《药理学》课程PPT教学课件（Central Nervous Sys）13 anesthesia

CompanynameAnesthetic drugs

Company name Anesthetic drugs

Key termsAnesthesiaIs a loss of feeling or sensation.There are two types of anesthesia: local anesthesia andgeneral anesthesiaLocal anesthesiaIs the provision of a pain-free state in a aspecific area(or region).The patient is fully awake but does not feel pain in thearea tha has been anesthetizeGeneral anesthesiaIs the provision of a pain-free state for the entire bodyThe patient loses consciousness and feels no pain.Company Logo

Company Logo Key terms Anesthesia Is a loss of feeling or sensation. There are two types of anesthesia: local anesthesia and general anesthesia. Local anesthesia Is the provision of a pain-free state in a aspecific area (or region). The patient is fully awake but does not feel pain in the area tha has been anesthetize. General anesthesia Is the provision of a pain-free state for the entire body. The patient loses consciousness and feels no pain

GeneralanesthesiaCNSInhalation,depressesCNs+LossofconsciousnessRegional anesthesiaInjectionintosubarachnoidSpinalspaceof spinal cord (levelofsecondlumbarvertebra)Conductionblock+Injection intospinenearanervetrunkRAbsenceofsensationLocalLocalarea(infiltrationintoanesthesiatissueoranapplicationoftopicalorlocalanestheticonsurfaceofskinormucousmembranes)FicuRE35-1.Sitesandmechanismsofactionofdrugsusedforanesthesia

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PREANESTHETICDRUGSPurpose of Preanesthetic Drugs? Narcotic or antianxiety drug-to decrease anxietyand apprehension immediately before surgery.? Cholinergic blocking drugto decrease secretions ofthe upper respiratory tract. invoid pneumonia oratelectasis· Antiemetic-to lessen the incidence of nausea andvomiting during the immediate postoperativerecovery periodCompany Logo

Company Logo PREANESTHETIC DRUGS Purpose of Preanesthetic Drugs • Narcotic or antianxiety drug—to decrease anxiety and apprehension immediately before surgery. • Cholinergic blocking drug—to decrease secretions of the upper respiratory tract. invoid pneumonia or atelectasis. • Antiemetic—to lessen the incidence of nausea and vomiting during the immediate postoperative recovery period

EXAMPLESOFPREANESTHETICTABLE35-2DRUGSGENERIC NAMETRADENAMENarcoticsdroperidolInapsinefentanylSublimaze,genericmeperidinehydrochlorideDemerol,genericDuramorph,genericmorphinesulfateBarbituratespentobarbitalNembutalSodium,genericsecobarbitalgenericCholinergic-BlockingDrugsgenericatropinesulfateRobinul,genericglycopyrrolatescopolaminegenericAntianxietyDrugsWithAntiemeticPropertieshydroxyzineAtarax,Vistaril,genericAntianxietyDrugschlordiazepoxideLibrium,genericValium,genericdiazepamVersedmidazolam-ogo

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GENERALANESTHESIAThe administration of general anesthesiarequires the use of one or more drugs. Thechoice of anesthetic drug depends on manyfactors, including·The general physical condition of the patient · The area, organ, or system being operated on · The anticipated length of the surgicalprocedureCompany Logo

Company Logo The administration of general anesthesia requires the use of one or more drugs. The choice of anesthetic drug depends on many factors, including:  • The general physical condition of the patient  • The area, organ, or system being operated on  • The anticipated length of the surgical procedure GENERAL ANESTHESIA

Methohexital and ThiopentalThese drugs have a rapid onset and a short duration ofaction. They depress the central nervous system (CNS)to produce hypnosis and anesthesia but do not produceanalgesia. Recovery after a small dose is rapidClinic use· Induction of anesthesia? Short surgical procedures with minimal painfulstimuli? In conjunction with or as a supplement to otheranesthetics? Control of convulsive states (thiopental)Company Logo

Company Logo Clinic use • Induction of anesthesia • Short surgical procedures with minimal painful stimuli • In conjunction with or as a supplement to other anesthetics • Control of convulsive states (thiopental) Methohexital and Thiopental These drugs have a rapid onset and a short duration of action. They depress the central nervous system (CNS) to produce hypnosis and anesthesia but do not produce analgesia. Recovery after a small dose is rapid

