Pharmacology in 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.
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.
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.
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.
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.
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.
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.
The drug is a yellowish, hygroscopic powder, stabilized with 6% anhydrous sodium carbonate as a
Anesthesia is a crucial component of modern medicine, enabling surgeons and healthcare providers to perform complex procedures while ensuring the patient’s comfort and safety. Achieving this delicate balance requires the use of various drugs tailored to the individual patient’s needs. Clink for detailed pharmacology of all the Anesthetic Drugs Below,…
Rocuronium is a non-depolarizing steroidal muscle relaxant of intermediate duration. However, onset may be rapid or intermediate depending on the injected dose.
