The Role and Effects of Adjuvant Medications in TIVA
Published online by Cambridge University Press: 18 November 2019
Propofol is a potent anaesthetic agent and may be used as a sole agent for sedation. Although it reduces post-operative pain, probably via its anti-oxidant and anti-inflammatory properties, it is not an analgesic. Consequently, to produce anaesthesia with no response to noxious stimuli a very large dose is required.[1–3] Therefore it is important to use an analgesic agent (usually an opioid) to produce surgical anaesthesia and decrease propofol requirements.[3] In some ways, this differs from inhalational anaesthetic drugs, which tend to have analgesic as well as hypnotic properties. Apart from opioids, which are the most potent analgesic agents, there are many other drugs that can be added to propofol and opioid-based anaesthesia. Among these are dexmedetomidine, magnesium, ketamine and lidocaine. The advantages and logic of mixing these agents with TIVA are discussed in this chapter.
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