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Last Updated on November 26, 2025 by Bilal Hasdemir
General anesthetic drugs are key to keeping patients safe and comfortable during surgery. They make sure patients don’t feel pain or distress. This is because these drugs cause a loss of consciousness and sensation.Understand the most typical anesthesia drugs, their names, and how they work during general anesthesia.
The main general anesthesia drug names include sevoflurane, desflurane, isoflurane, and nitrous oxide for inhalation. For intravenous use, we have propofol, ketamine, and etomidate. Knowing about these drugs is vital for doctors to give the best care.
General anesthesia is key in today’s medicine. It lets surgeons do complex, life-saving surgeries. Without it, these operations would be too painful for patients.
General anesthetics make patients unconscious and pain-free. “This has changed surgery a lot,” opening up many medical options.
General anesthetics interact with brain chemicals. They change how brain cells work, causing unconsciousness and pain relief. The exact way they work depends on the anesthetic used.
Some anesthetics boost GABA, a brain chemical that helps calm the brain. Others block glutamate, a chemical that excites the brain. They also affect other brain chemicals.
The history of general anesthetic drugs is fascinating. Old anesthetics like ether and chloroform have been replaced by safer ones.
Today’s anesthetics are better and safer. They are made to work quickly and have fewer side effects. Anesthesiologists can adjust them for each patient. Research keeps improving these drugs and methods.
Experts say,
“The perfect anesthetic would start working fast, be easy to control, and have few side effects.”
We’re getting closer to that goal, thanks to all the progress made.
The idea of balanced anesthesia has changed the way we think about anesthesia. It mixes different drugs to get the best results. This way, doctors can make sure each patient gets the right care, making things safer and more effective.
Balanced anesthesia uses many drugs to create the perfect anesthetic state. This includes making the patient unconscious, pain-free, and relaxed. By mixing anesthetic agents, doctors can avoid the dangers of using too much of one drug.
This method is key in modern anesthesia. It helps doctors give the best care to patients during surgery.
The best anesthetic agents start working fast, last a short time, and have few side effects. These traits help patients go smoothly into and come out of anesthesia. It also lowers the chance of problems.
No single drug has all these perfect qualities. But balanced anesthesia lets doctors mix drugs to get close to the ideal.
General anesthesia uses inhalational anesthetics a lot. These have changed over time to include important agents for surgeries. They help start and keep anesthesia during operations.
Sevoflurane is a top choice for inhalational anesthesia. It has a nice smell and doesn’t irritate the lungs much. It’s great for starting anesthesia in kids.
Key benefits of sevoflurane: it works fast, doesn’t bother the lungs much, and smells good.
Desflurane is perfect for outpatient surgeries because it works and wears off quickly. It doesn’t stay in the blood long, which helps with fast start and end times.
Advantages of desflurane: it starts and stops working fast, doesn’t stay in the blood long, and is good for day surgeries.
Isoflurane has been used for a long time in anesthesia. It gives a steady and controlled effect. But, it can irritate the lungs, so it needs careful use.
Clinical considerations for isoflurane: it might irritate the lungs, has a steady effect, and needs close watching.
Nitrous oxide is often used with other anesthetics. It helps with pain and anxiety. It’s used with other gases or drugs.
Benefits of nitrous oxide: it helps with pain and anxiety, works fast, and is used with other drugs.
| Inhalational Anesthetic | Key Properties | Clinical Applications |
| Sevoflurane | Pleasant odor, minimal respiratory irritation | Inhalational induction, pediatric patients |
| Desflurane | Rapid onset and recovery, low blood solubility | Outpatient surgery, rapid procedures |
| Isoflurane | Stable anesthetic effect, potentially irritating to the respiratory system | General surgery, controlled anesthesia |
| Nitrous Oxide | Analgesic and anxiolytic effects, rapid onset | Adjunct to other anesthetics, procedural sedation |
Propofol is the top choice for intravenous anesthetics. It works fast and doesn’t last long. This makes it perfect for starting and keeping anesthesia going.
Propofol works by boosting GABAA receptors. Its high lipid solubility lets it quickly get into the brain. It starts working fast and gets cleared from the body slowly.
Even after long use, propofol’s effects don’t last too long. This is great for quick recovery times.
“Propofol’s how it works supports its use in many situations,” says a top anesthesiology book.
Propofol is used for starting and keeping anesthesia, and for sedation in tests and treatments. Adults usually get 1.5 to 2.5 mg/kg for starting. For keeping anesthesia going, it’s given in a steady flow, adjusted based on how the patient reacts and the surgery type.
