Phenobarbital dosage include 3 to 5 mg/kg IV, produces rapid induction producing unconsciousness within 30 seconds. Although propofol is becoming the most popular drug for induction of anesthesia for its quick offset from anesthesia, thiopental is still in use due to its low cost in comparison particularly in developing countries. Phenobarbital dosage still remains the […]
The foregoing discussion is in the situation of a normal blood brain barrier about blood brain barrier crossing drugs. In a brain lesion, where the integrity of BBB varies according to the severity of damage, the control of fluid molecules is further complex. The osmotic/oncotic gradient will not be effective in areas of complete blood
Midazolam onset of action undergoes rapid absorption from gastrointestinal tract. Only about 50% of the orally administered dose of midazolam reaches the systemic circulation, reflecting extensive first-pass metabolism. It is highly protein bound and this does not depend on the plasma concentration of the drug. The short duration of the drug is due to its
The mechanisms for ketamine induced cardiovascular effects are complex and also Ketamine effect on blood pressure characteristics. Direct stimulation of the CNS leading to increased sympathetic nervous system outflow seems to be the most important mechanism for cardiovascular stimulation. One of the characteristic of Ketamine is related to blood pressure and is therefore termed as
Barbiturate drugs are defined as any drug derived from barbitunc acid. Barbituric acid, which lacks central nervous system (CNS) activity, is a cyclic compound obtained by the combination of urea and malonic acid. Barbiturate drugs with sedative hypnotic properties result from substitutions at the number 2 and 5 carbon atoms of barbituric acid. Barbiturates that
With respect to inhalation agent anesthetic , an increase in cardiac output and the consequent increased pulmonary blood flow removes more general anesthetic from the alveoli. The alveolar venous anesthetic gradient is determined by the amount of tissue uptake of an inhalation agent anesthetic . This depends on the tissue solubility, tissue blood flow and
Activation of NMDA receptors has been implicated in cerebral ischaemic damage. Therefore, by its antagonistic effect on NMDA receptors, Ketamine seizures may have a possible neuroprotective role. Systemic administration of ketamine has been reported to have neuroprotective effect, in terms of preoperative treatment, in preventing ischaemic and postischaemic spinal cord injury during thoracic and thoracoabdominal
Ketamine Preemptive Analgesia is an antinociceptive treatment targeted to block CNS hyperexcitability, and thereby leads to a reduced postoperative pain state. Excitatory amino acids aspartate, released by the C fibers, interacts with the NMDA receptors of the dorsal horn neurons, and thus, leads to increase in intracellular calcium ions, which is thought to be the
A special mention must be made here about the novel ways of using neuraxial regional anesthesia anticoagulation . The use started in 1979. Gradually they have become very popular and almost all the clinically available opioids have been tried by this route. Nowadays the flexibility of neuraxial regional anesthesia anticoagulation is available to be given
Pain control is an important aspect of critical care medicine and the use of opiate medications has typically been an important method of achieving control in the intensive care unit (ICU) setting. The brain has four opiate receptors that include the mu, kappa, delta, and sigma receptors. Currently used opioid analgesics bind to the mu
