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Sunday, March 9, 2014
What is the route of choice for general anesthetics and why?
In most cases there is no route of choice, but there are choices. General anesthesia is usually administered either by the intravenous route, or the inhaled route. Although at a molecular level the way the intravenous drugs and the inhaled drugs (gases) work may differ, the end result - unconsciousness, and insensibility to pain, are basically indistinguishable. Certain drugs that are given intravenously, such as ketamine, may also be given by intramuscular injection, but this is rarely done in practice.
Intravenous access is almost always available, but where it is not, inhalational anesthesia is obviously the route of choice. One example is in young children, who don't accept needles quite as happily as adults. For this reason, inhalational anesthesia is a standard technique in children. For must adults, the intravenous route is the standard way to induce unconsciousness. For the "maintenance" (continuation) of anesthesia, either inhalation or intravenous general anesthesia will do.
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University