An Overview on “Stages of Anesthesia and Some Novel General Anesthetics Drug”
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Rohit Jaysing Bhor. et al. /Asian Journal of Research in Chemistry and Pharmaceutical Sciences. 5(4), 2017, 132-140. Review Article ISSN: 2349 – 7106 Asian Journal of Research in Chemistry and Pharmaceutical Sciences Journal home page: www.ajrcps.com AN OVERVIEW ON “STAGES OF ANESTHESIA AND SOME NOVEL GENERAL ANESTHETICS DRUG” Rohit Jaysing Bhor *1 , Bhadange Shubhangi 1, C. J. Bhangale 1 1* Department of Pharmaceutical Chemistry, PRES’s College of Pharmacy Chincholi, Tal-Sinner, Dist-Nasik, Maharashtra, India. ABSTRACT Anesthesia is a painless performance of medical producers. There are both major and minor risks of anesthesia. Anesthesia is a state of temporary induced loss of sensation or awareness. It gives analgesia i.e. relief from pain or prevention of pain and paralysis. General anaesthesia is a medically induced state of unconsciousness. It gives loss of protective reflux. It is carried out to allow medical procedures or medical surgery. It can be classified into 3 types like Intravenous Anesthetics Drug; Miscellaneous Drug; and Inhalational anesthetic Drug. Sodium thiopental is an ultra-short-acting barbiturate and has been used commonly in the induction phase of anesthesia. Methohexital is an example of barbiturates derivatives. It is classified as short-acting, and has a rapid onset of action. KEYWORDS Anesthesia, Sodium thiopental, Methohexital and Propofol. Author for Correspondence: INTRODUCTON Anesthesia is a state of temporary induced loss of sensation or awareness. It gives analgesia i.e. relief 1 Rohit Jaysing Bhor, from pain or prevention of pain and paralysis . A patient under the effects of anesthetic drug is known Department of Pharmaceutical Chemistry, as anesthetized. Anesthesia enables the painless PRES’s College of Pharmacy Chincholi, performance of medical producers that would cause severe pain to an unanesthetized patient 2. Tal-Sinner, Dist-Nasik, Maharashtra, India. Anesthesia can be divided into two risks like major and minor risks of anesthesia. In major risks gives death, heart attacks and pulmonary embolism of the Email: [email protected] patient and minor risks like nausea and vomiting 3. Anesthesia means stopping of sensation and feeling. Available online: www.uptodateresearchpublication.com October - December 132 Rohit Jaysing Bhor. et al. /Asian Journal of Research in Chemistry and Pharmaceutical Sciences. 5(4), 2017, 132-140. It can be given in various ways and does not always Stage 4 make you unconscious. It includ es. Stage 4 is also known as overdose. It occurs when Local anesthesia too much anesthetic medication is given. Regional anesthesia Classification of General anaesthesia General anesthesia General anaesthesia or general anesthesia is a General anesthesia gives a state of controlled medically induced state of unconsciousness with unconsciousness. It is essential for some operations. loss of protective reflux. It is carried out to allow Patients are unconscious and feel nothing 4. A local medical procedures or medical surgery. It can be anesthetic is an example of medication which was classified into 3 types like used to control the pain sensation during surgery. It • Intravenous Anesthetics Drug is also gives anesthetic nerve block and paralysis • Miscellaneous Drug i.e. loss of muscle power. General • Inhalational anesthetic Drug anaesthesia or general anesthesia is a medically Intravenous Anesthetics 8,9 induced state of unconsciousness with loss of Sodium thiopental protective reflux. It is carried out to allow medical Another name of this Sodium thiopental is Sodium 5 procedures or medical surgery . Pentothal, thiopental, thiopentone, or Trapanal. It 6,7 Stages of anesthesia gives rapid-onset of action from barbiturates According to Guedel’s classification, it can be category general anesthetics drug. Sodium divided into four stages of anesthesia ; thiopental is an ultra-short-acting barbiturate and Stage 1 has been used commonly in the induction phase of In Stage 1 is the period between the administration anesthesia. Sodium thiopental was historically used of induction agents and loss of consciousness. It is to induce mental coma. Thiopental rapidly and also known as induction. During this stage, the easily crosses the blood brain barrier i.e. BBB. patient progresses from analgesia without amnesia Sodium thiopental is mainly metabolized to analgesia with amnesia. Patients can carry on a to Pentobarbital; 5-ethyl-5-(1'-methyl-3'- conversation or talk at this time. hydroxybutyl)-2-thiobarbituric acid, and 5-ethyl-5- Stage 2 (1'-methyl-3'-carboxypropyl)-2-thiobarbituric acid. Stage 2 is also known as the excitement stage. It It gives some side effects like cardiovascular and gives