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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.
3671: 2209: 3692: 2219: 496:. 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. 718:, 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 697:
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
85:—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. 577:. 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 238:
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.
475:, 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 622:
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
50:. 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. 2113: 722:. 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. 93: 342:. 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. 116:. 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. 461:
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.
2159: 57:. It remains somewhat controversial regarding how this state should be defined. General anesthetics, however, typically elicit several key reversible effects: immobility, analgesia, 659:. Generally, prolonged anesthetic drug infusions result in longer drug half-lives, slowed elimination from the brain and spinal cord, and delayed termination of general anesthesia. 276:
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
249:. The relative roles of different receptors is still under debate, but evidence exists for particular targets being involved with certain anaesthetics and drug effects. 1960: 2164: 375:
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
600:, eliciting nausea and vomiting following treatment. 151:. Researchers are also actively exploring the use of 139:. Older, less popular volatile anaesthetics include 2180:
Australian and New Zealand College of Anaesthetists
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frequently used in the operative setting in the US.
1153:"Molecular targets underlying general anaesthesia" 608: 551:. Some anesthetics, however, disrupt this reflex. 1476: 529: 520: 3709: 1333:Journal of Anaesthesiology Clinical Pharmacology 1270:"Studies on the mechanism of general anesthesia" 1326: 1274:Proceedings of the National Academy of Sciences 1217:PflĂĽgers Archiv: European Journal of Physiology 573:, an increase in respiratory rate, and reduced 504:The receiver of the anesthesia primarily feels 371:current, which reduces neuronal excitability. K 101:Inhalational anaesthetic substances are either 2263: 2687: 2249: 1462: 1412: 1042: 748:, prior to the development of modern agents, 541: 245:(CNS) receptors, and the inactivation of CNS 16:Compound that induces a loss of consciousness 2702:Major chemical drug groups – based upon the 1842:Intraoperative neurophysiological monitoring 1133:: CS1 maint: multiple names: authors list ( 397:general anesthetics are less pronounced in K 320: 2694: 2680: 2256: 2242: 2145:American Association of Nurse Anesthetists 1469: 1455: 1075:: CS1 maint: location missing publisher ( 255: 2190:International Anesthesia Research Society 1797:ASA physical status classification system 1395: 1354: 1344: 1303: 1293: 1244: 1184: 907: 64: 1542:Combined spinal and epidural anaesthesia 685: 549:baroreceptor-mediated feedback mechanism 175:. Among the most widely used drugs are: 92: 19:These drugs are not to be confused with 3723:Drugs with unknown mechanisms of action 2175:Association of Veterinary Anaesthetists 1439:from the original on 18 September 2017. 