Abstract
In developed countries, the choice of an anaesthetic agent for induction of anaesthesia remains based mainly on its pharmacodynamic properties. Until now, cardiovascular effects were the main factor in this decision. However, other factors, such as the depth of anaesthesia and effects on cortisol synthesis, can modify this simplistic view. A better understanding of the relationships between the pharmacokinetics and pharmacodynamics of these drugs, and the availability of new techniques, such as target-controlled infusions of anaesthetic drugs and inhalation induction, have led practitioners to the understanding that the way a drug is administered is a far more important factor for maintaining haemodynamic stability than the specific agent used. The ability of a drug to maintain spontaneous ventilation and to relax the upper airway is another factor in this decision, especially when considering difficult intubation, laryngeal mask insertion or tracheal intubation without neuromuscular blockade. Beyond the factors mentioned above, anaesthetists adapt current practice to suit patients’ willingness to comply with anaesthesia and to avoid the adverse effects that are most often feared by the patient. Although most practitioners are not concerned with the cost of anaesthesia, cost-containment policies have led some institutions to restrict the use of the more expensive drugs to particular indications. However, this is too simplistic an approach for the reduction of global costs, as other direct medical costs, such as those for staffing, form a greater proportion of total costs than do direct drug costs. Cost-benefit and cost-efficacy studies of the anaesthetics used for induction of anaesthesia are needed to help anaesthetists to choose a drug based on both cost and pharmacodynamic or pharmacokinetic properties.
Similar content being viewed by others
Notes
The use of trade names is for product identification purposes only and does not imply endorsement.
References
Payne K, Moore EW, Elliott RA, et al. Anaesthesia for day case surgery: a survey of paediatric clinical practice in the UK. Eur J Anaesthesiol 2003; 20 (4): 325–30
Davie MJ. General practitioner anaesthesia survey 2006. Anaesth Intensive Care 2006; 34 (6): 770–5
Chaudhri S, White M, Kenny GN. Induction of anaesthesia with propofol using a target-controlled infusion system. Anaesthesia 1992; 47 (7): 551–3
Manara AR, Monk CR, Bolsin SN, et al. Total i.v. anaesthesia with propofol and alfentanil for coronary artery bypass grafting. Br J Anaesth 1991; 66 (6): 716–8
Philip BK, Lombard LL, Roaf ER, et al. Comparison of vital capacity induction with sevoflurane to intravenous induction with propofol for adult ambulatory anesthesia. Anesth Analg 1999; 89 (3): 623–7
Kirkbride DA, Parker JL, Williams GD, et al. Induction of anesthesia in the elderly ambulatory patient: a double-blinded comparison of propofol and sevoflurane. Anesth Analg 2001; 93 (5): 1185–7
Dolk A, Cannerfelt R, Anderson RE, et al. Inhalation anaesthesia is cost-effective for ambulatory surgery: a clinical comparison with propofol during elective knee arthroscopy. Eur J Anaesthesiol 2002; 19 (2): 88–92
Warden JC, Horan BF, Holland R. Morbidity and mortality associated with anaesthesia. Acta Anaesthesiol Scand 1997; 41 (7): 949
Lienhart A, Auroy Y, Pequignot F, et al. Preliminary results from the SFAR-iNSERM inquiry on anaesthesia-related deaths in France: mortality rates have fallen ten-fold over the past two decades. Bull Acad Natl Med 1906; 188 (8): 1429–37
Pedersen T, Eliasen K, Henriksen E. A prospective study of risk factors and cardiopulmonary complications associated with anaesthesia and surgery: risk indicators of cardiopulmonary morbidity. Acta Anaesthesiol Scand 1990; 34 (2): 144–55
