614-8441-7 773:Local anaesthesia 731:context-dependent 668:context-dependent 598:endotracheal tube 547:vasomotor centers 476:Dopamine receptor 321:sodium thiopental 271:receptor agonists 16:(Redirected from 3741: 3705: 3684: 3683: 3668:Senotherapeutics 3522:Neuroprotectives 3517:Mood stabilizers 3416:Anti-ADHD agents 3356:Muscle relaxants 3289:Immunostimulants 3284:Immunomodulators 3116:Thyroid hormones 3054:Fertility agents 2957:Renin inhibitors 2848:Antihemorrhagics 2815:forming organs ( 2801:Dietary minerals 2707: 2700: 2693: 2684: 2387: 2269: 2262: 2255: 2246: 2232: 2231: 2222: 2221: 2069:Anesthesiologist 1858:Mallampati score 1818:Bispectral index 1658:Anticholinergics 1482: 1475: 1468: 1459: 1452: 1451: 1427: 1421: 1420: 1410: 1386: 1380: 1379: 1369: 1359: 1335: 1329: 1328: 1318: 1308: 1276: 1270: 1269: 1259: 1219: 1210: 1209: 1199: 1159: 1150: 1149: 1143: 1135: 1109: 1092: 1091: 1085: 1077: 1051: 1012: 1011: 1005: 997: 972: 933: 932: 922: 874: 849: 848: 804: 706:partial pressure 687:partial-pressure 615:Pharmacokinetics 575:thermoregulatory 21: 3749: 3748: 3744: 3743: 3742: 3740: 3739: 3738: 3719: 3718: 3717: 3712: 3708:Medicine portal 3672: 3628: 3600: 3595: 3587:Cough medicines 3582:Bronchodilators 3563: 3556: 3436:Antidepressants 3426:Anticonvulsants 3374: 3365: 3361:Bisphosphonates 3351:Corticosteroids 3313: 3300: 3272: 3263: 3247:Spindle poisons 3237:Antimetabolites 3220: 3211: 3133: 3124: 3099:Glucocorticoids 3094:Corticosteroids 3075: 3068: 3035: 3028: 2985: 2903:Antiarrhythmics 2876: 2869: 2826:Antithrombotics 2814: 2805: 2781:Antipropulsives 2777:Antidiarrhoeals 2754: 2725: 2717: 2711: 2681: 2676: 2675: 2660:Clinical trials 2635: 2614: 2586: 2553: 2494: 2467:Benzodiazepines 2461: 2413: 2376: 2283: 2273: 2243: 2238: 2210: 2144: 2108: 2057: 2011: 1945: 1877: 1823:Body mass index 1796: 1760: 1707: 1673:Benzodiazepines 1646: 1495: 1486: 1456: 1455: 1444: 1429: 1428: 1424: 1388: 1387: 1383: 1337: 1336: 1332: 1278: 1277: 1273: 1221: 1220: 1213: 1174:(S1): S72–S81. 1161: 1160: 1153: 1136: 1124: 1111: 1110: 1095: 1078: 1066: 1053: 1052: 1015: 998: 986: 974: 973: 936: 876: 875: 852: 821:10.1038/nrn2372 806: 805: 801: 796: 769: 753: 747: 742: 723: 695: 676: 666:are said to be 663:drug metabolism 648:adipose tissues 640: 627: 622: 617: 582:bronchodilation 555: 543: 534: 525: 513: 505:unconsciousness 501: 466:dexmedetomidine 438:Opioid receptor 434: 411: 406: 402: 394: 389: 385: 380:hyperpolarizing 371: 364: 361: 334: 301:benzodiazepines 280: 273: 270: 246: 240: 218:Benzodiazepines 172: 102: 78: 50:righting reflex 39: 28: 23: 22: 15: 12: 11: 5: 3747: 3745: 3737: 3736: 3731: 3721: 3720: 