Posted by kaleidoscope on April 17, 2007, at 16:27:03
In reply to Drugs used to induce anesthesia, posted by Klavot on April 13, 2007, at 10:19:31
Hi
Various posters seem to be confused between the drugs used for premedication (eg. lorazepam), the drugs used to induce anesthesia (eg. propofol) and the drugs used to maintain anesthesia (eg. desflurane).
Propofol, an intravenous hypnotic, is one of the most widely used induction agents. Etomidate is little used outside emergency medicine. Thiopental (an IV barbiturate) is still used in some hospitals but is not as popular as it was because of the growing popularity of propofol.
In modern anesthetic practice, inhalational anesthetics are normally started only after the administration of the IV induction agent. As such, the inhalational agents are used predominantly to maintain anesthesia rather than to induce it. Induction of anesthesia using inhalational agents alone is slow and therefore unsatisfactory.
Fentanyl (or another potent opioid) is often given shortly before propofol but it is important to understand that fentanyl is not an anesthetic, but merely a supplement to anesthesia.
Deep sedation is induced by midazolam (Versed) or propofol, under the supervision of an anesthetist. Opioids are used as an adjunct during painful procedures.
Chloral hydrate was formerly a popular premedication for children but has been replaced by midazolam in most cases. Chloral was never used to induce anesthesia,. The Demerol/Phenergan/Thorazine premedication is obsolete. These days, a benzodiazepine is used as a premedication for very anxious patients. For everyone else, premedication is not usually necessary.
Ed
poster:kaleidoscope
thread:749491
URL: http://www.dr-bob.org/babble/20070413/msgs/750767.html