Biboulet P, Aubas P, Dubourdieu J, et al. Fatal and non fatal cardiac arrests related to anesthesia. Can J Anaesth 2001; 48 (4): 326–32
Holzer JF. Analysis of anesthetic mishaps: current concepts in risk management. Int Anesthesiol Clin 1984; 22 (2): 91–116
Kawashima Y, Takahashi S, Suzuki M, et al. Anesthesia-related mortality and morbidity over a 5-year period in 2 363 038 patients in Japan. Acta Anaesthesiol Scand 2003; 47 (7): 809–17
Taylor G, Larson Jr CP, Prestwich R. Unexpected cardiac arrest during anesthesia and surgery: an environmental study. JAMA 1976; 236 (24): 2758–60
Fox MA, Webb RK, Singleton R, et al., for the Australian Incident Monitoring Study. Problems with regional anaesthesia: an analysis of 2000 incident reports. Anaesth Intensive Care 1993; 21 (5): 646–9
Keenan RL, Boyan CP. Cardiac arrest due to anesthesia: a study of incidence and causes. JAMA 1985; 253 (16): 2373–7
Cohen MM, Duncan PG, Tate RB. Does anesthesia contribute to operative mortality? JAMA 1988; 260 (19): 2859–63
Urban MK, Gordon MA, Harris SN, et al. Intraoperative hemodynamic changes are not good indicators of myocardial ischemia. Anesth Analg. 1993; 76 (5): 942–9
Grounds RM, Twigley AJ, Carli F, et al. The haemodynamic effects of intravenous induction: comparison of the effects of thiopentone and propofol. Anaesthesia 1985; 40 (8): 735–40
Patrick MR, Blair IJ, Feneck RO, et al. A comparison of the haemodynamic effects of propofol (‘Diprivan’) and thiopentone in patients with coronary artery disease. Postgrad Med J 1985; 61 Suppl. 3: 23–7
Rouby JJ, Andreev A, Leger P, et al. Peripheral vascular effects of thiopental and propofol in humans with artificial hearts. Anesthesiology 1991; 75 (1): 32–42
Ebert TJ, Muzi M, Berens R, et al. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology 1992; 76 (5): 725–33
Rolly G, Versichelen L. Comparison of propofol and thiopentone for induction of anaesthesia in premedicated patients. Anaesthesia 1985; 40 (10): 945–8
Nauta J, Stanley TH, de Lange S, et al. Anaesthetic induction with alfentanil: comparison with thiopental, midazolam, and etomidate. Can Anaesth Soc J 1983; 30 (1): 53–60
O’Hare R, McAtamney D, Mirakhur RK, et al. Bolus dose remifentanil for control of haemodynamic response to tracheal intubation during rapid sequence induction of anaesthesia. Br J Anaesth 1999; 82 (2): 283–5
Taha S, Siddik-Sayyid S, Alameddine M, et al. Propofol is superior to thiopental for intubation without muscle relaxants. Can J Anaesth 2005; 52 (3): 249–53
Billard V, Moulla F, Bourgain JL, et al. Hemodynamic response to induction and intubation: propofol/fentanyl interaction. Anesthesiology 1994; 81 (6): 1384–93
Wilhelm W, Biedler A, Huppert A, et al. Comparison of the effects of remifentanil or fentanyl on anaesthetic induction characteristics of propofol, thiopental or etomidate. Eur J Anaesthesiol 2002; 19 (5): 350–6
Peacock JE, Lewis RP, Reilly CS, et al. Effect of different rates of infusion of propofol for induction of anaesthesia in elderly patients. Br J Anaesth 1990; 65 (3): 346–52
Chan VW, Chung FF. Propofol infusion for induction and maintenance of anesthesia in elderly patients: recovery and hemodynamic profiles. J Clin Anesth 1996; 8 (4): 317–23
Gold MI, Abraham EC, Herrington C. A controlled investigation of propofol, thiopentone and methohexitone. Can J Anaesth 1987; 34 (5): 478–83
Boysen K, Sanchez R, Krintel JJ, et al. Induction and recovery characteristics of propofol, thiopental and etomidate. Acta Anaesthesiol Scand 1989; 33 (8): 689–92
Muzi M, Berens RA, Kampine JP, et al. Venodilation contributes to propofol-mediated hypotension in humans. Anesth Analg 1992; 74 (6): 877–83
