RESUMO
For nearly a century, sodium pentothal was the undisputed king of anesthetics. Anesthesiologists were not, however, the sole consumers of pentothal, as psychiatrists used it to treat acute anxiety during psychoanalysis. The associated drug-induced inhibitions were attractive not only to psychotherapists, but also to a new generation of policing and Cold War espionage searching for the elusive truth serum. Cameo appearances of pentothal in media, film, and popular culture propagated the anesthetic's negative public image. While legal challenges to the admissibility of pentothal-induced confessions and congressional investigations of clandestine truth serum programs may have tainted the popular anesthetic, it was pentothal's widespread adaptation as part of the lethal injection cocktail that finally killed the king of anesthetics as pharmaceutical companies around the world refused to manufacture what had been transformed into a largely unprofitable drug, associated with capital punishment.
Assuntos
Anestésicos Intravenosos/história , Hipnóticos e Sedativos/história , Tiopental/história , Anestésicos Intravenosos/administração & dosagem , História do Século XX , História do Século XXI , Hipnóticos e Sedativos/administração & dosagem , Medicina nas Artes/história , Tiopental/administração & dosagemRESUMO
BACKGROUND: Within the history of intravenous anesthesia, barbiturates represent a chapter of considerable importance. Although the reference barbiturate thiopental had several limitations, it dominated the scene of the intravenous anesthesia until the mid-1980s, when propofol was introduced on the market. In the meantime, several barbiturate derivatives were placed on the market and abounded. This work is aimed at evaluating the clinical impact of the barbiturate derivatives methitural, analyzing the reasons for its rapid abandonment, in the late 1950s. METHODS: A systematic methodology of the search was associated with a descriptive analysis of the bibliography found. A computer-operated search strategy using Medline and Google Scholar databases was implemented. The algorithm was composed by using the words "Diogenal" OR "Thiogenal" OR "Methitural" OR "Metigenal" OR "Neraval" including biochemical and marketed terms. A manual search of the sources was carried out, and precise inclusion and exclusion criteria were established. The narrative synthesis was conducted taken into account the historical context of anesthesia. RESULTS: The database search yielded 3645 records. Nineteen records were identified through other sources. After duplicates removing (nâ¯=â¯238), and exclusion of not pertinent 3027 records, 314 full-text articles were assessed for eligibility. Of those, other 225 papers were excluded and 89 articles were included in the qualitative synthesis. CONCLUSION: Although methitural could be useful in particular surgical settings such as short-acting surgery, and in patients with liver diseases, a limited advantage over thiopental, and its scarce market diffusion due to increased costs, have limited its use. Through a critical analysis of literature, the lack of high-quality studies does not allow us to draw definitive conclusions on the drug.
Assuntos
Anestesia Intravenosa/história , Anestesiologia/história , Anestésicos Intravenosos/história , Tiobarbitúricos/história , Alemanha , História do Século XXAssuntos
Anestesia Geral/história , Anestésicos Combinados/história , Anestésicos Combinados/uso terapêutico , Anestésicos Inalatórios/história , Anestésicos Intravenosos/história , Inglaterra , História do Século XX , Humanos , Monitoração Neuromuscular/história , Fármacos Neuromusculares não Despolarizantes/históriaRESUMO
For millennia, mankind has sought a means of altering consciousness, often aided by naturally occurring elements. Psychotropic substances have been an integral part of spiritual, medicinal, and recreational aspects of life. The origin of anesthesiology stems directly from the use of recreational drugs; early inhaled anesthetics were first used as a means of entertainment. Hence, it is no surprise that many medications in the anesthesiologist's armamentarium are diverted for recreational use. In the 172 years following the first successful public demonstration of ether anesthesia, many drugs with abuse potential have been introduced to the practice of anesthesia. Although anesthesiologists are aware of the abuse potential of these drugs, how these drugs are obtained and used for recreational purposes is worthy of discussion. There are articles describing the historical and recreational use of specific drug classes. However, to the best of our knowledge, this is the first comprehensive review focusing on the breadth of drugs used by anesthesiologists.
Assuntos
Analgésicos Opioides/história , Analgésicos/história , Anestesiologia/história , Anestésicos Inalatórios/história , Anestésicos Intravenosos/história , Analgésicos/uso terapêutico , Analgésicos Opioides/uso terapêutico , História do Século XVIII , História do Século XIX , História do Século XX , História Antiga , História Medieval , HumanosRESUMO
Target-controlled infusion (TCI) is a technique of infusing IV drugs to achieve a user-defined predicted ("target") drug concentration in a specific body compartment or tissue of interest. In this review, we describe the pharmacokinetic principles of TCI, the development of TCI systems, and technical and regulatory issues addressed in prototype development. We also describe the launch of the current clinically available systems.
