Adjuvants for balanced anesthesia in ambulatory surgery.
Autor: | Coppens M; University Hospital Ghent, Belgium, Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, University Ghent, Belgium. Electronic address: marc.coppens@uzgent.be., Steenhout A; Department of Anesthesiology and Perioperative Medicine, University Hospital, Ghent, Belgium. Electronic address: annelien.steenhout@uzgent.be., De Baerdemaeker L; University Hospital Ghent, Belgium, Faculty of Medicine and Health Sciences, Department of Basic and Applied Medical Sciences, University Ghent, Belgium. Electronic address: luc.debaerdemaeker@ugent.be. |
---|---|
Jazyk: | angličtina |
Zdroj: | Best practice & research. Clinical anaesthesiology [Best Pract Res Clin Anaesthesiol] 2023 Sep; Vol. 37 (3), pp. 409-420. Date of Electronic Publication: 2023 Jan 04. |
DOI: | 10.1016/j.bpa.2022.12.003 |
Abstrakt: | Balanced anesthesia relies on the simultaneous administration of different drugs to attain an anesthetic state. The classic triad of anesthesia is a combination of a hypnotic, an analgesic, and a neuromuscular blocker. It is predominantly the analgesic pillar of this triad that became more and more supported by adjuvant therapy. The aim of this approach is to evolve into an opioid-sparing technique to cope with undesirable side effects of the opioids and is fueled by the opioid epidemic. The optimal strategy for balanced general anesthesia in ambulatory surgery must aim for a transition to a multimodal analgesic regimen dealing with acute postoperative pain and ideally reduce the most common adverse effects patients are faced with at home; sore throat, delayed awakening, memory disturbances, headache, nausea and vomiting, and negative behavioral changes. Over the years, this continuum of "multimodal general anesthesia" adopted many drugs with different modes of action. This review focuses on the most recent evidence on the different adjuvants that entered clinical practice and gives an overview of the different mechanisms of action, the potential as opioid-sparing or hypnotic-sparing drugs, and the applicability specifically in ambulatory surgery. Competing Interests: Declaration of competing interests The authors declare no conflicts of interest. (Copyright © 2023 Elsevier Ltd. All rights reserved.) |
Databáze: | MEDLINE |
Externí odkaz: |