Price ML, Millar B, Grounds M, et al. Changes in cardiac index and estimated systemic vascular resistance during induction of anaesthesia with thiopentone, methohexitone, propofol and etomidate. Br J Anaesth 1992; 69 (2): 172–6
Lindgren L, Yli-Hankala A, Randell T, et al. Haemodynamic and catecholamine responses to induction of anaesthesia and tracheal intubation: comparison between propofol and thiopentone. Br J Anaesth 1993; 70 (3): 306–10
Wilmot G, Bhimsan N, Rocke DA, et al. Intubating conditions and haemodynamic changes following thiopentone or propofol for early tracheal intubation. Can J Anaesth 1993; 40 (3): 201–5
Flaishon R, Windsor A, Sigl J, et al. Recovery of consciousness after thiopental or propofol: bispectral index and isolated forearm technique. Anesthesiology 1997; 86 (3): 613–9
Watson KR, Shah MV. Clinical comparison of ‘single agent’ anaesthesia with sevoflurane versus target controlled infusion of propofol. Br J Anaesth 2000; 85 (4): 541–6
Ganatra SB, D’Mello J, Butani M, et al. Conditions for insertion of the laryngeal mask airway. Comparisons between sevoflurane and propofol using fentanyl as a co-induction agent: a pilot study. Eur J Anaesthesiol 2002; 19 (5): 371–5
Nathan N, Vandroux D, Benrhaiem M, et al. Low alfentanil target-concentrations improve hemodynamic and intubating conditions during induction with sevoflurane. Can J Anaesth 2004; 51 (4): 382–7
Fredman B, Nathanson MH, Smith I, et al. Sevoflurane for outpatient anesthesia: a comparison with propofol. Anesth Analg 1995; 81 (4): 823–8
Smith I, Ding Y, White PF. Comparison of induction, maintenance, and recovery characteristics of sevoflurane-N2O and propofol-sevoflurane-N2O with propofol-isoflurane-N2O anesthesia. Anesth Analg 1992; 74 (2): 253–9
Jellish WS, Lien CA, Fontenot HJ, et al. The comparative effects of sevoflurane versus propofol in the induction and maintenance of anesthesia in adult patients. Anesth Analg 1996; 82 (3): 479–85
Godet G, Watremez C, El Kettani C, et al. A comparison of sevoflurane, target-controlled infusion propofol, and propofol/isoflurane anesthesia in patients undergoing carotid surgery: a quality of anesthesia and recovery profile. Anesth Analg 2001; 93 (3): 560–5
Nathan N, Vial G, Benrhaiem M, et al. Induction with propofol target-concentration infusion vs. 8% sevoflurane inhalation and alfentanil in hypertensive patients. Anaesthesia 2001; 56 (3): 251–7
Nathan N, Vandroux D, Benrhaiem M, et al. Low alfentanil target-concentrations improve hemodynamic and intubating conditions during induction with sevoflurane. Can J Anaesth 2004; 51 (4): 382–7
Sivalingam P, Kandasamy R, Madhavan G, et al. Conditions for laryngeal mask insertion: a comparison of propofol versus sevoflurane with or without alfentanil. Anaesthesia 1999; 54 (3): 271–6
Yli-Hankala A, Vakkuri A, Sarkela M, et al. Epileptiform electroencephalogram during mask induction of anesthesia with sevoflurane. Anesthesiology 1999; 91 (6): 1596–603
Vakkuri A, Jantti V, Sarkela M, et al. Epileptiform EEG during sevoflurane mask induction: effect of delaying the onset of hyperventilation. Acta Anaesthesiol Scand 2000; 44 (6): 713–9
Dandoy M, Poisson F, Lampl E. Cardiocirculatory arrest during anesthesia with propofol and fentanyl [in French]. Ann Fr Anesth Reanim 1990; 9 (5): 465
Ricos P, Trillo L, Crespo MT, et al. Bradycardia and asystole associated with the simultaneous administration of propofol and fentanyl during anesthetic induction. Rev Esp Anestesiol Reanim 1994; 41 (3): 194–5
Altermatt FR, Munoz HR. Asystole with propofol and remifentanil. Br J Anaesth 2000; 84 (5): 696–7
