Raheema Javed
Last Activity: 10 Years ago
An anesthetic is a drug that causes anesthesia—reversible loss of sensation. Anesthetics contrast with analgesics (painkillers), which relieve pain without eliminating sensation. These drugs are generally administered to facilitate surgery.
Anesthetics are categorized into two classes: general anesthetics, which cause a reversible loss of consciousness, and local anesthetics, which cause a reversible loss of sensation for a limited region of the body while maintaining consciousness.
Local Anesthetics
Each of the local anesthetics have the suffix "-caine" in their names.
Exampla procaine, amethocaine, cocaine, lidocaine (also known as Lignocaine), prilocaine, bupivacaine etc. Local anesthetics are agents that prevent transmission of nerve impulses without causing unconsciousness. They act by binding to fast sodium channels from within (in an open state). Local anesthetics can be either ester- or amide-based.
General Anesthetics
Drugs given to induce or maintain general anaesthesia can be either as gases or vapours (inhalational anaesthetics), or as injections (intravenous anaesthetics or even intramuscular). It is possible to deliver anaesthesia solely by inhalation or injection, but most commonly the two forms are combined, with an injection given to induce anaesthesia and a gas used to maintain it.
Inhalation
Inhalational anaesthetic substances are either volatile liquids or gases, and are usually delivered using an anaesthesia machine. An anaesthesia machine allows composing a mixture of oxygen, anaesthetics and ambient air, delivering it to the patient and monitoring patient and machine parameters. Liquid anaesthetics are vapourized in the machine. All of these agents share the property of being quite hydrophobic (i.e., as liquids, they are not freely miscible—or mixable—in water, and as gases they dissolve in oils better than in water).
Many compounds have been used for inhalation anaesthesia, but only a few are still in widespread use. Desflurane, isoflurane and sevoflurane are the most widely used volatile anaesthetics today. They are often combined with nitrous oxide. Older, less popular, volatile anaesthetics, include halothane, enflurane, and methoxyflurane. Researchers are also actively exploring the use of xenon as an anaesthetic.
Injection
Injectable anaesthetics are used for the induction and maintenance of a state of unconsciousness. Anaesthetists prefer to use intravenous injections, as they are faster, generally less painful and more reliable than intramuscular or subcutaneous injections. Among the most widely used drugs are:
Propofol
Etomidate
Barbiturates such as methohexital and thiopentone/thiopental
Benzodiazepines such as midazolam
Ketamine is used in the UK as "field anaesthesia", for instance at a road traffic incidents or similar situations where an operation must be conducted at the scene or when there is not enough time to move to an operating room, while preferring other anesthetics where conditions allow their use. It is more frequently used in the operative setting in the US.
It should be noted that Benzodiazepines are strictly sedatives and are used in combinations with other general anaesthetics