511: 487: 3710: 3681:Pharmacological classification systems 3048:Selective estrogen receptor modulators 1150: 1038: 1036: 1034: 1032: 1030: 1028: 1026: 959: 957: 955: 953: 951: 949: 947: 795: 233:Theories of general anaesthetic action 226: 53:General anesthetics elicit a state of 3328:Non-steroidal anti-inflammatory drugs 2675: 2237: 2155:American Society of Anesthesiologists 1450: 1206: 1204: 1146: 1144: 1096: 1094: 1092: 1090: 1088: 1086: 1024: 1022: 1020: 1018: 1016: 1014: 1012: 1010: 1008: 1006: 945: 943: 941: 939: 937: 935: 933: 931: 929: 927: 861: 859: 857: 855: 853: 851: 849: 847: 845: 843: 499: 112:, and are usually delivered using an 46:and should also not be confused with 2160:Anaesthesia Trauma and Critical Care 592:General anesthetics also affect the 408:counterparts. Cumulatively, TASK-1, 135:today. They are often combined with 2941:Angiotensin II receptor antagonists 2185:Australian Society of Anaesthetists 2093:Physicians' assistant (anaesthesia) 1996:Postoperative residual curarization 884:10.1146/annurev-neuro-060909-153200 752:was used as a general anaesthetic. 603: 13: 2073:Operating department practitioners 1201: 1141: 1100: 1083: 1003: 924: 840: 14: 3734: 2083:Certified anesthesia technologist 1991:Postoperative nausea and vomiting 1506:Procedural sedation and analgesia 1151:Franks, Nicholas P (2006-01-01). 457:leads to sedation that resembles 3690: 3670: 3669: 2217: 2208: 2207: 1624:Transverse abdominis plane block 1422:The Wondrous Story of Anesthesia 1384:European Journal of Pharmacology 709: 663:Inhalational general anesthetics 631:Following distribution into the 3078:Hypothalamic–pituitary hormones 2218: 2124:History of neuraxial anesthesia 2078:Certified anesthesia technician 1900:Double-lumen endobronchial tube 1761:Blood–gas partition coefficient 1594:Intravenous regional anesthesia 1371: 1157:British Journal of Pharmacology 1045:Basic and clinical pharmacology 716:blood:gas partition coefficient 609:Intravenous general anesthetics 2370: 2170:Royal College of Anaesthetists 2129:History of tracheal intubation 1776:Minimum alveolar concentration 1713:Anesthesia provision in the US 1320: 1261: 1103:Rang & Dale's pharmacology 789: 681: 668:Minimal alveolar concentration 626: 530:Stage IV: Medullary Depression 521:Stage III: Surgical Anesthesia 467:antagonists have sedative and 357:Two-pore potassium channels (K 347:Two-pore potassium channels (K 1: 2830:Thrombolytics / fibrinolytics 2119:History of general anesthesia 1631:Total intravenous anaesthesia 1579:Inferior alveolar nerve block 1525:Continuous wound infiltration 1397:10.1016/S0014-2999(97)89174-1 872:Annual Review of Neuroscience 782: 777:History of general anesthesia 88: 3541:Wakefulness-promoting agents 1682:Neuromuscular-blocking drugs 613: 589:, to ensure patient safety. 158: 7: 2017:Critical emergency medicine 798:Nature Reviews Neuroscience 755: 272:are chloride channels that 10: 3739: 3191:Intravenous immunoglobulin 2063:Anesthesiologist assistant 1925:Relative analgesia machine 1346:10.4103/joacp.joacp_334_16 737: 733: 728: 594:chemoreceptor trigger zone 579:lower esophageal sphincter 542:Physiological side effects 451:alpha2 adrenergic receptor 365:resting membrane potential 230: 18: 3665: 3621: 3593: 3549: 3358: 3293: 3256: 3204: 3117: 3061: 3021: 2978: 2862: 2798: 2710: 2632: 2607: 