Intravenous medications for anesthesia

Content provided by Healthwise

Intravenous medications for anesthesia

Intravenous (IV) anesthetic medications are given into a vein. Medications can be given quickly and are rapidly absorbed into the bloodstream.

Intravenous anesthetic medications are used to relieve pain (analgesia), to relax (sedate), to induce sleepiness (hypnosis) or forgetfulness (amnesia), or to make you unconscious for general anesthesia. Most IV anesthetics cannot produce all of these effects on their own. An IV anesthetic is often combined with another IV anesthetic or with an inhalant (vaporized liquid) anesthetic.

Intravenous anesthetics include barbiturates, benzodiazepines, propofol, opioids, and other medications.

Barbiturates

Barbiturates used for anesthesia include sodium thiopental (Pentothal) and methohexital (Brevital). These fast-acting medications are sometimes used for general anesthesia induction.

Benzodiazepines

Benzodiazepines cause sedation, sleepiness, forgetfulness, and unconsciousness. In higher doses they also produce muscle relaxation. The most commonly used benzodiazepine is midazolam (Versed). Benzodiazepines may be used to provide sedation and amnesia during local or regional anesthesia or during procedural sedation, which combines the use of local anesthesia with sedatives to relax you for minor procedures.

These medications can also be given orally (as a pill) as a premedication before anesthesia to help relieve anxiety.

Propofol

The first phase of anesthesia, when an anesthetic is first given, is called induction. Propofol is the most commonly used anesthetic induction agent. It causes rapid and reversible decrease in consciousness with minimal, if any, aftereffects.

Opioids

Opioids are medications that can reduce the sensation of pain and cause deep sleep. Many opioids are used in anesthesia, primarily to relieve pain. Since they cause some sedation and sleepiness, they may reduce the need for other sedative-hypnotic medications during anesthesia. However, opioids by themselves are generally not used for anesthesia, because there have been reported cases of awareness during anesthesia when opioids alone were used as anesthetics.

Opioids also may be used for pain relief after surgery.

Opioids commonly used for anesthesia include fentanyl (Sublimaze), alfentanil (Alfenta), sufentanil (Sufenta), remifentanil, morphine, and meperidine (Demerol).

Opioids affect breathing but at usual doses have only minor effects on the cardiovascular system. At higher doses, however, opioids may affect heart rate and blood pressure. Opioids may be associated with nausea and vomiting after surgery. They may also cause constipation, difficulty urinating, and itching of the skin. Allergic reactions are rare.

Credits

Last updated:	March 21, 2006
Author:	Ralph Poore
Reviewed By:	Kathleen Romito, MD - Family Medicine, John M. Freedman, MD - Anesthesiology
Editors:	Susan Van Houten, RN, BSN, MBA, Pat Truman