3714: 3713: 3711: 3710: 3699: 3694: 3689: 3677: 3674: 3673: 3671: 3670: 3665: 3660: 3655: 3653:Contrast media 3650: 3644: 3642: 3630: 3629: 3627: 3626: 3621: 3615: 3613: 3606:sensory organs 3602: 3601: 3599: 3598: 3593: 3589: 3584: 3579: 3573: 3571: 3558: 3557: 3555: 3554: 3549: 3544: 3539: 3534: 3529: 3524: 3519: 3514: 3505: 3504: 3503: 3498: 3493: 3483: 3478: 3473: 3468: 3463: 3458: 3453: 3451:Antipsychotics 3448: 3443: 3438: 3433: 3428: 3423: 3421:Antiaddictives 3418: 3413: 3408: 3407: 3406: 3401: 3391: 3385: 3383: 3376:nervous system 3367: 3366: 3364: 3363: 3358: 3353: 3348: 3346:Antirheumatics 3343: 3342: 3341: 3331: 3325: 3323: 3302: 3301: 3299: 3298: 3297: 3296: 3291: 3280: 3278: 3265: 3264: 3262: 3261: 3260: 3259: 3254: 3252:Antineoplastic 3249: 3244: 3239: 3228: 3226: 3213: 3212: 3210: 3209: 3204: 3199: 3198: 3197: 3192: 3187: 3185:Antiprotozoals 3180:Antiparasitics 3177: 3172: 3167: 3160:Antibacterials 3156:Antimicrobials 3152: 3150: 3126: 3125: 3123: 3122: 3113: 3108: 3107: 3106: 3101: 3091: 3085: 3083: 3070: 3069: 3067: 3066: 3061: 3056: 3051: 3045: 3043: 3030: 3029: 3027: 3026: 3021: 3019:Antipsoriatics 3016: 3011: 3006: 3000: 2998: 2987: 2986: 2984: 2983: 2982: 2981: 2976: 2971: 2961: 2960: 2959: 2954: 2949: 2947:ACE inhibitors 2937: 2932: 2927: 2922: 2917: 2912: 2911: 2910: 2905: 2900: 2886: 2884: 2875:cardiovascular 2871: 2870: 2868: 2867: 2866: 2865: 2860: 2855: 2845: 2844: 2843: 2838: 2836:Anticoagulants 2833: 2822: 2820: 2807: 2806: 2804: 2803: 2798: 2793: 2788: 2783: 2774: 2769: 2764: 2763: 2762: 2757: 2752: 2748: 2737: 2735: 2719: 2718: 2712: 2710: 2709: 2702: 2695: 2687: 2678: 2677: 2674: 2673: 2672: 2671: 2668: 2657: 2651: 2645: 2644: 2641: 2640: 2637: 2636: 2634: 2633: 2628: 2622: 2620: 2616: 2615: 2613: 2612: 2607: 2602: 2596: 2594: 2588: 2587: 2585: 2584: 2579: 2574: 2569: 2563: 2561: 2555: 2554: 2552: 2551: 2546: 2540: 2535: 2530: 2525: 2520: 2515: 2510: 2504: 2502: 2496: 2495: 2493: 2492: 2487: 2482: 2477: 2471: 2469: 2463: 2462: 2460: 2459: 2454: 2449: 2444: 2439: 2434: 2429: 2423: 2421: 2415: 2414: 2412: 2411: 2406: 2401: 2395: 2393: 2384: 2378: 2377: 2375: 2374: 2369: 2364: 2359: 2354: 2349: 2347:Methoxypropane 2344: 2342:Methoxyflurane 2339: 2334: 2329: 2324: 2319: 2314: 2309: 2304: 2299: 2293: 2291: 2285: 2284: 2274: 2272: 2271: 2264: 2257: 2249: 2240: 2239: 2237: 2236: 2226: 2215: 2212: 2211: 2209: 2208: 2203: 2198: 2193: 2188: 2183: 2178: 2173: 2168: 2163: 2158: 2152: 2150: 2146: 2145: 2143: 2142: 2137: 2132: 2127: 2122: 2116: 2114: 2110: 2109: 2107: 2106: 2101: 2096: 2091: 2086: 2081: 2076: 2071: 2065: 2063: 2059: 2058: 2056: 2055: 2050: 2045: 2040: 2035: 