Intravenous Induction Agents

5.4Intravenous Induction Agents

  • All benzodiazepines and intravenous induction agents are GABAA receptor allosteric modulators augmenting GABA function (Figure 5.12)
    • Except ketamine
A diagram of ligand-gated G A B A ion channel which influxes chloride. The upper layer is extracellular and the lower layer is intracellular. These layered iron channels are present on either side of the G A B A A receptor. The receptor is made of alpha, beta, and gamma.

Figure 5.12

Propofol

  • Clinical Indications
    • General anesthesia induction
      • 2–4 mg/kg IV
    • Intravenous infusion
    • Antiemetic
    • Antiepileptic
  • Cerebral
    • ↓ CBF
    • ↓ CMRO2
    • Antiemetic
    • Antiepileptic
  • Cardiovascular
    • ↓ CO
    • ↓ MAP
    • ↓ SVR
    • ↓ Baroreceptor reflex
  • Pulmonary
    • ↓ TV
    • ↓ RR
  • Renal
    • Minimal
  • Hepatic
    • Primary site of metabolism
  • Contraindications
    • Poor cardiac reserve
      • Especially with induction dosage
    • Not contraindicated with egg, soy, or peanut allergies [28]
  • Board Facts
    • Pain on injection
      • Can be attenuated with lidocaine [29]
    • Lipid vehicle supports bacterial growth
    • Fospropofol
      • H2O soluble prodrug
      • Decreased burning sensation on injection
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Oct 16, 2024 | Posted by in Oral and Maxillofacial Surgery | Comments Off on Intravenous Induction Agents

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