TIVA – Total Intravenous Anesthesia

TIVA uses IV agents (propofol + remifentanil) for anesthesia without inhalational gases. Regimens: Propofol (TCI 2–6 mcg/mL or 100–200 mcg/kg/min) + remifentanil (TCI 2–6 ng/mL or 0.05–0.3 mcg/kg/min). Monitoring: BIS (40–60) ensures depth. Ideal for MH risk, PONV-prone patients, or neurosurgery. Enables precise titration and rapid emergence.

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Atracurium

Atracurium Chemical Structure

Atracurium is an intermediate-acting, non-depolarizing neuromuscular blocker. Hofmann elimination (independent of renal/hepatic function). Causes histamine release (risk of hypotension/tachycardia). Dose: 0.4-0.5 mg/kg IV. Reversed by neostigmine/glycopyrrolate. Ideal for patients with organ dysfunction.

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Isoflurane

Isoflurane

Isoflurane is a potent, reliable inhalational anesthetic (MAC ~1.2%) with moderate blood solubility (λB:G 1.4). Known for cardiovascular stability and bronchodilation, it uses a standard vaporizer. Pungent but less than Desflurane; suitable for pediatric maintenance. Cost-effective with minimal metabolism, making it a staple in anesthesia practice.

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Desflurane

Desflurane Vaporizer

Desflurane is a potent inhalational anesthetic prized for its rapid emergence due to low blood solubility (MAC 6-7%). Ideal for outpatient surgery and fast wake-up needs. Requires a special heated vaporizer. Pungent and irritating, it’s contraindicated for inhalational induction. Minimal metabolism offers low toxicity risk. Key for anesthesia efficiency.

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Sevoflurane

Sevoflurane

Sevoflurane is a potent, non-pungent inhalational anesthetic (MAC ~2%) with low blood solubility (λB:G 0.65). Ideal for smooth inhalational induction (especially pediatrics) and rapid emergence. Uses a standard vaporizer. Minimal airway irritation; monitor for Compound A with low-flow anesthesia. Low metabolism ensures safety.

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Midazolam

Midazolam Injection

Midazolam is a short-acting benzodiazepine used for preoperative sedation, anxiolysis, and amnesia. Rapid IV onset (1-2 min), metabolized hepatically. Causes respiratory depression; requires reversal with flumazenil. Synergistic with opioids. Key for procedural sedation and anxiolysis in anesthesia.

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Etomidate

Etomidate chemical structure

Etomidate is a rapid-onset IV hypnotic for induction (0.2-0.3 mg/kg). Cardiovascularly stable (minimal hemodynamic effects). Causes myoclonus and adrenal suppression (limit use in sepsis/critical illness). Minimal respiratory depression. Preferred for hemodynamically unstable patients.

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Rocuronium

Rocuronium

Rocuronium is a non-depolarizing steroidal muscle relaxant of intermediate duration. However, onset may be rapid or intermediate depending on the injected dose.

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Ketamine

Ketamine

Ketamine is a water-soluble molecule that chemically resembles phencyclidine. It exists as two isomers S(+) and R(-). The S(+) isomer has thr

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