Anaesthesia
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Total intravenous anaesthesia is a feasible alternative to the use of inhalational agents and the rationale behind such a technique is presented. The various intravenous agents are discussed, particularly with regard to their suitability for this form of anaesthesia, and their physiological effects compared with those of the inhalational anaesthetics. Some of the problems associated with the use of total intravenous anaesthesia are mentioned.
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Review
General kinetic and dynamic principles and their application to continuous infusion anaesthesia.
The use of intravenous anaesthetic agents by continuous infusion requires knowledge of their pharmacokinetic properties. In this article, the general pharmacokinetic principles behind the use of infusions of intravenous agents are presented and the literature with regard to the individual drugs used in this way is reviewed.
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A review of the hypnotic, anticonvulsant and brain protective action of etomidate in animals shows that when given as a single injection in different animal species recovery from hypnosis is quick and that the safety margin is large. In dogs a bolus or infusion produces high amplitude theta activity on the electroencephalogram (EEG). During infusion burst suppression is seen. ⋯ Studies in various animal models show that etomidate might have brain resuscitative properties. In hypoxic-ischaemic conditions etomidate has some protective effects, where its anticonvulsant action is probably important. Lowering of the cerebral metabolic rate of oxygen consumption, and reducing the rise of intracranial pressure, coupled with immobilisation and prevention of hyperactivity enables animals to resist a hypoxic insult.