2030: 2025: 2023:Cardiothoracic 2019: 2017: 2016:Subspecialties 2013: 2012: 2010: 2009: 2004: 1999: 1994: 1989: 1984: 1979: 1974: 1969: 1964: 1959: 1953: 1951: 1947: 1946: 1944: 1943: 1938: 1933: 1931:Magill forceps 1928: 1926:Laryngeal tube 1923: 1918: 1913: 1908: 1903: 1898: 1893: 1887: 1885: 1879: 1878: 1876: 1875: 1870: 1865: 1860: 1855: 1850: 1845: 1840: 1838:Fick principle 1835: 1830: 1825: 1820: 1815: 1810: 1804: 1802: 1798: 1797: 1795: 1794: 1789: 1784: 1779: 1774: 1768: 1766: 1762: 1761: 1759: 1758: 1757: 1756: 1746: 1741: 1736: 1731: 1726: 1721: 1715: 1713: 1709: 1708: 1706: 1705: 1700: 1695: 1690: 1685: 1680: 1675: 1670: 1668:Butyrophenones 1665: 1660: 1654: 1652: 1648: 1647: 1645: 1644: 1639: 1638: 1637: 1632: 1627: 1622: 1617: 1612: 1607: 1602: 1597: 1592: 1587: 1582: 1577: 1567: 1566: 1565: 1560: 1555: 1545: 1544: 1543: 1538: 1528: 1527: 1526: 1521: 1520: 1519: 1503: 1501: 1497: 1496: 1493:anesthesiology 1487: 1485: 1484: 1477: 1470: 1462: 1454: 1453: 1442: 1422: 1401:(2–3): 121–7. 1381: 1350:(3): 306–316. 1330: 1271: 1234:(5): 907–916. 1211: 1151: 1123:978-0443069116 1122: 1093: 1064: 1013: 984: 934: 889:(1): 601–628. 850: 815:(5): 370–386. 798: 797: 795: 792: 791: 790: 785: 780: 775: 768: 765: 749:Main article: 746: 743: 741: 738: 722: 719: 694: 691: 675: 672: 639: 636: 626: 623: 621: 618: 616: 613: 554: 551: 542: 539: 533: 530: 524: 521: 512: 509: 500: 497: 496: 495: 473: 458: 433: 430: 429: 428: 413:knock-out mice 409: 404: 400: 392: 387: 383: 369: 363: 359: 356: 355: 354: 351:hallucinations 333: 330: 329: 328: 278: 272: 268: 265: 239: 236: 232: 231: 224: 215: 198: 193: 171: 168: 160:methoxyflurane 101: 98: 77: 74: 32:sleep medicine 26: 24: 14: 13: 10: 9: 6: 4: 3: 2: 3746: 3735: 3732: 3730: 3727: 3726: 3724: 3709: 3704: 3700: 3698: 3695: 3693: 3690: 3688: 3679: 3678: 3675: 3669: 3666: 3664: 3661: 3659: 3656: 3654: 3651: 3649: 3646: 3645: 3643: 3640: 3636: 3631: 3625: 3622: 3620: 3617: 3616: 3614: 3611: 3607: 3603: 3597: 3590: 3588: 3585: 3583: 3580: 3578: 3577:Decongestants 3575: 3574: 3572: 3569: 3565: 3559: 3553: 3550: 3548: 3545: 3543: 3540: 3538: 3535: 3533: 3530: 3528: 3525: 3523: 3520: 3518: 3515: 3513: 3509: 3506: 3502: 3499: 3497: 3496:Dissociatives 3494: 3492: 3489: 3488: 3487: 3486:Hallucinogens 3484: 3482: 3479: 3477: 3474: 3472: 3469: 3467: 3464: 3462: 3459: 3457: 3454: 3452: 3449: 3447: 3444: 3442: 3439: 3437: 3434: 3432: 3429: 3427: 3424: 3422: 3419: 3417: 3414: 3412: 3409: 3405: 3402: 3400: 3397: 3396: 3395: 3392: 3390: 3387: 3386: 3384: 3381: 3377: 3372: 3368: 3362: 3359: 3357: 3354: 3352: 3349: 3347: 3344: 3340: 3337: 3336: 3335: 3332: 3330: 3327: 3326: 3324: 