It’s important to adjust the dose carefully to avoid hypotension and make sure the patient is properly anesthetized.
One big risk with propofol is Propofol Infusion Syndrome (PRIS). PRIS is a rare but serious condition. It can cause metabolic acidosis, muscle breakdown, and heart problems. It often happens in patients on high doses for a long time, like in the ICU.
Spotting PRIS early is key. If it happens, propofol must stop right away, and the patient needs special care. Watch for signs like unexplained acidosis or heart rhythm problems in patients on long-term propofol.
Ketamine has been a key part of anesthesia for many years. It has special qualities that make it different from other anesthetics. Its flexibility in different medical situations makes it very useful for anesthesiologists.
Ketamine works by creating a state of dissociative anesthesia. This means the patient feels disconnected from their surroundings. It does this by affecting N-methyl-D-aspartate (NMDA) receptors, which are important for pain.
This unique effect is not just about pain relief. It also changes how the patient sees their environment. This makes ketamine great for situations where other anesthetics don’t work well.
Ketamine is good for patients with unstable blood pressure. Unlike many anesthetics, it increases blood pressure and heart rate. This makes it perfect for patients at risk of low blood pressure.
New studies show that low-dose ketamine is good for pain relief. Low-dose ketamine has been shown to help with chronic pain and pain after surgery.
| Study | Findings |
| Study on postoperative pain | Low-dose ketamine reduced opioid consumption |
| Chronic pain management study | Significant reduction in pain scores |
These findings suggest ketamine could be used in new ways. It might help manage pain without needing as many opioids.
In the anesthesia setting, opioid analgesics are key for effective pain relief. They are vital in managing pain during surgeries. This helps a lot in patient care.
Fentanyl is a strong opioid used in anesthesia. It works fast and doesn’t last long. This makes it great for quick pain relief in surgeries.
Its quick action and short life make it perfect for outpatient surgeries. Here, quick recovery is important.
Morphine is seen as the top choice for opioid analgesics. It’s known for its strong pain relief and safety. It’s used a lot in the time before and after surgery, even though it takes longer to start working.
Morphine lasts longer, which is good in some cases. It keeps pain away without needing to give more medicine often.
Remifentanil is a very short-acting opioid. It starts working fast and stops fast too. This makes it great for surgeries needing intense pain relief for a short time.
Even after using it for a long time, its effect doesn’t last long. This gives doctors a lot of control over pain relief.
Using opioid analgesics in anesthesia is tricky. It’s hard to give enough pain relief without causing breathing problems. Breathing issues can be very dangerous.
Anesthesiologists have to watch patients closely. They need to adjust the opioid doses carefully. They also need to be ready to use reversal agents if needed to avoid breathing problems.
Neuromuscular blocking agents are key in surgery. They relax muscles, making surgery easier. This helps surgeons do complex tasks with more precision.
Succinylcholine works like acetylcholine at the neuromuscular junction. It starts working fast and lasts a short time. But, it can cause high potassium levels and muscle pain.
Rocuronium is a fast-acting neuromuscular blocker. It’s a good choice for quick intubation. It lasts longer than succinylcholine and is usually well-tolerated.
Vecuronium and cisatracurium are in the middle in terms of how long they last. Vecuronium is good for the heart. Cisatracurium breaks down on its own, without needing other organs. Both help keep muscles relaxed during surgery.
It’s important to check how deep the muscle block is. This ensures muscles are relaxed but not too much. To reverse the block, neostigmine is used. This keeps patients safe after surgery.
In the world of anesthesia, benzodiazepines are key for relaxing and forgetting. They help make patients comfortable and ensure procedures go smoothly.
Midazolam is a top pick for anesthesia. It works fast and doesn’t last long. It’s great for calming patients before surgery.
Its quick start and fast end make it perfect for many situations.
Diazepam is used in anesthesia too. It lasts longer than midazolam. It’s good for calming patients before surgery and keeps them calm for a while.
Its long-lasting effects come from its active parts. This is useful in some cases.
Dexmedetomidine is special. It sedates without hurting breathing. This makes it great for places where breathing is important.
Choosing the right sedative is important in anesthesia. Knowing the differences between midazolam, diazepam, and dexmedetomidine helps improve care.
| Sedative | Onset | Duration | Primary Use |
| Midazolam | Rapid | Short | Preoperative anxiolysis and amnesia |
| Diazepam | Moderate | Long | Preoperative sedation |
| Dexmedetomidine | Moderate | Variable | Procedural sedation and ICU sedation |
The table shows the main features of sedatives used in anesthesia. It shows how different they are and what they’re used for.