Wang J, Winship S, Russell G. Induction of anaesthesia with sevoflurane and low-dose remifentanil: asystole following laryngoscopy. Br J Anaesth 1998; 81 (6): 994–5
Kurdi O, Deleuze A, Marret E, et al. Asystole during anaesthetic induction with remifentanil and sevoflurane. Br J Anaesth 2001; 87 (6): 943
Cardinal V, Martin R, Tetrault JP, et al. Severe bradycardia and asystole with low dose sufentanil during induction with sevoflurane: a report of three cases. Can J Anaesth 2004; 51 (8): 806–9
Ebert TJ, Muzi M, Berens R, et al. Sympathetic responses to induction of anesthesia in humans with propofol or etomidate. Anesthesiology 1992; 76 (5): 725–33
Latson TW, McCarroll SM, Mirhej MA, et al. Effects of three anesthetic induction techniques on heart rate variability. J Clin Anesth 1992; 4 (4): 265–76
Zheng D, Upton RN, Martinez AM, et al. The influence of the bolus injection rate of propofol on its cardiovascular effects and peak blood concentrations in sheep. Anesth Analg 1998; 86 (5): 1109–15
Sato M, Tanaka M, Umehara S, et al. Baroreflex control of heart rate during and after propofol infusion in humans. Br J Anaesth 2005; 94 (5): 577–81
Nagasaki G, Tanaka M, Nishikawa T. The recovery profile of baroreflex control of heart rate after isoflurane or sevoflurane anesthesia in humans. Anesth Analg 2001; 93 (5): 1127–31
Constant I, Dubois MC, Piat V, et al. Changes in electroencephalogram and autonomic cardiovascular activity during induction of anesthesia with sevoflurane compared with halothane in children. Anesthesiology 1999; 91 (6): 1604–15
Suzer O, Suzer A, Aykac Z, et al. Direct cardiac effects in isolated perfused rat hearts measured at increasing concentrations of morphine, alfentanil, fentanyl, ketamine, etomidate, thiopentone, midazolam and propofol. Eur J Anaesthesiol 1998; 15 (4): 480–5
Mulier JP, Wouters PF, Van Aken H, et al. Cardiodynamic effects of propofol in comparison with thiopental: assessment with a transesophageal echocardiographic approach. Anesth Analg 1991; 72 (1): 28–35
Belo SE, Kolesar R, Mazer CD. Intracoronary propofol does not decrease myocardial contractile function in the dog. Can J Anaesth 1994; 41 (1): 43–9
Gelissen HP, Epema AH, Henning RH, et al. Inotropic effects of propofol, thiopental, midazolam, etomidate, and ketamine on isolated human atrial muscle. Anesthesiology 1996; 84 (2): 397–403
Lepage JY, Pinaud ML, Helias JH, et al. Left ventricular function during propofol and fentanyl anesthesia in patients with coronary artery disease: assessment with a radionuclide approach. Anesth Analg 1988; 67 (10): 949–55
Bilotta F, Fiorani L, La Rosa I, et al. Cardiovascular effects of intravenous propofol administered at two infusion rates: a transthoracic echocardiographic study. Anaesthesia 2001; 56 (3): 266–71
Ismail S, Azam SI, Khan FA. Effect of age on haemodynamic response to tracheal intubation: a comparison of young, middle-aged and elderly patients. Anaesth Intensive Care 2002; 30 (5): 608–14
Habib AS, Parker JL, Maguire AM, et al. Effects of remifentanil and alfentanil on the cardiovascular responses to induction of anaesthesia and tracheal intubation in the elderly. Br J Anaesth 2002; 88 (3): 430–3
Holzman RS, van der Velde ME, Kaus SJ, et al. Sevoflurane depresses myocardial contractility less than halothane during induction of anesthesia in children. Anesthesiology 1996; 85 (6): 1260–7
Rivenes SM, Lewin MB, Stayer SA, et al. Cardiovascular effects of sevoflurane, isoflurane, halothane, and fentanyl-midazolam in children with congenital heart disease: an echocardiographic study of myocardial contractility and hemodynamics. Anesthesiology 2001; 94 (2): 223–9