2579: 2546: 2487: 2454: 2406: 2378: 2369: 2276: 2203: 2137: 2101: 2050: 2004: 1971:Local anesthetic toxicity 1938: 1870: 1789: 1753: 1700: 1639: 1488: 1229:10.1007/s00424-014-1654-4 598:brainstem vomiting center 420: 321:NMDA receptor antagonists 131:are the most widely used 71:inhalational anaesthetics 3246:Topoisomerase inhibitors 2930:renin–angiotensin system 2924:Calcium channel blockers 1986:Postanesthetic shivering 1852:Neuromuscular monitoring 1743:Rapid sequence induction 1672:Inhalational anesthetics 772:Intraoperative awareness 558:, as the aforementioned 2037:Oral sedation dentistry 2027:Intensive care medicine 1981:Perioperative mortality 1837:Guedel's classification 1584:Intercostal nerve block 1295:10.1073/pnas.2004259117 404:, as compared to their 173:subcutaneous injections 3038:Hormonal contraception 2968:Bile acid sequestrants 2749:Proton-pump inhibitors 2712:gastrointestinal tract 2088:Anaesthetic technician 1976:Malignant hyperthermia 1169:10.1038/sj.bjp.0706441 995:: CS1 maint: others ( 767:Mechanical ventilation 690: 633:central nervous system 449:Administration of the 243:central nervous system 165:intravenous injections 98: 65:Mode of administration 1910:Laryngeal mask airway 1754:Scientific principles 1723:Dogliotti's principle 1599:Occipital nerve block 1564:Brachial plexus block 1101:M., Dale, M. (2007). 703:partition coefficient 689: 133:volatile anaesthetics 96: 73:), or as injections ( 3647:Radiopharmaceuticals 3435:Antiparkinson agents 2581:Neuroactive steroids 2548:Arylcyclohexylamines 1956:Drug-induced amnesia 1951:Anesthesia awareness 1885:Anesthetic vaporizer 1862:Thyromental distance 1766:Concentration effect 1640:Pharmacologic agents 1609:Pudendal nerve block 512:Stage II: Excitement 488:Stages of anesthesia 386:electrophysiological 247:excitatory receptors 31:General anaesthetics 3430:Antimigraine agents 3420:Antidementia agents 3323:Anti-inflammatories 3013:Medicated dressings 2953:Antihyperlipidemics 2780:Diabetes medication 2265:General anesthetics 1880:Anaesthetic machine 1738:Tracheal intubation 1728:Intravenous therapy 1667:General anesthetics 1619:Sciatic nerve block 1574:Femoral nerve block 1569:Fascia iliaca block 1547:Epidural anesthesia 1513:Twilight anesthesia 1286:2020PNAS..11713757P 1280:(24): 13757–13766. 740:Alcohols (medicine) 227:Mechanism of action 155:as an anaesthetic. 114:anaesthesia machine 3283:Immunosuppressants 3153:Antimycobacterials 3109:Antithyroid agents 3093:Mineralocorticoids 2897:Cardiac stimulants 2887:Cardiac glycosides 2879:cardiac therapy / 2775:Anti-obesity drugs 2659:Never to phase III 1966:Emergence delirium 1946:Allergic reactions 1822:Entropy monitoring 1604:Paracervical block 1589:Interpleural block 1552:Spinal anaesthesia 1537:Neuraxial blockade 691: 500:Stage I: Analgesia 99: 55:general anesthesia 3705: 3704: 3608:Ophthalmologicals 3318:Anabolic steroids 3221:Anticancer agents 3184:Ectoparasiticides 2904:Antihypertensives 2852:Antifibrinolytics 2669: 2668: 2628: 2627: 2446:Thiotetrabarbital 2351:Trichloroethylene 2231: 2230: 2068:Nurse anesthetist 1895:Bronchial blocker 1890:Arterial catheter 1781:Second gas effect 1708:Airway management 1677:Local anesthetics 1614:Retrobulbar block 1432:978-1-4614-8441-7 762:Local anaesthesia 720:context-dependent 657:context-dependent 587:endotracheal tube 536:vasomotor centers 465:Dopamine receptor 310:sodium thiopental 260:receptor