Modern Anesthetics

1. Front Matter

   Pages i-xv

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2. Molecular Mechanisms of Anesthetic Action

   1. The Site of Anesthetic Action

      • B. W. Urban

      Pages 3-29

   2. Inhibitory Ligand-Gated Ion Channels as Substrates for General Anesthetic Actions

      • A. Zeller, R. Jurd, S. Lambert, M. Arras, B. Drexler, C. Grashoff et al.

      Pages 31-51

   3. Actions of Anesthetics on Excitatory Transmitter-Gated Channels

      • G. Akk, S. Mennerick, J. H. Steinbach

      Pages 53-84

   4. Voltage-Gated Ion Channels

      • C. Nau

      Pages 85-92

   5. G-Protein-Coupled Receptors

      • R. D. Sanders, D. Brian, M. Maze

      Pages 93-117

3. Modern Inhalation Anesthetics

   1. Inhalation Anaesthesia: From Diethyl Ether to Xenon

      • J. G. Bovill

      Pages 121-142

   2. General Anesthetics and Long-Term Neurotoxicity

      • M. Perouansky

      Pages 143-157

   3. Special Aspects of Pharmacokinetics of Inhalation Anesthesia

      • J. F. A. Hendrickx, A. De Wolf

      Pages 159-186

   4. Inhalational Anaesthetics and Cardioprotection

      • N. C. Weber, W. Schlack

      Pages 187-207

   5. Non-Immobilizing Inhalational Anesthetic-Like Compounds

      • M. Perouansky

      Pages 209-223

4. Modern Intravenous Anesthetics

   1. Propofol

      • C. Vanlersberghe, F. Camu

      Pages 227-252

   2. Pharmacokinetics and Pharmacodynamics of GPI 15715 or Fospropofol (Aquavan Injection) — A Water-Soluble Propofol Prodrug

      • J. Fechner, H. Schwilden, J. Schüttler

      Pages 253-266

   3. Etomidate and Other Non-Barbiturates

      • C. Vanlersberghe, F. Camu

      Pages 267-282

   4. Remifentanil and Other Opioids

      • F. S. Servin, V. Billard

      Pages 283-311

   5. Ketamine

      • B. Sinner, B. M. Graf

      Pages 313-333

   6. Midazolam and Other Benzodiazepines

      • K. T. Olkkola, J. Ahonen

      Pages 335-360

5. Pharmacokinetics-Pharmacodynamics Based Administration of Anesthetics

   1. The Effect of Altered Physiological States on Intravenous Anesthetics

      • T. K. Henthorn

      Pages 363-377

   2. Anesthetics Drug Pharmacodynamics

      • P. Bischoff, G. Schneider, E. Kochs

      Pages 379-408

   3. Defining Depth of Anesthesia

      • S. L. Shafer, D. R. Stanski

      Pages 409-423

Some important constraints of anesthesia must be taken into consideration when the pharmacological properties of modern anesthetics are discussed. The most imp- tant of these could be that the target effect be achieved preferably within seconds, at most within a few minutes. Similarly, offset of drug action should be achieved within minutes rather hours. The target effects, such as unconsciousness, are pot- tially life-threatening, as are the side effects of modern anesthetics, such as respi- tory and cardiovascular depression. Finally, the patient’s purposeful responses are not available to guide drug dosage, because, either the patient is unconscious, or more problematically, the patient is aware but unable to communicate pain because of neuromuscular blockade. These constraints were already recognised 35 years ago, when in 1972 Volume XXX entitled “Modern Inhalation Anesthetics” appeared in this Handbook Series. The present volume is meant as a follow up and extension of that volume. At the beginning of the 1970’s anesthesia was commonly delivered by inhalation, with only very few exceptions. The clinical understanding of that time considered anesthesia as a unique state achieved by any of the inhalation anesthetics, in- pendent of their specific molecular structure. “The very mechanism of anesthetic action at the biophase” was discussed within the theoretical framework of the “u- tary theory of narcosis”.

• CNS
• Modern Anesthetics
• anesthesia
• depression
• drug
• kinetics
• neurotoxicity
• opioid
• pain
• pharmacodynamics
• pharmacokinetics
• research
• toxicity

• Klinik fūr Anästhesiologie, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany

  Jürgen Schüttler, Helmut Schwilden

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