Non-opioid analgesics and adjuncts are key in multimodal anesthesia. This method combines different drugs for better pain control and less opioid use. It makes patients more comfortable and lowers opioid side effects.
Acetaminophen is a mainstay in pain management. Its exact action is not fully known but is thought to affect the brain and body’s pain system. Its safe profile makes it great for those who can’t take NSAIDs.
Acetaminophen is used in several ways:
Ketorolac and other NSAIDs block COX enzymes to reduce pain. They are effective in managing pain after surgery, making them useful in pain plans.
But, NSAIDs have downsides and risks, like:
Choosing the right patient and dose is key to their benefits and safety.
Dexamethasone, a steroid, is used in anesthesia for its anti-inflammatory and anti-nausea effects. It helps reduce nausea and vomiting after surgery, improving patient satisfaction.
Dexamethasone also helps with pain, possibly reducing opioid needs. But, it can cause high blood sugar and weaken the immune system.
Anesthesia is evolving with new drugs and methods. These changes have made patient care better and surgery outcomes more successful. They’ve also made anesthesia safer and more effective.
Target-Controlled Infusion (TCI) systems are a big step forward. They let doctors control the amount of anesthetic in the blood precisely. This makes anesthesia safer and more stable.
TCI systems use special models to figure out how much anesthetic to give. This helps avoid too much or too little anesthetic.
The benefits of TCI systems include:
Processed EEG monitoring is a new tool for checking how deep a patient is under anesthesia. It gives doctors real-time feedback on the patient’s consciousness. This helps them adjust the anesthesia better.
This technology helps avoid patients being awake during surgery and uses less anesthetic. It’s very useful in complex surgeries or when using total intravenous anesthesia (TIVA).
New agents and techniques are being tested in clinical trials. These include new intravenous anesthetics, better neuromuscular blockers, and more targeted pain relievers. They aim to improve anesthesia care by reducing side effects and speeding up recovery.
Research is focused on:
As these new agents move through trials, they could make anesthesia safer and more effective.
Choosing the right anesthetic drugs is key to keeping patients safe during surgery. The choice depends on the patient’s needs and the situation. It’s important to pick drugs that fit each patient’s unique case.
It’s vital to think carefully about the drugs used. Knowing how different drugs work helps doctors make better choices. This way, they can reduce risks and improve patient results.
Choosing the right drugs involves a detailed approach. It means using the latest research and guidelines. This helps doctors give the best care and keep patients safe.
The main aim is to get the best results for patients having surgery. By focusing on safety and keeping up with new research, doctors can achieve this goal.
Common general anesthesia drugs include propofol, sevoflurane, desflurane, isoflurane, and nitrous oxide. Opioid analgesics like fentanyl and morphine are also used.
General anesthetics depress the central nervous system. They induce unconsciousness and relieve pain. They interact with brain receptors and ion channels, affecting neurotransmitter release and neuronal activity.
Balanced anesthesia combines different anesthetic agents. This approach allows for precise control over anesthesia. It also reduces the risk of complications.
Ideal anesthetic agents have a rapid onset and recovery. They are easy to administer and have minimal side effects. They provide effective pain relief, muscle relaxation, and sedation.
Inhalational anesthetics, like sevoflurane and desflurane, maintain general anesthesia during surgery. They offer a reliable way to induce and maintain unconsciousness.
Propofol is widely used for its rapid onset and recovery. But, it can cause hypotension, respiratory depression, and, rarely, propofol infusion syndrome.
Opioid analgesics, such as fentanyl and morphine, provide pain relief during surgery. But, they can cause respiratory depression and other side effects, requiring careful dosing and monitoring.
Neuromuscular blocking agents, like succinylcholine and rocuronium, facilitate muscle relaxation. They enable surgical access. They require careful monitoring and reversal to avoid residual paralysis.
Benzodiazepines, such as midazolam, provide anxiolysis, sedation, and amnesia. They are useful for preoperative preparation and procedural sedation.
Recent advances include target-controlled infusion systems and processed EEG monitoring. Emerging agents in clinical trials aim to improve anesthetic safety and efficacy.
Optimizing anesthetic drug selection involves considering patient-specific factors. This includes medical history, age, and comorbidities. It helps choose the most suitable anesthetic agents and techniques.
Monitoring anesthetic depth, using techniques like processed EEG, ensures patients receive adequate anesthesia. It minimizes the risk of awareness or excessive anesthetic administration.
References |
Milam, S. B. (1984). General anesthetics: A comparative review. NCBI. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235804/