agonists 3730: 3694: 3673: 3672: 3657:Senotherapeutics 3511:Neuroprotectives 3506:Mood stabilizers 3405:Anti-ADHD agents 3345:Muscle relaxants 3278:Immunostimulants 3273:Immunomodulators 3105:Thyroid hormones 3043:Fertility agents 2946:Renin inhibitors 2837:Antihemorrhagics 2804:forming organs ( 2790:Dietary minerals 2696: 2689: 2682: 2673: 2672: 2376: 2375: 2258: 2251: 2244: 2235: 2234: 2221: 2220: 2211: 2210: 2058:Anesthesiologist 1847:Mallampati score 1807:Bispectral index 1647:Anticholinergics 1471: 1464: 1457: 1448: 1447: 1441: 1440: 1416: 1410: 1409: 1399: 1375: 1369: 1368: 1358: 1348: 1324: 1318: 1317: 1307: 1297: 1265: 1259: 1258: 1248: 1208: 1199: 1198: 1188: 1148: 1139: 1138: 1132: 1124: 1098: 1081: 1080: 1074: 1066: 1040: 1001: 1000: 994: 986: 961: 922: 921: 911: 863: 838: 837: 793: 695:partial pressure 676:partial-pressure 604:Pharmacokinetics 564:thermoregulatory 3738: 3737: 3733: 3732: 3731: 3729: 3728: 3727: 3708: 3707: 3706: 3701: 3697:Medicine portal 3661: 3617: 3589: 3584: 3576:Cough medicines 3571:Bronchodilators 3552: 3545: 3425:Antidepressants 3415:Anticonvulsants 3363: 3354: 3350:Bisphosphonates 3340:Corticosteroids 3302: 3289: 3261: 3252: 3236:Spindle poisons 3226:Antimetabolites 3209: 3200: 3122: 3113: 3088:Glucocorticoids 3083:Corticosteroids 3064: 3057: 3024: 3017: 2974: 2892:Antiarrhythmics 2865: 2858: 2815:Antithrombotics 2803: 2794: 2770:Antipropulsives 2766:Antidiarrhoeals 2743: 2714: 2706: 2700: 2670: 2665: 2664: 2649:Clinical trials 2624: 2603: 2575: 2542: 2483: 2456:Benzodiazepines 2450: 2402: 2365: 2272: 2262: 2232: 2227: 2199: 2133: 2097: 2046: 2000: 1934: 1866: 1812:Body mass index 1785: 1749: 1696: 1662:Benzodiazepines 1635: 1484: 1475: 1445: 1444: 1433: 1417: 1413: 1376: 1372: 1325: 1321: 1266: 1262: 1209: 1202: 1163:(S1): S72–S81. 1149: 1142: 1126: 1125: 1113: 1099: 1084: 1068: 1067: 1055: 1041: 1004: 988: 987: 975: 963: 962: 925: 864: 841: 810:10.1038/nrn2372 794: 790: 785: 758: 742: 736: 731: 712: 684: 665: 655:are said to be 652:drug metabolism 637:adipose tissues 629: 616: 611: 606: 571:bronchodilation 544: 532: 523: 514: 502: 494:unconsciousness 490: 455:dexmedetomidine 427:Opioid receptor 423: 400: 395: 391: 383: 378: 374: 369:hyperpolarizing 360: 353: 350: 323: 290:benzodiazepines 269: 262: 259: 235: 229: 207:Benzodiazepines 161: 91: 67: 39:righting reflex 28: 17: 12: 11: 5: 3736: 3726: 3725: 3720: 3703: 3702: 3700: 3699: 3688: 3683: 3678: 3666: 3663: 3662: 3660: 3659: 3654: 3649: 3644: 3642:Contrast media 3639: 3633: 3631: 3619: 3618: 3616: 3615: 3610: 3604: 3602: 3595:sensory organs 3591: 3590: 3588: 3587: 3582: 3578: 3573: 3568: 3562: 3560: 3547: 3546: 3544: 3543: 3538: 3533: 3528: 3523: 3518: 3513: 3508: 3503: 3494: 3493: 3492: 3487: 3482: 3472: 3467: 3462: 3457: 3452: 3447: 3442: 3440:Antipsychotics 3437: 3432: 3427: 3422: 3417: 3412: 3410:Antiaddictives 3407: 3402: 3397: 3396: 3395: 3390: 3380: 3374: 3372: 3365:nervous system 3356: 3355: 3353: 3352: 3347: 3342: 3337: 3335:Antirheumatics 3332: 3331: 3330: 3320: 3314: 3312: 3291: 3290: 3288: 3287: 3286: 3285: 3280: 3269: 3267: 3254: 3253: 3251: 3250: 3249: 3248: 3243: 3241:Antineoplastic 3238: 3233: 3228: 3217: 3215: 3202: 3201: 3199: 3198: 3193: 3188: 3187: 3186: 3181: 3176: 3174:Antiprotozoals 3169:Antiparasitics 3166: 3161: 3156: 3149:Antibacterials 3145:Antimicrobials 3141: 3139: 3115: 3114: 3112: 3111: 3102: 3097: 3096: 3095: 3090: 3080: 3074: 3072: 