Morray JP, Geiduschek JM, Ramamoorthy C, et al. Anesthesia-related cardiac arrest in children: initial findings of the Pediatric Perioperative Cardiac Arrest (POCA) Registry. Anesthesiology 2000; 93 (1): 6–14
Obal D, Scharbatke H, Barthel H, et al. Cardioprotection against reperfusion injury is maximal with only two minutes of sevoflurane administration in rats. Can J Anaesth 2003; 50 (9): 940–5
Yvon A, Hanouz JL, Haelewyn B, et al. Mechanisms of sevoflurane-induced myocardial preconditioning in isolated human right atria in vitro. Anesthesiology 2003; 99 (1): 27–33
Obal D, Dettwiler S, Favoccia C, et al. The influence of mitochondrial KATP-channels in the cardioprotection of preconditioning and postconditioning by sevoflurane in the rat in vivo. Anesth Analg 2005; 101 (5): 1252–60
De Hert SG, Cromheecke S, ten Broecke PW, et al. Effects of propofol, desflurane, and sevoflurane on recovery of myocardial function after coronary surgery in elderly high-risk patients. Anesthesiology 2003; 99 (2): 314–23
Van der Linden PJ, Daper A, Trenchant A, et al. Cardioprotective effects of volatile anesthetics in cardiac surgery. Anesthesiology 2003; 99 (2): 516–7
De Hert SG, Van der Linden PJ, Cromheecke S, et al. Cardioprotective properties of sevoflurane in patients undergoing coronary surgery with cardiopulmonary bypass are related to the modalities of its administration. Anesthesiology 2004; 101 (2): 299–310
De Hert SG, Van der Linden PJ, Cromheecke S, et al. Choice of primary anesthetic regimen can influence intensive care unit length of stay after coronary surgery with cardiopulmonary bypass. Anesthesiology 2004; 101 (1): 9–20
Gooding JM, Corssen G. Effect of etomidate on the cardiovascular system. Anesth Analg 1977; 56 (5): 717–9
Gooding JM, Weng JT, Smith RA, et al. Cardiovascular and pulmonary responses following etomidate induction of anesthesia in patients with demonstrated cardiac disease. Anesth Analg 1979; 58 (1): 40–1
Keyl C, Lemberger P, Palitzsch KD, et al. Cardiovascular autonomic dysfunction and hemodynamic response to anesthetic induction in patients with coronary artery disease and diabetes mellitus. Anesth Analg 1999; 88 (5): 985–91
Allolio B, Stuttmann R, Leonhard U, et al. Adrenocortical suppression by a single induction dose of etomidate. Klin Wochenschr 1984; 62 (21): 1014–7
Absalom A, Pledger D, Kong A. Adrenocortical function in critically ill patients 24h after a single dose of etomidate. Anaesthesia 1999; 54 (9): 861–7
Schenarts CL, Burton JH, Riker RR. Adrenocortical dysfunction following etomidate induction in emergency department patients. Acad Emerg Med 2001; 8 (1): 1–7
Malerba G, Romano-Girard F, Cravoisy A, et al. Risk factors of relative adrenocortical deficiency in intensive care patients needing mechanical ventilation. Intensive Care Med 2005; 31 (3): 388–92
Pedersen T, Engbaek J, Klausen NO, et al. Effects of low-dose ketamine and thiopentone on cardiac performance and myocardial oxygen balance in high-risk patients. Acta Anaesthesiol Scand 1982; 26 (3): 235–9
Stefansson T, Wickstrom I, Haljamae H. Hemodynamic and metabolic effects of ketamine anesthesia in the geriatric patient. Acta Anaesthesiol Scand 1982; 26 (4): 371–7
Kaplan JA, Cooperman LH. Alarming reactions to ketamine in patients taking thyroid medication: treatment with propranolol. Anesthesiology 1971; 35 (2): 229–30
Waxman K, Shoemaker WC, Lippmann M. Cardiovascular effects of anesthetic induction with ketamine. Anesth Analg 1980; 59 (5): 355–8
Marlow R, Reich DL, Neustein S, et al. Haemodynamic response to induction of anaesthesia with ketamine/midazolam. Can J Anaesth 1991; 38 (7): 844–8
Sprung J, Schuetz SM, Stewart RW, et al. Effects of ketamine on the contractility of failing and nonfailing human heart muscles in vitro.