3321: 3317: 3311: 3307: 3303: 3295: 3292: 3290: 3287: 3286: 3285: 3282: 3281: 3279: 3276: 3270: 3266: 3258: 3255: 3253: 3250: 3248: 3245: 3243: 3240: 3238: 3235: 3234: 3233: 3230: 3229: 3227: 3224: 3218: 3214: 3208: 3205: 3203: 3200: 3196: 3193: 3191: 3190:Anthelmintics 3188: 3186: 3183: 3182: 3181: 3178: 3176: 3173: 3171: 3168: 3165: 3161: 3157: 3154: 3153: 3151: 3148: 3144: 3140: 3136: 3131: 3127: 3121: 3117: 3114: 3112: 3109: 3105: 3102: 3100: 3097: 3096: 3095: 3092: 3090: 3087: 3086: 3084: 3081: 3077: 3071: 3065: 3062: 3060: 3057: 3055: 3052: 3050: 3047: 3046: 3044: 3041: 3037: 3034:genitourinary 3031: 3025: 3022: 3020: 3017: 3015: 3014:Antipruritics 3012: 3010: 3007: 3005: 3002: 3001: 2999: 2996: 2992: 2988: 2980: 2977: 2975: 2972: 2970: 2967: 2966: 2965: 2962: 2958: 2955: 2953: 2950: 2948: 2945: 2944: 2943: 2942: 2938: 2936: 2933: 2931: 2930:Beta blockers 2928: 2926: 2923: 2921: 2918: 2916: 2913: 2909: 2906: 2904: 2901: 2899: 2896: 2895: 2894: 2893: 2888: 2887: 2885: 2882: 2878: 2872: 2864: 2861: 2859: 2856: 2854: 2851: 2850: 2849: 2846: 2842: 2839: 2837: 2834: 2832: 2831:Antiplatelets 2829: 2828: 2827: 2824: 2823: 2821: 2818: 2812: 2808: 2802: 2799: 2797: 2794: 2792: 2789: 2787: 2784: 2782: 2778: 2775: 2773: 2770: 2768: 2765: 2761: 2758: 2756: 2749: 2747: 2744: 2743: 2742: 2739: 2738: 2736: 2733: 2729: 2724: 2720: 2716: 2708: 2703: 2701: 2696: 2694: 2689: 2688: 2685: 2669: 2667: 2664: 2663: 2661: 2658: 2655: 2652: 2650: 2647: 2646: 2642: 2632: 2629: 2627: 2624: 2623: 2621: 2617: 2611: 2608: 2606: 2603: 2601: 2598: 2597: 2595: 2593: 2589: 2583: 2580: 2578: 2577:Phencyclidine 2575: 2573: 2570: 2568: 2565: 2564: 2562: 2560: 2556: 2550: 2547: 2544: 2541: 2539: 2538:Phenoperidine 2536: 2534: 2531: 2529: 2526: 2524: 2521: 2519: 2516: 2514: 2511: 2509: 2506: 2505: 2503: 2501: 2497: 2491: 2488: 2486: 2483: 2481: 2478: 2476: 2473: 2472: 2470: 2468: 2464: 2458: 2455: 2453: 2450: 2448: 2445: 2443: 2442:Narcobarbital 2440: 2438: 2435: 2433: 2430: 2428: 2425: 2424: 2422: 2420: 2416: 2410: 2407: 2405: 2402: 2400: 2397: 2396: 2394: 2392: 2388: 2385: 2383: 2379: 2373: 2370: 2368: 2365: 2363: 2360: 2358: 2355: 2353: 2352:Nitrous oxide 2350: 2348: 2345: 2343: 2340: 2338: 2335: 2333: 2330: 2328: 2325: 2323: 2320: 2318: 2315: 2313: 2312:Diethyl ether 2310: 2308: 2305: 2303: 2300: 2298: 2295: 2294: 2292: 2290: 2286: 2281: 2277: 2270: 2265: 2263: 2258: 2256: 2251: 2250: 2247: 2235: 2227: 2225: 2217: 2216: 2213: 2207: 2204: 2202: 2199: 2197: 2194: 2192: 2189: 2187: 2184: 2182: 2179: 2177: 2174: 2172: 2169: 2167: 2164: 2162: 2159: 2157: 2154: 2153: 2151: 2149:Organizations 2147: 2141: 2138: 2136: 2133: 2131: 