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General Anesthetics
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Aman Upaganlawar, Abdulla Sherikar, Chandrashekhar Upasani
Elementarily general anesthetic causes differed rate of analgesia, loss of memory, loss of all feelings, reflexes and perception, relaxation of muscle with partial loss of respiratory and cardiovascular functions. A model anesthetic drug should provoke the unconsciousness smoothly and rapidly and should provide recovery also after its discontinuation (Brunton et al., 2011; Rang et al., 2011). No single agent is able to achieve all these desirable effect without risk of toxicity. Therefore, in anesthetic practice a number of different categories of drug are utilized concomitantly to produce a “balanced anesthesia” with respect to their both beneficial and minimized toxicity producing effects. While performing the surgery, it is general practice to use the pre-anesthetic medication followed by administration of intravenous thiopental or propofol for rapid and soft initiation of anesthesia. In addition to this therapy, combinations of inhaled and intravenous anesthetics agents are administering to maintain the balanced state of anesthesia. There are other drugs such as neuromuscular blockers which facilitate intubation and suppress muscle tone. In case of minor surgery, the low doses of general anesthetics along with local anesthetics are given. This technique is called as “monitored anesthesia” where distinct analgesia is achieved with no loss of respiratory functions as well as allowing the verbal communication of the patient (Katzung et al., 2009; Sharma and Sharma, 2017).
Esmolol hypotension maintains tissue perfusion during myomectomy judged by Masimo monitoring of regional cerebral oxygen saturation and pleth variability index
Published in Egyptian Journal of Anaesthesia, 2018
Samar A. Salman, Hany A. Shehab
All patients were premedicated by midazolam 0.02 mg/kg; anesthesia was induced using propofol 2 mg/kg, fentanyl 1–2 ug/kg, and rocuronium 0.6 mg/kg. For both groups, balanced anesthesia was continued with sevoflurane, fentanyl and rocuronium adapted to the patient’s physiological reaction to surgical stimuli. After intubation of the trachea, the lungs were ventilated with 100% O2 using a semi-closed circle system. For group HA, esmolol 0.5 mg/kg diluted in 10 ml of 0.9% normal saline was given as an intravenous bolus followed by esmolol (Esmolol hydrochloride 100 mg/10 ml, Baxter Healthcare Corporation, Deerfield, USA) infusion at rate of 0.05–0.3 mg/kg/min to maintain MAP of 60–70 mmHg until myomectomy was completed. Then, esmolol infusion was stopped to allow restoration of blood pressure so that perfect hemostasis could be achieved. For both groups, ventilation was controlled with a tidal volume of 6–8 ml/kg, and the ventilatory rate was adjusted to maintain an end-tidal carbon dioxide (ETCO2) of 30–35 mmHg. Patients were continuously monitored for electrocardiogram, non-invasive arterial blood pressure (SBP, DBP and MAP), heart rate (HR) and temperature.
A comparative study of clonidine and magnesium sulfate premedication on perioperative hormonal stress responses, hemodynamic stability and postoperative analgesia in patients with gallbladder diseases undergoing laparoscopic cholecystectomy. A randomized, double-blind, controlled study
Published in Egyptian Journal of Anaesthesia, 2022
Hatem Saber Mohamed Ali, Gad Sayed Gad, Hanan Mahmoud Fayed
Laparoscopic cholecystectomy has become the milestone accomplishment in the modern arena of surgical practice as a great advance in the management of patients with symptomatic gallbladder diseases. It has also become an integral component of ambulatory and one-day procedures; hence, it requires a balanced anesthesia technique to obtain a smooth post-operative recovery. It has the advantages of lesser tissue trauma, reduced post-operative pain, shorter hospital stay, more rapid return of normal activities with significant cost savings [1].