Journal of Perioperative Medicine
Open Access

Anaesthetic and Analgesic Agents: An Overview of Current Practice

Erwin Pradia^{* *}Correspondence: Erwin Pradia, Department of Anesthesiology and Intensive Care, Dr. Hasan Sadikin Central General Hospital, Padjadjaran University, Bandung, Indonesia, Email:

Author info »

Description

Anaesthetic and analgesic agents play a crucial role in modern medicine, providing effective pain relief and sedation during surgical and diagnostic procedures. The use of these agents has evolved significantly over the past few decades, with the introduction of new drugs and techniques that have improved patient outcomes and safety. This article provides an overview of the most commonly used anaesthetic and analgesic agents, their mechanisms of action, and their applications in clinical practice.

Anaesthetic agents

General anaesthesia involves the use of drugs to induce unconsciousness, amnesia, and analgesia. The most commonly used anaesthetic agents include intravenous agents such as propofol and etomidate and inhaled agents such as sevoflurane and desflurane. These agents act by depressing the central nervous system, resulting in loss of consciousness and analgesia.

Propofol is a short-acting intravenous anaesthetic agent that is commonly used for induction and maintenance of general anaesthesia. It has a rapid onset and offset of action and produces a smooth induction and recovery. Propofol is also used for sedation in critical care and diagnostic procedures.

Etomidate is another intravenous anaesthetic agent that is used for induction of general anaesthesia. It has a similar onset and duration of action as propofol but has less cardiovascular and respiratory depression. However, etomidate can cause adrenal suppression, making it less suitable for prolonged sedation.

Inhaled anaesthetic agents such as sevoflurane and desflurane are also commonly used for maintenance of general anaesthesia. These agents act by potentiating the effects of Gamma- Aminobutyric Acid (GABA) and other inhibitory neurotransmitters, resulting in depression of the central nervous system.

Analgesic agents

Analgesic agents are drugs that provide pain relief without inducing unconsciousness. They are commonly used in the management of acute and chronic pain and in conjunction with anaesthetic agents during surgical and diagnostic procedures. The most commonly used analgesic agents include opioids, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs), and local anaesthetics.

Opioids are the most potent analgesic agents available and are commonly used for acute and chronic pain management. They act by binding to opioid receptors in the central and peripheral nervous system, resulting in decreased pain perception. Common opioids include morphine, fentanyl, and hydromorphone.

NSAIDs are a class of drugs that provide pain relief by inhibiting Cyclooxygenase (COX) enzymes, which are responsible for the production of prostaglandins. Prostaglandins play a role in inflammation and pain perception, and inhibition of their production results in analgesia and anti-inflammatory effects. Common NSAIDs include ibuprofen and naproxen.

Local anaesthetics are drugs that provide pain relief by blocking nerve conduction in a specific area. They are commonly used for regional anaesthesia and for the management of acute and chronic pain. Common local anaesthetics include lidocaine and bupivacaine.

Combination therapy

The use of combination therapy involving anaesthetic and analgesic agents has become increasingly common in clinical practice. The use of multimodal analgesia, which involves the use of two or more analgesic agents with different mechanisms of action, has been shown to improve pain control and reduce opioid use in the perioperative setting.

Regional anaesthesia, which involves the use of local anaesthetics and nerve blocks, has also become an essential component of perioperative analgesia. Regional anaesthesia techniques can provide targeted pain relief, reduce the need for systemic analgesia, and improve patient outcomes.