口Etomidate Etomidate (Amidate),a nonbarbiturate,isusedforinduction of anesthesia.Etomidate also may beusedtosupplementotheranesthetics,suchasnitrousoxide,forshortsurgical procedures.Itisahypnoticwithoutanalgesic activity口PropofolPropofol (Diprivan)is usedfor induction andmaintenance of anesthesia.It also may be usedforsedation during diagnostic procedures andprocedures that use a local anesthetic.This drugalso is usedforcontinuous sedation ofintubated orrespiratory-controlled patients in intensive careunits.Company Logo

Company Logo  Etomidate  Etomidate (Amidate), a nonbarbiturate, is used for induction of anesthesia. Etomidate also may be used to supplement other anesthetics, such as nitrous oxide, for short surgical procedures. It is a hypnotic without analgesic activity.  Propofol  Propofol (Diprivan) is used for induction and maintenance of anesthesia. It also may be used for sedation during diagnostic procedures and procedures that use a local anesthetic. This drug also is used for continuous sedation of intubated or respiratory-controlled patients in intensive care units

MidazolamMidazolam Versed),a short-acting benzodiazepine CNSdepressant,is used as a preanesthetic drugto relieveanxiety:forinduction of anesthesia,for conscioussedation beforeminorprocedures,suchas endoscopicprocedures;andto supplementnitrous oxide andoxygenfor short surgical procedures.Whenthedrug is used forinduction anesthesia,thepatient graduallylosesconsciousness duringaperiodof 1to2minutesSevoflurane口Sevoflurane (Ultane)is an inhalational analgesic.It is口usedforinduction andmaintenance ofgeneralanesthesia in adult and pediatric patients for inpatientand outpatient surgical procedures.Company Logo

Company Logo  Midazolam  Midazolam (Versed), a short-acting benzodiazepine CNS depressant, is used as a preanesthetic drug to relieve anxiety; for induction of anesthesia; for conscious sedation before minor procedures, such as endoscopic procedures; and to supplement nitrous oxide and oxygen for short surgical procedures. When the drug is used for induction anesthesia, the patient gradually loses consciousness during a period of 1 to 2 minutes.  Sevoflurane  Sevoflurane (Ultane) is an inhalational analgesic. It is used for induction and maintenance of general anesthesia in adult and pediatric patients for inpatient and outpatient surgical procedures

KetamineKetamine(Ketalar)isarapid-actinggeneralanesthetic.Itproduces ananestheticstatecharacterizedbyprofoundanalgesia,cardiovascularandrespiratorystimulation,normalorenhancedskeletalmuscletone,andoccasionallymildrespiratorydepression.Ketamineisusedfordiagnosticandsurgicalproceduresthat donotreguirerelaxationofskeletalmuscles,forinductionofanesthesiabeforetheadministrationofotheranestheticdrugs,and as asupplementto otheranestheticdrugs.Cyclopropane口Ananestheticgas,cyclopropanehasarapidonsetofaction口and maybeusedforinductionandmaintenanceofanesthesia.Skeletalmusclerelaxationisproducedwithfullanestheticdoses.Cyclopropaneissuppliedinorangecylinders.Disadvantagesofcyclopropanearedifficultyindetectingtheplanesofanesthesia,occasionallaryngospasmcardiacarrhythmias,andpostanesthesianausea,vomiting,andheadache.Cyclopropaneandoxygenmixtures areexplosive,whichlimitstheuseofthisgasanestheticCompanyLogo

Company Logo  Ketamine  Ketamine (Ketalar) is a rapid-acting general anesthetic. It produces an anesthetic state characterized by profound analgesia, cardiovascular and respiratory stimulation, normal or enhanced skeletal muscle tone, and occasionally mild respiratory depression. Ketamine is used for diagnostic and surgical procedures that do not require relaxation of skeletal muscles, for induction of anesthesia before the administration of other anesthetic drugs, and as a supplement to other anesthetic drugs.  Cyclopropane  An anesthetic gas, cyclopropane has a rapid onset of action and may be used for induction and maintenance of anesthesia. Skeletal muscle relaxation is produced with full anesthetic doses. Cyclopropane is supplied in orange cylinders. Disadvantages of cyclopropane are difficulty in detecting the planes of anesthesia, occasional laryngospasm, cardiac arrhythmias, and postanesthesia nausea, vomiting, and headache. Cyclopropane and oxygen mixtures are explosive, which limits the use of this gas anesthetic