2128: 2126: 2123: 2121: 2118: 2117: 2115: 2111: 2105: 2102: 2100: 2097: 2095: 2092: 2090: 2087: 2085: 2082: 2080: 2077: 2075: 2072: 2070: 2067: 2066: 2064: 2060: 2054: 2053:Pain medicine 2051: 2049: 2046: 2044: 2041: 2039: 2036: 2034: 2031: 2029: 2026: 2024: 2021: 2020: 2018: 2014: 2008: 2005: 2003: 2000: 1998: 1995: 1993: 1990: 1988: 1985: 1983: 1980: 1978: 1975: 1973: 1970: 1968: 1965: 1963: 1960: 1958: 1955: 1954: 1952: 1950:Complications 1948: 1942: 1941:Tracheal tube 1939: 1937: 1934: 1932: 1929: 1927: 1924: 1922: 1919: 1917: 1914: 1912: 1909: 1907: 1904: 1902: 1899: 1897: 1894: 1892: 1889: 1888: 1886: 1884: 1880: 1874: 1871: 1869: 1866: 1864: 1861: 1859: 1856: 1854: 1851: 1849: 1846: 1844: 1843:Goldman index 1841: 1839: 1836: 1834: 1831: 1829: 1826: 1824: 1821: 1819: 1816: 1814: 1811: 1809: 1806: 1805: 1803: 1799: 1793: 1790: 1788: 1785: 1783: 1780: 1778: 1775: 1773: 1770: 1769: 1767: 1763: 1755: 1752: 1751: 1750: 1747: 1745: 1742: 1740: 1737: 1735: 1732: 1730: 1727: 1725: 1722: 1720: 1717: 1716: 1714: 1710: 1704: 1701: 1699: 1696: 1694: 1691: 1689: 1686: 1684: 1681: 1679: 1676: 1674: 1671: 1669: 1666: 1664: 1661: 1659: 1656: 1655: 1653: 1649: 1643: 1640: 1636: 1633: 1631: 1628: 1626: 1623: 1621: 1618: 1616: 1613: 1611: 1608: 1606: 1603: 1601: 1598: 1596: 1593: 1591: 1588: 1586: 1583: 1581: 1578: 1576: 1573: 1572: 1571: 1568: 1564: 1561: 1559: 1556: 1554: 1551: 1550: 1549: 1546: 1542: 1539: 1537: 1534: 1533: 1532: 1529: 1525: 1522: 1518: 1515: 1514: 1513: 1510: 1509: 1508: 1505: 1504: 1502: 1498: 1494: 1490: 1483: 1478: 1476: 1471: 1469: 1464: 1463: 1460: 1449: 1445: 1439: 1435: 1434: 1426: 1423: 1418: 1414: 1409: 1404: 1400: 1396: 1392: 1385: 1382: 1377: 1373: 1368: 1363: 1358: 1353: 1349: 1345: 1341: 1334: 1331: 1326: 1322: 1317: 1312: 1307: 1302: 1298: 1294: 1290: 1286: 1282: 1275: 1272: 1267: 1263: 1258: 1253: 1249: 1245: 1241: 1237: 1233: 1229: 1225: 1218: 1216: 1212: 1207: 1203: 1198: 1193: 1189: 1185: 1181: 1177: 1173: 1169: 1165: 1158: 1156: 1152: 1147: 1141: 1133: 1129: 1125: 1119: 1115: 1108: 1106: 1104: 1102: 1100: 1098: 1094: 1089: 1083: 1075: 1071: 1067: 1065:9780071825054 1061: 1057: 1050: 1048: 1046: 1044: 1042: 1040: 1038: 1036: 1034: 1032: 1030: 1028: 1026: 1024: 1022: 1020: 1018: 1014: 1009: 1003: 995: 991: 987: 985:9780071624428 981: 977: 971: 969: 967: 965: 963: 961: 959: 957: 955: 953: 951: 949: 947: 945: 943: 941: 939: 935: 930: 926: 921: 916: 912: 908: 904: 900: 896: 892: 888: 884: 880: 873: 871: 869: 867: 865: 863: 861: 859: 857: 855: 851: 846: 842: 838: 834: 830: 826: 822: 818: 814: 810: 803: 800: 793: 789: 786: 784: 781: 779: 776: 774: 771: 770: 766: 764: 762: 758: 752: 744: 739: 737: 734: 732: 728: 720: 718: 715: 710: 707: 699: 692: 690: 688: 684: 680: 673: 671: 669: 664: 660: 655: 653: 649: 645: 637: 635: 632: 624: 619: 614: 612: 610: 606: 601: 599: 595: 591: 587: 583: 578: 576: 572: 568: 563: 561: 552: 550: 548: 540: 538: 531: 529: 528:of delirium. 