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Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Local Anesthetics: Clinical Application as Spinal Anesthesia

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
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Local Anesthetics: Clinical Application as Epidural Anesthesia

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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...

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Related Experiment Video

Updated: Jul 15, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Propofol infusion for sedation during spinal anesthesia.

Tomoki Nishiyama¹

¹Department of Anesthesiology, The University of Tokyo, Faculty of Medicine, 7-3-1, Hongo, Tokyo 113-8655, Japan.

Journal of Anesthesia

|April 27, 2007

Summary

This study determined the optimal propofol infusion strategy for rapid sedation during spinal anesthesia. A stepwise reduction in propofol dosage effectively achieved and maintained desired sedation levels without oversedation.

Related Experiment Videos

Last Updated: Jul 15, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Area of Science:

Anesthesiology
Pharmacology

Background:

Spinal anesthesia requires careful sedation management to ensure patient comfort and safety.
Propofol is a commonly used anesthetic agent for sedation, but its optimal infusion parameters for specific procedures require investigation.

Purpose of the Study:

To investigate the appropriate propofol infusion dose and time course for achieving rapid, yet not excessive, sedation during spinal anesthesia.
To establish a sedation protocol that maintains a specific level of alertness and sedation.

Main Methods:

Forty patients undergoing spinal and epidural anesthesia were studied.
Propofol infusion was initiated at 10 mg.kg(-1).h(-1), reduced to 5 mg.kg(-1).h(-1) upon eye closure, and adjusted to maintain an Observer's Assessment of Alertness Sedation (OAAS) score of 3 or 4.
Sedation levels were monitored and adjusted dynamically based on the OAAS score.

Main Results:

Spontaneous eye closure, indicating initial sedation, occurred within 1.0 +/- 0.4 minutes.
The maintenance propofol infusion dose required to keep the OAAS score at 3 or 4 was approximately 2.5 mg.kg(-1).h(-1).

Conclusions:

A propofol infusion regimen starting at 10 mg.kg(-1).h(-1), decreasing to 5 mg.kg(-1).h(-1) after one minute, and further reducing to 2.5 mg.kg(-1).h(-1) after an additional minute, effectively induces rapid sedation.
This titration strategy successfully maintained the desired sedation level (OAAS score 3-4) throughout spinal anesthesia without causing oversedation.