Propofol is a global central nervous system depressant. Propofol general anesthesia decreases cerebral metabolic rate for oxygen (CMRO2), cerebral blood flow (CBF), and intracranial pressure (ICP). Decrease in CBF is more than sevoflurane. Propofol is a cerebral vasoconstrictor and thus lowers ICP. Propofol decreases ICP greater than isoflurane and sevoflurane while cerebral perfusion pressure is
Excitatory events following propofol administration are well described. The pathophysiology of these propofol myoclonus movements is not known. The drug should be used cautiously in patients with movement disorders. Miller’s anesthesia says the following about Propofol Myoclonus – Induction of anesthesia with propofol is associated with several side effects, including pain on injection, propofol myoclonus , apnea,
Visual analogue scale for pain intensity is a numerical pain rating scale which uses a 10 cm line with the numbers ranging from 0-10. Patients points out the number that corresponds to the level of pain they are feeling. The significance of the numbers must be explained to the patient. Intensity of the pain is
Propofol has a chemical structure similar to that of phenol-based free radical scavengers such as vitamin E, and reduces free radicals. This Propofol antioxidant may directly intervene at the critical phase of reperfusion injury by reducing free radicals, Ca 2+ influx and neutrophil activity. Oxygen leads to the formation of free oxygen radicals which react
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
Midazolam structure is characterized by pH dependent ring opening phenomenon in which the ring remains open at pH values of less than 4, thus maintaining its water solubility. The pK of midazolam is 6.15, which permits the preparations of salts to be water soluble. The parenteral solution of midazolam used clinically is buffered to an
For the phenobarbital metabolism the binding of thiopentone in human serum is about 85% and remarkably constant over the concentration range between 4 and 80 micrograms/mL. The higher percentage of protein binding occurs at lower plasma concentrations of thiopental In phenobarbital metabolism . The percentage binding increases with increasing pH from approximate 75% at pH
Etomidate shortens the onset time of the neuromuscular block with vecuronium. This etomidate drug interactions enhances the bradycardia induced by vecuronium. Miller’s anesthesia says the following about etomidate drug interactions – The specific endocrine effects manifested by etomidate are a dose-dependent reversible inhibition of the enzyme 11β-hydroxylase, which converts 11-deoxycortisol to cortisol, and a relatively minor
In patients with acute renal failure, total body clearance is lower and the elimination half-life, while considering midazolam duration of action becomes longer than in patients with normal kidney function. In patients with impaired kidney function, the excretion of 1-hydroxymethyl midazolam glucuronide, the major metabolite of midazolam, is impaired. In healthy children aged 1 year
Propofol contamination in an emulsion formulation, has been associated with infective complications. It becomes contaminated once the ampoules have been opened. Propofol contamination supports the growth of all microorganisms. Diphtheroid bacilli and coagulase-negative staphylococci were the most frequent microorganisms. Others are E. coli, S. aureus, and P. aeruginosa. Adding lidocaine, or storing opened ampoules at