522: 520: 518: 510: 508: 506: 498: 493: 489: 485: 481: 477: 474: 471: 467: 463: 459: 456: 452: 451:hydromorphone 448: 444: 439: 436: 435: 431: 426: 422: 418: 414: 398: 395:conductance, 381: 377: 373: 366: 365: 362:s) activation 357: 352: 347: 343: 342:NMDA receptor 339: 336: 335: 331: 326: 322: 318: 314: 310: 306: 302: 298: 294: 290: 286: 285:hyperpolarize 282: 275: 274: 266: 264: 261: 259: 255: 250: 245: 237: 235: 228: 225: 223: 219: 216: 214: 210: 206: 202: 199: 197: 194: 192: 189: 188: 187: 185: 181: 180:intramuscular 177: 169: 167: 165: 161: 157: 153: 149: 148:nitrous oxide 145: 141: 137: 133: 128: 126: 122: 118: 115: 106: 99: 97: 95: 91: 90:intramuscular 87: 83: 75: 73: 71: 67: 62: 60: 56: 51: 47: 43: 37: 33: 19: 3491:Psychedelics 3461:Aphrodisiacs 3398: 3135:infestations 3111:Sex hormones 3064:Sex hormones 3009:Cicatrizants 2939: 2925:Vasodilators 2892:antianginals 2889: 2741:stomach acid 2740: 2610:Hydroxydione 2543:Remifentanil 2437:Methohexital 2432:Hexobarbital 2419:Barbiturates 2302:Cyclopropane 2289:Inhalational 2275: 1916:Gas cylinder 1801:Measurements 1744:Laryngoscopy 1729:Bronchoscopy 1432: 1425: 1398: 1394: 1384: 1347: 1343: 1333: 1288: 1284: 1274: 1231: 1227: 1171: 1167: 1113: 1055: 975: 903:1721.1/86331 886: 882: 812: 808: 802: 754: 735: 724: 711: 703: 677: 656: 641: 628: 602: 594:asphyxiation 586:tidal volume 579: 571:vasodilation 564: 556: 544: 535: 526: 514: 502: 455:remifentanil 325:methohexital 317:barbiturates 262: 251: 247: 233: 205:methohexital 201:Barbiturates 173: 129: 111: 79: 63: 45: 41: 40: 3624:Otologicals 3596:antagonists 3562:respiratory 3537:Orexigenics 3532:Neurotoxins 3481:Euphoriants 3471:Entactogens 3466:Depressants 3456:Anxiolytics 3394:Anesthetics 3170:Antifungals 2767:Antiemetics 2755:antagonists 2656:from market 2523:Embutramide 2518:Anileridine 2490:Remimazolam 2427:Amobarbital 2404:Fospropofol 2367:Vinyl ether 2357:Sevoflurane 2120:ACE mixture 2062:Professions 1883:Instruments 1828:Capnography 1782:Fink effect 1663:Antiemetics 1570:Nerve block 721:Elimination 638:Elimination 567:hypothermia 488:haloperidol 209:thiopentone 140:sevoflurane 86:intravenous 46:anesthetics 3729:Anesthesia 3723:Categories 3547:Stimulants 3527:Nootropics 3501:Deliriants 3476:Entheogens 3411:Anorectics 3389:Analgesics 3242:Alkylating 3175:Antivirals 3130:infections 3004:Emollients 