TY - CHAP M1 - Book, Section TI - Intravenous Anesthetics A1 - Butterworth IV, John F. A1 - Mackey, David C. A1 - Wasnick, John D. PY - 2018 T2 - Morgan & Mikhail's Clinical Anesthesiology, 6e AB - KEY CONCEPTS Repetitive administration of highly lipid-soluble barbiturates (eg, infusion of thiopental for “barbiturate coma” and brain protection) saturates the peripheral compartments, minimizing any effect of redistribution and rendering the duration of action more dependent on elimination. This is an example of context sensitivity. Barbiturates constrict the cerebral vasculature, causing a decrease in cerebral blood flow, cerebral blood volume, and intracranial pressure. Although apnea may be relatively uncommon after benzodiazepine induction, even small intravenous doses of these agents have resulted in respiratory arrest. In contrast to other anesthetic agents, ketamine increases arterial blood pressure, heart rate, and cardiac output, particularly after rapid bolus injections. Induction doses of etomidate transiently inhibit enzymes involved in cortisol and aldosterone synthesis. When used for sedation in the intensive care unit, etomidate was reported to produce consistent adrenocortical suppression. Propofol formulations can support the growth of bacteria, so sterile technique must be observed in preparation and handling. Propofol should be administered within 6 h of opening the ampule. SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessmedicine.mhmedical.com/content.aspx?aid=1161426512 ER -