3059: 3058: 3056: 3055: 3050: 3045: 3040: 3034: 3032: 3019: 3018: 3016: 3015: 3010: 3008:Antipsoriatics 3005: 3000: 2995: 2989: 2987: 2976: 2975: 2973: 2972: 2971: 2970: 2965: 2960: 2950: 2949: 2948: 2943: 2938: 2936:ACE inhibitors 2926: 2921: 2916: 2911: 2906: 2901: 2900: 2899: 2894: 2889: 2875: 2873: 2864:cardiovascular 2860: 2859: 2857: 2856: 2855: 2854: 2849: 2844: 2834: 2833: 2832: 2827: 2825:Anticoagulants 2822: 2811: 2809: 2796: 2795: 2793: 2792: 2787: 2782: 2777: 2772: 2763: 2758: 2753: 2752: 2751: 2746: 2741: 2737: 2726: 2724: 2708: 2707: 2699: 2698: 2691: 2684: 2676: 2667: 2666: 2663: 2662: 2661: 2660: 2657: 2646: 2640: 2634: 2633: 2630: 2629: 2626: 2625: 2623: 2622: 2617: 2611: 2609: 2605: 2604: 2602: 2601: 2596: 2591: 2585: 2583: 2577: 2576: 2574: 2573: 2568: 2563: 2558: 2552: 2550: 2544: 2543: 2541: 2540: 2535: 2529: 2524: 2519: 2514: 2509: 2504: 2499: 2493: 2491: 2485: 2484: 2482: 2481: 2476: 2471: 2466: 2460: 2458: 2452: 2451: 2449: 2448: 2443: 2438: 2433: 2428: 2423: 2418: 2412: 2410: 2404: 2403: 2401: 2400: 2395: 2390: 2384: 2382: 2373: 2367: 2366: 2364: 2363: 2358: 2353: 2348: 2343: 2338: 2336:Methoxypropane 2333: 2331:Methoxyflurane 2328: 2323: 2318: 2313: 2308: 2303: 2298: 2293: 2288: 2282: 2280: 2274: 2273: 2261: 2260: 2253: 2246: 2238: 2229: 2228: 2226: 2225: 2215: 2204: 2201: 2200: 2198: 2197: 2192: 2187: 2182: 2177: 2172: 2167: 2162: 2157: 2152: 2147: 2141: 2139: 2135: 2134: 2132: 2131: 2126: 2121: 2116: 2111: 2105: 2103: 2099: 2098: 2096: 2095: 2090: 2085: 2080: 2075: 2070: 2065: 2060: 2054: 2052: 2048: 2047: 2045: 2044: 2039: 2034: 2029: 2024: 2019: 2014: 2012:Cardiothoracic 2008: 2006: 2005:Subspecialties 2002: 2001: 1999: 1998: 1993: 1988: 1983: 1978: 1973: 1968: 1963: 1958: 1953: 1948: 1942: 1940: 1936: 1935: 1933: 1932: 1927: 1922: 1920:Magill forceps 1917: 1915:Laryngeal tube 1912: 1907: 1902: 1897: 1892: 1887: 1882: 1876: 1874: 1868: 1867: 1865: 1864: 1859: 1854: 1849: 1844: 1839: 1834: 1829: 1827:Fick principle 1824: 1819: 1814: 1809: 1804: 1799: 1793: 1791: 1787: 1786: 1784: 1783: 1778: 1773: 1768: 1763: 1757: 1755: 1751: 1750: 1748: 1747: 1746: 1745: 1735: 1730: 1725: 1720: 1715: 1710: 1704: 1702: 1698: 1697: 1695: 1694: 1689: 1684: 1679: 1674: 1669: 1664: 1659: 1657:Butyrophenones 1654: 1649: 1643: 1641: 1637: 1636: 1634: 1633: 1628: 1627: 1626: 1621: 1616: 1611: 1606: 1601: 1596: 1591: 1586: 1581: 1576: 1571: 1566: 1556: 1555: 1554: 1549: 1544: 1534: 1533: 1532: 1527: 1517: 1516: 1515: 1510: 1509: 1508: 1492: 1490: 1486: 1485: 1482:anesthesiology 1474: 1473: 1466: 1459: 1451: 1443: 1442: 1431: 1411: 1390:(2–3): 121–7. 1370: 1339:(3): 306–316. 1319: 1260: 1223:(5): 907–916. 1200: 1140: 1112:978-0443069116 1111: 1082: 1053: 1002: 973: 923: 878:(1): 601–628. 839: 804:(5): 370–386. 787: 786: 784: 781: 780: 779: 774: 769: 764: 757: 754: 738:Main article: 735: 732: 730: 727: 711: 708: 683: 680: 664: 661: 628: 625: 615: 612: 610: 607: 605: 602: 543: 540: 531: 528: 522: 519: 513: 510: 501: 498: 489: 486: 485: 484: 462: 447: 422: 419: 418: 417: 402:knock-out mice 398: 393: 389: 381: 376: 372: 358: 352: 348: 345: 344: 343: 340:hallucinations 322: 319: 318: 317: 267: 261: 257: 254: 228: 225: 221: 220: 213: 204: 187: 182: 160: 157: 149:methoxyflurane 90: 87: 66: 63: 21:sleep medicine 15: 9: 6: 4: 3: 2: 3735: 3724: 3721: 3719: 3716: 3715: 3713: 3698: 3693: 3689: 3687: 3684: 3682: 3679: 3677: 3668: 3667: 3664: 3658: 3655: 3653: 