Clinical Trial Focuses on Determining Efficacy of Intravenous Anesthetics Vs Inhalation Anesthesia
Two most common anesthesia techniques used in the United States
are intravenous and inhalation. Intravenous anesthetics or commonly known as
IVAs are delivered to the lungs by means of the infusion pump, whereas inhalation
anesthesia or commonly called inhalation anesthetics are inhaled directly into
the nose. The inhalation method is less popular than the intravenous method
mainly because of the difficulty in determining the exact drug concentration
needed for effective anesthesia. Several studies and clinical trials have
focused on determining the efficacy of both types of anesthesia techniques. For
instance, in November 2020, a new clinical trial, The Volatile vs Total
intravenous Anesthesia for major non-cardiac surgery (VITAL) trial was launched
to compare two types of anesthetic to determine how soon after surgery they
allow patients to return home. The trail will compare two methods of delivering
anesthesia to a patient: inhalation and intravenous.
The main functions of inhalation anesthesia are to
relieve chest pain, provide relief to the airways in asthma and reduce the
amount of sepsis (severe respiratory distress) in critically ill patients. The
mechanism of action is quite similar to that of different drugs in the field of
medication wherein it effects the different tissues in the body to produce a
desired effect. It affects the muscles, ligaments and tissues in the airways by
blocking the airway. Inhalation anesthetics are also referred to as
antidepressants because it affects the brain chemical systems such as those
responsible for depression and anxiety.
There are different types of inhalation anesthesia available for
the patients. The amount of the dosage will depend on the patient's age, sex
and body size. The first type of anesthesia available is Nitrous Oxide which is
by far the cheapest one that can be bought from medical stores. This is also
the safest one for individuals who cannot bear any kind of pain. Nitrous oxide anesthetics
have fewer complications compared to other anesthetics like propofol.
Then there is a kind of inhalation anesthesia called Peroxygen
which is even more expensive than Nitrous Oxide. However it has fewer
complications compared to Nitrous Oxide and this makes it a better choice for
those who have sensitive respiratory system. Peroxygen anesthetics have very
slow release properties and therefore take much longer time to reach the lungs
compared to other anesthetics such as inhalation Nitrous Oxides. There are also
mixed oxygen and carbon dioxide mixture, which can help patients undergoing
severe respiratory arrest when the quantity of oxygen does not satisfy the
amount of carbon dioxide in the body system. These mixed dosage of anesthesia
will result in faster relief from severe respiratory arrest.
The combination of two different agents is also a good method for
fast acting and long lasting effect of inhalation anesthesiologists often use
this method of preconditioning. They use two drugs - the alpha-adrenergic
agonist and the beta-adrenergic agonist - at one time so that a patient is put
under a state of partial anesthesia. They are given just prior to the actual
procedure, so that they will have enough time to get into the proper cardiac
rhythm, as desired by the anesthesiologist. In this way, the risk of mortality
is greatly reduced.
It is important to know that inhalation anesthesia is only
effective for the short term and that it will not prevent a heart attack or
other abnormal medical conditions. This is not to say, however, that inhaled
agents are not used for severe cases. In fact, they are often used in
conjunction with IV fluids and coronary artery dilation to achieve even greater
success in the treatment of deep-seated problems.
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