2858:Coagulants 2728:metabolism 2631:Propanidid 2605:Alfaxalone 2600:Alfadolone 2582:Tiletamine 2567:Esketamine 2549:Sufentanil 2533:Alfentanil 2452:Thiopental 2337:Isoflurane 2307:Desflurane 2297:Chloroform 1868:Pain scale 1712:Techniques 1489:Anesthesia 794:References 631:lipophilic 492:droperidol 480:antiemetic 297:isoflurane 242:See also: 213:thiopental 136:isoflurane 132:Desflurane 100:Inhalation 55:analgesics 3697:ATC codes 3663:Dressings 3648:Antidotes 3512:Sedatives 3508:Hypnotics 3217:malignant 3074:endocrine 2920:Diuretics 2853:Platelets 2813:and blood 2772:Laxatives 2666:Phase III 2654:Withdrawn 2626:Etomidate 2513:Oxycodone 2485:Lorazepam 2475:Midazolam 2447:Thiamylal 2382:Injection 2332:Halothane 2327:Fluroxene 2317:Enflurane 2043:Obstetric 2033:Geriatric 1703:Sedatives 1248:0031-6768 1188:1476-5381 1140:cite book 1082:cite book 1074:875520239 1002:cite book 994:498979404 911:0147-006X 829:1471-0048 757:antiquity 693:Induction 683:potencies 659:half-life 625:Induction 517:analgesia 484:catalepsy 417:wild-type 346:off-label 309:lorazepam 305:midazolam 293:etomidate 281:receptors 222:midazolam 196:Etomidate 170:Injection 156:enflurane 152:halothane 59:sedatives 3542:Serenics 3207:Vaccines 2974:Fibrates 2796:Vitamins 2746:Antacids 2572:Ketamine 2528:Fentanyl 2508:Morphine 2480:Diazepam 2409:Propofol 2399:Ciprofol 2322:Ethylene 2224:Category 1813:Baricity 1512:Sedation 1448:Archived 1376:29109627 1325:32467161 1266:25482669 1206:16402123 1132:76798115 929:21513454 845:14020693 837:18425091 767:See also 464:agonist 447:fentanyl 443:morphine 391:affect K 338:Ketamine 313:diazepam 289:propofol 227:Ketamine 220:such as 203:such as 191:Propofol 114:volatile 94:miscible 88:or even 36:insomnia 3399:General 3306:muscles 3275:L03–L04 3271:disease 3223:L01–L02 3219:disease 2969:Statins 2500:Opioids 2391:Phenols 2234:Outline 2113:History 1698:Opioids 1541:Topical 1507:General 1417:9226403 1367:5672515 1316:7306821 1293:Bibcode 1257:4428837 1197:1760740 920:3390788 761:alcohol 745:Ethanol 740:History 470:non-REM 349:visual 315:), and 117:liquids 70:amnesia 3706:  3685:  3633:other 3564:system 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Index

Anesthetics, general
sleep medicine
insomnia
righting reflex
analgesics
sedatives
general anesthesia
amnesia
inhalational anaesthetics
intravenous
intramuscular
miscible

volatile
liquids
gases
anaesthesia machine
Desflurane
isoflurane
sevoflurane
volatile anaesthetics
nitrous oxide
halothane
enflurane
methoxyflurane
xenon
intravenous injections
intramuscular
subcutaneous injections
Propofol

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