loss of consciousness and marked by excited respiratory depression, headache, nausea and and delirious activity. During this stage, the vomiting. patient's heart rate may become irregular; Mechanism of action uncontrolled movements, vomiting and pulmonary Sodium thiopental is a member of the barbiturate dilation. class of drugs. It binds to GABA A receptor channel. Stage 3 The GABA A receptor is an inhibitory channel that In Stage 3 is also known as surgical anesthesia. decreases neuronal activity, and barbiturates During this stage, the skeletal muscles relax, enhance the inhibitory action of the vomiting stops, respiratory depression occurs, and GABA A receptor. eye movements slow and then stop. The patient is Thiamylal unconscious and ready for surgery. This stage is Thiamylal is an example of barbiturates derivatives. divided into four planes: It was discovered in the 1950s. It gives sedative, The eyes roll, then become fixed. hypnotic effects. It is used in the surgery as surgical Corneal and laryngeal reflexes are lost. anesthetic drug. It is the thiobarbiturate analogue The pupils dilate and light reflex is lost. of Secobarbital. Body paralysis. Methohexital Methohexital is also known as methohexitone. It was sold under the brand names like Available online: www.uptodateresearchpublication.com October – December 133 Rohit Jaysing Bhor. et al. /Asian Journal of Research in Chemistry and Pharmaceutical Sciences. 5(4), 2017, 132-140. Brevital and Brietal. Methohexital is an example of Methoxy propane barbiturates derivatives. It is classified as short- Trichloro ethylene acting, and has a rapid onset of action. Vinyl Ether Miscellaneous Drug 10 Desflurane Propanidid Desflurane is an example of highly fluorinated Propanidid is an example of ultra short acting ether. It was used maintenance of general general anesthetic drug. It was discovered In 1963 anesthesia. It is available in the form of racemic by the scientist Bayer. mixture. It has the most rapid onset of Propofol action. Desflurane act on GABA A receptors. Propofol is an example of general anesthetic drug. It Isoflurane decreased level of consciousness and lack of Isoflurane is an example of highly fluorinated ether. memory events. It gives common side effects like It was used maintenance of general anesthesia. It irregular heart rate, low blood pressure, and burning was sold under the brand names like Forane. It is sensation. It appears to be safe for using used by inhalation. It gives some side effects like during pregnancy. Propofol was discovered in 1977 decreases the breath, low blood pressure and and approved for use in the United States in 1989. irregular heart beat. Isoflurane was approved for Ketamine medical use in the United States in 1979. Similar to Ketamine is an example of general anesthetic drug. many general anesthetics, the exact mechanism of It was sold under the brand names like Ketalar. It is the action has not been clearly understood. used for starting and maintaining anesthesia. It Isoflurane likely binds to GABA A receptors which gives on set of action within five minutes when decreases motor function. It inhibits receptor given by injection and this effects lasting up to 25 activity in the NMDA receptors which decreases minutes. It gives common side effects like motor function. Isoflurane inhibits conduction in confusion, hallucination, and Agitation. Ketamine activated potassium channels. was discovered in 1962, first tested in humans in Sevoflurane 1964. It was approved for use in the United States Sevoflurane is a sweet-smelling, nonflammable in 1970. Ketamine may be used for postoperative drug. It is used as inhalation anesthetics drug. it is pain management. the volatile anesthetic with the fastest onset of Inhalational anesthetic Drug 11,12 action. Sevoflurane was discovered by the scientist It gives effects via inhalation. It is an example of Ross Terrell. It acts as positive allosteric modulator chemical compound possessing general anesthetic of the GABA A receptors. it also acts as an NMDA effect. antagonist. Classification of Inhalational anesthetic Drug Nitrous oxide Currently-used agents Nitrous oxide is also known as laughing gas. It is an Desflurane example of chemical compounds it contains oxide Isoflurane of nitrogen with molecular formula N 2O. At room Nitrous oxide temperature, it is a colorless and non-flammable Sevoflurane gas. It gives anesthetic effect and analgesic effects. Previously-used agents Nitrous oxide occurs in small amounts in the Ethyl Chloride or chloroethane atmosphere. Chloroform Chloroethane Cryofluorane Chloroethane is also known as monochloroethane or Diethyl Ether ethyl chloride. It is an example of chemical Enflurane compounds. It is a colorless, flammable gas or Halothane refrigerated liquid with a faintly sweet odor. It gives Methoxy