Knoche E, Traub E, Dick W. Effects of diazepam and flunitrazepam on the undesired postoperative side-effects of ketamine anaesthesia (author’s transl) [in German]. Anaesthesist 1978; 27 (6): 302–8
Grace RF. The effect of variable-dose diazepam on dreaming and emergence phenomena in 400 cases of ketamine-fentanyl anaesthesia. Anaesthesia 2003; 58 (9): 904–10
St Pierre M, Landsleitner B, Schwilden H, et al. Awareness during laryngoscopy and intubation: quantitating incidence following induction of balanced anesthesia with etomidate and cisatracurium as detected with the isolated forearm technique. J Clin Anesth 2000; 12 (2): 104–8
Passot S, Servin F, Allary R, et al. Target-controlled versus manually-controlled infusion of propofol for direct laryngoscopy and bronchoscopy. Anesth Analg 2002; 94 (5): 1212–6
Servin FS. TCI compared with manually controlled infusion of propofol: a multicentre study. Anaesthesia 1998; 53 Suppl. 1: 82–6
Hu C, Horstman DJ, Shafer SL. Variability of target-controlled infusion is less than the variability after bolus injection. Anesthesiology 2005; 102 (3): 639–45
Passot S, Servin F, Pascal J, et al. A comparison of target- and manually controlled infusion of propofol and etomidate/desflurane anesthesia in elderly patients undergoing hip fracture surgery. Anesth Analg 2005; 100 (5): 1338–42
Hunt-Smith J, Donaghy A, Leslie K, et al. Safety and efficacy of target controlled infusion (Diprifusor) vs manually controlled infusion of propofol for anaesthesia. Anaesth Intensive Care 1999; 27 (3): 260–4
Lehmann A, Boldt J, Rompert R, et al. Target-controlled infusion or manually controlled infusion of propofol in high-risk patients with severely reduced left ventricular function. J Cardiothorac Vasc Anesth 2001; 15 (4): 445–50
Lehmann A, Boldt J, Thaler E, et al. Bispectral index in patients with target-controlled or manually-controlled infusion of propofol. Anesth Analg 2002; 95 (3): 639–44
Gale T, Leslie K, Kluger M. Propofol anaesthesia via target controlled infusion or manually controlled infusion: effects on the bispectral index as a measure of anaesthetic depth. Anaesth Intensive Care 2001; 29 (6): 579–84
Breslin DS, Mirakhur RK, Reid JE, et al. Manual versus target-controlled infusions of propofol. Anaesthesia 2004; 59 (11): 1059–63
De Castro V, Godet G, Mencia G, et al. Target-controlled infusion for remifentanil in vascular patients improves hemodynamics and decreases remifentanil requirement. Anesth Analg 2003; 96 (1): 33–8
Godet G, Reina M, Raux M, et al. Anaesthesia for carotid endarterectomy: comparison of hypnotic- and opioid-based techniques. Br J Anaesth 2004; 92 (3): 329–34
Vuyk J, Engbers FH, Burm AG, et al. Pharmacodynamic interaction between propofol and alfentanil when given for induction of anesthesia. Anesthesiology 1996; 84 (2): 288–99
Wakeling HG, Zimmerman JB, Howell S, et al. Targeting effect compartment or central compartment concentration of propofol: what predicts loss of consciousness? Anesthesiology 1999; 90 (1): 92–7
Struys MM, De Smet T, Depoorter B, et al. Comparison of plasma compartment versus two methods for effect compartment-controlled target-controlled infusion for propofol. Anesthesiology 2000; 92 (2): 399–406