3650: 3648: 3645: 3643: 3640: 3638: 3635: 3634: 3632: 3629: 3625: 3620: 3614: 3611: 3609: 3606: 3605: 3603: 3600: 3596: 3592: 3586: 3579: 3577: 3574: 3572: 3569: 3567: 3566:Decongestants 3564: 3563: 3561: 3558: 3554: 3548: 3542: 3539: 3537: 3534: 3532: 3529: 3527: 3524: 3522: 3519: 3517: 3514: 3512: 3509: 3507: 3504: 3502: 3498: 3495: 3491: 3488: 3486: 3485:Dissociatives 3483: 3481: 3478: 3477: 3476: 3475:Hallucinogens 3473: 3471: 3468: 3466: 3463: 3461: 3458: 3456: 3453: 3451: 3448: 3446: 3443: 3441: 3438: 3436: 3433: 3431: 3428: 3426: 3423: 3421: 3418: 3416: 3413: 3411: 3408: 3406: 3403: 3401: 3398: 3394: 3391: 3389: 3386: 3385: 3384: 3381: 3379: 3376: 3375: 3373: 3370: 3366: 3361: 3357: 3351: 3348: 3346: 3343: 3341: 3338: 3336: 3333: 3329: 3326: 3325: 3324: 3321: 3319: 3316: 3315: 3313: 3310: 3306: 3300: 3296: 3292: 3284: 3281: 3279: 3276: 3275: 3274: 3271: 3270: 3268: 3265: 3259: 3255: 3247: 3244: 3242: 3239: 3237: 3234: 3232: 3229: 3227: 3224: 3223: 3222: 3219: 3218: 3216: 3213: 3207: 3203: 3197: 3194: 3192: 3189: 3185: 3182: 3180: 3179:Anthelmintics 3177: 3175: 3172: 3171: 3170: 3167: 3165: 3162: 3160: 3157: 3154: 3150: 3146: 3143: 3142: 3140: 3137: 3133: 3129: 3125: 3120: 3116: 3110: 3106: 3103: 3101: 3098: 3094: 3091: 3089: 3086: 3085: 3084: 3081: 3079: 3076: 3075: 3073: 3070: 3066: 3060: 3054: 3051: 3049: 3046: 3044: 3041: 3039: 3036: 3035: 3033: 3030: 3026: 3023:genitourinary 3020: 3014: 3011: 3009: 3006: 3004: 3003:Antipruritics 3001: 2999: 2996: 2994: 2991: 2990: 2988: 2985: 2981: 2977: 2969: 2966: 2964: 2961: 2959: 2956: 2955: 2954: 2951: 2947: 2944: 2942: 2939: 2937: 2934: 2933: 2932: 2931: 2927: 2925: 2922: 2920: 2919:Beta blockers 2917: 2915: 2912: 2910: 2907: 2905: 2902: 2898: 2895: 2893: 2890: 2888: 2885: 2884: 2883: 2882: 2877: 2876: 2874: 2871: 2867: 2861: 2853: 2850: 2848: 2845: 2843: 2840: 2839: 2838: 2835: 2831: 2828: 2826: 2823: 2821: 2820:Antiplatelets 2818: 2817: 2816: 2813: 2812: 2810: 2807: 2801: 2797: 2791: 2788: 2786: 2783: 2781: 2778: 2776: 2773: 2771: 2767: 2764: 2762: 2759: 2757: 2754: 2750: 2747: 2745: 2738: 2736: 2733: 2732: 2731: 2728: 2727: 2725: 2722: 2718: 2713: 2709: 2705: 2697: 2692: 2690: 2685: 2683: 2678: 2677: 2674: 2658: 2656: 2653: 2652: 2650: 2647: 2644: 2641: 2639: 2636: 2635: 2631: 2621: 2618: 2616: 2613: 2612: 2610: 2606: 2600: 2597: 2595: 2592: 2590: 2587: 2586: 2584: 2582: 2578: 2572: 2569: 2567: 2566:Phencyclidine 2564: 2562: 2559: 2557: 2554: 2553: 2551: 2549: 2545: 2539: 2536: 2533: 2530: 2528: 2527:Phenoperidine 2525: 2523: 2520: 2518: 2515: 2513: 2510: 2508: 2505: 2503: 2500: 2498: 2495: 2494: 2492: 2490: 2486: 2480: 2477: 2475: 2472: 2470: 2467: 2465: 2462: 2461: 2459: 2457: 2453: 2447: 2444: 2442: 2439: 2437: 2434: 2432: 2431:Narcobarbital 2429: 2427: 2424: 2422: 2419: 2417: 2414: 2413: 2411: 2409: 2405: 2399: 2396: 2394: 2391: 2389: 2386: 2385: 2383: 2381: 2377: 2374: 2372: 2368: 2362: 2359: 2357: 2354: 2352: 2349: 2347: 2344: 2342: 2341:Nitrous oxide 2339: 2337: 2334: 2332: 2329: 2327: 2324: 2322: 2319: 2317: 2314: 2312: 2309: 2307: 2304: 2302: 2301:Diethyl ether 2299: 2297: 2294: 2292: 2289: 2287: 2284: 2283: 2281: 2279: 2275: 2270: 2266: 2259: 2254: 2252: 2247: 2245: 2240: 2239: 2236: 2224: 2216: 2214: 2206: 2205: 2202: 2196: 2193: 2191: 2188: 2186: 2183: 2181: 2178: 2176: 2173: 2171: 2168: 2166: 2163: 2161: 2158: 2156: 2153: 2151: 2148: 2146: 2143: 2142: 2140: 2138:Organizations 2136: 2130: 