Assuntos
Anestésicos Intravenosos/história , Estado de Consciência , Sistemas de Liberação de Medicamentos/história , Hipnóticos e Sedativos/história , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/efeitos adversos , Anestésicos Intravenosos/sangue , Anestésicos Intravenosos/farmacocinética , Estado de Consciência/efeitos dos fármacos , Sistemas de Liberação de Medicamentos/instrumentação , Cálculos da Dosagem de Medicamento , Monitoramento de Medicamentos/história , Desenho de Equipamento , História do Século XX , História do Século XXI , Humanos , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/efeitos adversos , Hipnóticos e Sedativos/sangue , Hipnóticos e Sedativos/farmacocinética , Infusões Intravenosas , Modelos Biológicos , Monitorização Intraoperatória/história , SoftwareAssuntos
Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/história , Estado de Consciência/efeitos dos fármacos , Sistemas de Liberação de Medicamentos/história , Hipnóticos e Sedativos/administração & dosagem , Hipnóticos e Sedativos/história , Erros de Medicação/prevenção & controle , HumanosRESUMO
The article shows the role off Jeremic Alexander in the discovery and development of the first methods of intravenous anesthesia in the world.
Assuntos
Anestesia Intravenosa/história , Anestesia Intravenosa/métodos , Anestésicos Intravenosos , Descoberta de Drogas/história , Anestesia Intravenosa/efeitos adversos , Anestésicos Intravenosos/química , Anestésicos Intravenosos/história , Animais , Carbamatos/química , Carbamatos/história , Cães , História do Século XX , História do Século XXI , Humanos , Federação Russa , Uretana/análogos & derivados , Uretana/química , Uretana/históriaAssuntos
Anestesia Intravenosa , Anestésicos Intravenosos/uso terapêutico , Descoberta de Drogas , Propofol/uso terapêutico , Anestesia Intravenosa/história , Anestésicos Intravenosos/efeitos adversos , Anestésicos Intravenosos/química , Anestésicos Intravenosos/economia , Anestésicos Intravenosos/história , Animais , Comportamento Cooperativo , Análise Custo-Benefício , Custos de Medicamentos , Descoberta de Drogas/história , História do Século XX , História do Século XXI , Humanos , Propriedade Intelectual , Comunicação Interdisciplinar , Propofol/efeitos adversos , Propofol/química , Propofol/economia , Propofol/históriaRESUMO
Propofol is a common hypnotic agent in anaesthesiology and intensive care medicine and for procedural sedation as well. Despite the intensive usage the full potential, pharmacokinetic and -dynamic abilities, interactions and side effects of the substance may not be realized by all providers. Additionally there is dispute and unwarranted myth about the substance. Propofol is a highly potent hypnotic with a wide range of (un)desired effects. This article is reviewing the diversity of the substance in clinical practice.
Assuntos
Anestésicos Intravenosos/história , Anestésicos Intravenosos/farmacologia , Propofol/história , Propofol/farmacologia , Anestésicos Intravenosos/administração & dosagem , Anestésicos Intravenosos/farmacocinética , Antieméticos , Pena de Morte , Sedação Consciente , Contraindicações , Contaminação de Medicamentos/prevenção & controle , Ácido Edético , Emulsões , Excipientes , Alemanha , Hemodinâmica/efeitos dos fármacos , História do Século XX , Humanos , Fatores Imunológicos , Propofol/administração & dosagem , Propofol/farmacocinéticaAssuntos
Anestesia Intravenosa , Anestésicos Intravenosos , Tiopental , Mistura de Alfaxalona Alfadolona/química , Mistura de Alfaxalona Alfadolona/história , Mistura de Alfaxalona Alfadolona/farmacologia , Anestesia Intravenosa/história , Anestesiologia , Anestésicos Intravenosos/química , Anestésicos Intravenosos/história , Anestésicos Intravenosos/farmacologia , Barbitúricos/história , Criança , História do Século XX , Humanos , Ketamina/história , Ketamina/farmacologia , Pediatria , Propofol/história , Propofol/farmacologia , Oxibato de Sódio/química , Oxibato de Sódio/história , Oxibato de Sódio/farmacologia , Relação Estrutura-Atividade , Tiopental/química , Tiopental/história , Tiopental/farmacologiaRESUMO
Our speciality commonly traces its origin to a demonstration of the inhalation of ether by a patient undergoing surgery in Boston in 1846. Less well known is the demonstration of the i.v. injection of opium with alcohol into a dog in Oxford in 1656, leading to anaesthesia followed by full long-term recovery. After gaining i.v. access, a mixture of opium and alcohol was injected, resulting in a brief period of anaesthesia. After a period during which the dog was kept moving to assist recovery, a full recovery was made. Details from this momentous experiment allow us to compare the technique used with modern management. It is important to consider why there was a failure to translate the results into clinical practice and nearly 200 yr of potentially pain-free surgery. Possible factors include lack of equipment for i.v. access, lack of understanding of dose-response effects, and a climate of scientific discovery rather than clinical application. Given the current interest in total i.v. anaesthesia, it seems appropriate to identify its origins well before those of inhalation anaesthesia.