2127: 2125: 2122: 2120: 2117: 2115: 2112: 2110: 2107: 2106: 2104: 2100: 2094: 2091: 2089: 2086: 2084: 2081: 2079: 2076: 2074: 2071: 2069: 2066: 2064: 2061: 2059: 2056: 2055: 2053: 2049: 2043: 2042:Pain medicine 2040: 2038: 2035: 2033: 2030: 2028: 2025: 2023: 2020: 2018: 2015: 2013: 2010: 2009: 2007: 2003: 1997: 1994: 1992: 1989: 1987: 1984: 1982: 1979: 1977: 1974: 1972: 1969: 1967: 1964: 1962: 1959: 1957: 1954: 1952: 1949: 1947: 1944: 1943: 1941: 1939:Complications 1937: 1931: 1930:Tracheal tube 1928: 1926: 1923: 1921: 1918: 1916: 1913: 1911: 1908: 1906: 1903: 1901: 1898: 1896: 1893: 1891: 1888: 1886: 1883: 1881: 1878: 1877: 1875: 1873: 1869: 1863: 1860: 1858: 1855: 1853: 1850: 1848: 1845: 1843: 1840: 1838: 1835: 1833: 1832:Goldman index 1830: 1828: 1825: 1823: 1820: 1818: 1815: 1813: 1810: 1808: 1805: 1803: 1800: 1798: 1795: 1794: 1792: 1788: 1782: 1779: 1777: 1774: 1772: 1769: 1767: 1764: 1762: 1759: 1758: 1756: 1752: 1744: 1741: 1740: 1739: 1736: 1734: 1731: 1729: 1726: 1724: 1721: 1719: 1716: 1714: 1711: 1709: 1706: 1705: 1703: 1699: 1693: 1690: 1688: 1685: 1683: 1680: 1678: 1675: 1673: 1670: 1668: 1665: 1663: 1660: 1658: 1655: 1653: 1650: 1648: 1645: 1644: 1642: 1638: 1632: 1629: 1625: 1622: 1620: 1617: 1615: 1612: 1610: 1607: 1605: 1602: 1600: 1597: 1595: 1592: 1590: 1587: 1585: 1582: 1580: 1577: 1575: 1572: 1570: 1567: 1565: 1562: 1561: 1560: 1557: 1553: 1550: 1548: 1545: 1543: 1540: 1539: 1538: 1535: 1531: 1528: 1526: 1523: 1522: 1521: 1518: 1514: 1511: 1507: 1504: 1503: 1502: 1499: 1498: 1497: 1494: 1493: 1491: 1487: 1483: 1479: 1472: 1467: 1465: 1460: 1458: 1453: 1452: 1449: 1438: 1434: 1428: 1424: 1423: 1415: 1407: 1403: 1398: 1393: 1389: 1385: 1381: 1374: 1366: 1362: 1357: 1352: 1347: 1342: 1338: 1334: 1330: 1323: 1315: 1311: 1306: 1301: 1296: 1291: 1287: 1283: 1279: 1275: 1271: 1264: 1256: 1252: 1247: 1242: 1238: 1234: 1230: 1226: 1222: 1218: 1214: 1207: 1205: 1196: 1192: 1187: 1182: 1178: 1174: 1170: 1166: 1162: 1158: 1154: 1147: 1145: 1136: 1130: 1122: 1118: 1114: 1108: 1104: 1097: 1095: 1093: 1091: 1089: 1087: 1078: 1072: 1064: 1060: 1056: 1054:9780071825054 1050: 1046: 1039: 1037: 1035: 1033: 1031: 1029: 1027: 1025: 1023: 1021: 1019: 1017: 1015: 1013: 1011: 1009: 1007: 998: 992: 984: 980: 976: 974:9780071624428 970: 966: 960: 958: 956: 954: 952: 950: 948: 946: 944: 942: 940: 938: 936: 934: 932: 930: 928: 919: 915: 910: 905: 901: 897: 893: 889: 885: 881: 877: 873: 869: 862: 860: 858: 856: 854: 852: 850: 848: 846: 844: 835: 831: 827: 823: 819: 815: 811: 807: 803: 799: 792: 788: 778: 775: 773: 770: 768: 765: 763: 760: 759: 753: 751: 747: 741: 726: 723: 721: 717: 707: 704: 699: 696: 688: 679: 677: 673: 669: 660: 658: 653: 649: 644: 642: 638: 634: 624: 621: 601: 599: 595: 590: 588: 584: 580: 576: 572: 567: 565: 561: 557: 552: 550: 539: 537: 527: 518: 517:of delirium. 509: 507: 497: 495: 482: 478: 474: 470: 466: 463: 460: 456: 452: 448: 445: 441: 440:hydromorphone 437: 433: 428: 425: 424: 415: 411: 407: 403: 387: 384:conductance, 370: 366: 362: 355: 354: 351:s) activation 341: 336: 332: 331:NMDA receptor 328: 325: 324: 315: 311: 307: 303: 299: 295: 291: 287: 283: 279: 275: 274:hyperpolarize 271: 264: 263: 253: 250: 248: 244: 239: 234: 224: 217: 214: 212: 208: 205: 203: 199: 195: 191: 188: 186: 183: 181: 178: 177: 176: 174: 170: 169:intramuscular 166: 156: 154: 150: 146: 142: 138: 137:nitrous oxide 134: 130: 126: 122: 117: 115: 111: 107: 104: 95: 86: 84: 80: 79:intramuscular 76: 72: 62: 60: 56: 51: 49: 45: 40: 36: 32: 26: 22: 3480:Psychedelics 3450:Aphrodisiacs 3387: 3124:infestations 3100:Sex hormones 3053:Sex hormones 2998:Cicatrizants 2928: 2914:Vasodilators 2881:antianginals 2878: 2730:stomach acid 2729: 2599:Hydroxydione 2532:Remifentanil 2426:Methohexital 2421:Hexobarbital 2408:Barbiturates 2291:Cyclopropane 2278:Inhalational 2264: 1905:Gas cylinder 1790:Measurements 1733:Laryngoscopy 1718:Bronchoscopy 1421: 1414: 1387: 1383: 1373: 1336: 1332: 1322: 1277: 1273: 1263: 1220: 1216: 1160: 1156: 1102: 1044: 964: 892:1721.1/86331 875: 871: 801: 797: 791: 743: 724: 713: 700: 692: 666: 645: 630: 617: 591: 583:asphyxiation 575:tidal volume 568: 560:vasodilation 553: 545: 533: 524: 515: 503: 491: 444:remifentanil 314:methohexital 306:barbiturates 251: 240: 236: 222: 194:methohexital 190:Barbiturates 162: 118: 100: 68: 52: 34: 30: 29: 3613:Otologicals 3585:antagonists 3551:respiratory 3526:Orexigenics 3521:Neurotoxins 3470:Euphoriants 3460:Entactogens 3455:Depressants 3445:Anxiolytics 3383:Anesthetics 3159:Antifungals 2756:Antiemetics 2744:antagonists 2645:from market 2512:Embutramide 2507:Anileridine 2479:Remimazolam 2416:Amobarbital 2393:Fospropofol 2356:Vinyl ether 2346:Sevoflurane 2109:ACE mixture 2051:Professions 1872:Instruments 1817:Capnography 1771:Fink effect 1652:Antiemetics 1559:Nerve block 710:Elimination 627:Elimination 556:hypothermia 477:haloperidol 198:thiopentone 129:sevoflurane 75:intravenous 35:anesthetics 3718:Anesthesia 3712:Categories 3536:Stimulants 3516:Nootropics 3490:Deliriants 3465:Entheogens 3400:Anorectics 3378:Analgesics 3231:Alkylating 3164:Antivirals 3119:infections 2993:Emollients 2847:Coagulants 2717:metabolism 2620:Propanidid 2594:Alfaxalone 2589:Alfadolone 2571:Tiletamine 2556:Esketamine 2538:Sufentanil 2522:Alfentanil 2441:Thiopental 2326:Isoflurane 2296:Desflurane 2286:Chloroform 1857:Pain scale 1701:Techniques 1478:Anesthesia 783:References 620:lipophilic 481:droperidol 469:antiemetic 286:isoflurane 231:See also: 202:thiopental 125:isoflurane 121:Desflurane 89:Inhalation 44:analgesics 3686:ATC codes 3652:Dressings 3637:Antidotes 3501:Sedatives 3497:Hypnotics 3206:malignant 3063:endocrine 2909:Diuretics 2842:Platelets 2802:and blood 2761:Laxatives 2655:Phase III 2643:Withdrawn 2615:Etomidate 2502:Oxycodone 2474:Lorazepam 2464:Midazolam 2436:Thiamylal 2371:Injection 2321:Halothane 2316:Fluroxene 2306:Enflurane 2032:Obstetric 2022:Geriatric 1692:Sedatives 1237:0031-6768 1177:1476-5381 1129:cite book 1071:cite book 1063:875520239 991:cite book 983:498979404 900:0147-006X 818:1471-0048 746:antiquity 682:Induction 672:potencies 648:half-life 614:Induction 506:analgesia 473:catalepsy 406:wild-type 335:off-label 298:lorazepam 294:midazolam 282:etomidate 270:receptors 211:midazolam 185:Etomidate 159:Injection 145:enflurane 141:halothane 48:sedatives 3531:Serenics 3196:Vaccines 2963:Fibrates 2785:Vitamins 2735:Antacids 2561:Ketamine 2517:Fentanyl 2497:Morphine 2469:Diazepam 2398:Propofol 2388:Ciprofol 2311:Ethylene 2213:Category 1802:Baricity 1501:Sedation 1437:Archived 1365:29109627 1314:32467161 1255:25482669 1195:16402123 1121:76798115 918:21513454 834:14020693 826:18425091 756:See also 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Index

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
Etomidate

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