Barvais L, Rausin I, Glen JB, et al. Administration of propofol by target-controlled infusion in patients undergoing coronary artery surgery. J Cardiothorac Vasc Anesth 1996; 10 (7): 877–83
Lieutaud T, Billard V, Khalaf H, et al. Muscle relaxation and increasing doses of propofol improve intubating conditions. Can J Anaesth 2003; 50 (2): 121–6
Sie MY, Goh PK, Chan L, et al. Bispectral index during modified rapid sequence induction using thiopentone or propofol and rocuronium. Anaesth Intensive Care 2004; 32 (1): 28–30
Beck GN, Masterson GR, Richards J, et al. Comparison of intubation following propofol and alfentanil with intubation following thiopentone and suxamethonium. Anaesthesia 1993; 48 (10): 876–80
Baillard C, Adnet F, Borron SW, et al. Tracheal intubation in routine practice with and without muscular relaxation: an observational study. Eur J Anaesthesiol 2005; 22 (9): 672–7
Barker P, Langton JA, Wilson IG, et al. Movements of the vocal cords on induction of anaesthesia with thiopentone or propofol. Br J Anaesth 1992; 69 (1): 23–5
Erhan E, Ugur G, Gunusen I, et al. Propofol — not thiopental or etomidate — with remifentanil provides adequate intubating conditions in the absence of neuromuscular blockade. Can J Anaesth 2003; 50 (2): 108–15
Doi M, Gajraj RJ, Mantzaridis H, et al. Prediction of movement at laryngeal mask airway insertion: comparison of auditory evoked potential index, bispectral index, spectral edge frequency and median frequency. Br J Anaesth 1999; 82 (2): 203–7
Coste C, Guignard B, Menigaux C, et al. Nitrous oxide prevents movement during orotracheal intubation without affecting BIS value. Anesth Analg 2000; 91 (1): 130–5
McKeating K, Bali IM, Dundee JW. The effects of thiopentone and propofol on upper airway integrity. Anaesthesia 1988; 43 (8): 638–40
Cros AM, Lopez C, Kandel T, et al. Determination of sevoflurane alveolar concentration for tracheal intubation with remifentanil, and no muscle relaxant. Anaesthesia 2000; 55 (10): 965–9
Joo HS, Perks WJ, Belo SE. Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents. Can J Anaesth 2001; 48 (7): 646–50
Sivalingam P, Kandasamy R, Dhakshinamoorthi P, et al. Tracheal intubation without muscle relaxant: a technique using sevoflurane vital capacity induction and alfentanil. Anaesth Intensive Care 2001; 29 (4): 383–7
Meaudre E, Boret H, Suppini A, et al. Sufentanil supplementation of sevoflurane during induction of anaesthesia: a randomized study. Eur J Anaesthesiol 2004; 21 (10): 793–6
Stevens JB, Vescovo MV, Harris KC, et al. Tracheal intubation using alfentanil and no muscle relaxant: is the choice of hypnotic important? Anesth Analg 1997; 84 (6): 1222–6
Erhan E, Ugur G, Alper I, et al. Tracheal intubation without muscle relaxants: remifentanil or alfentanil in combination with propofol. Eur J Anaesthesiol 2003; 20 (1): 37–43
McNeil IA, Culbert B, Russell I. Comparison of intubating conditions following propofol and succinylcholine with propofol and remifentanil 2 micrograms kg−1 or 4 micrograms kg−1. Br J Anaesth 2000; 85 (4): 623–5
Thompson JP, Hall AP, Russell J, et al. Effect of remifentanil on the haemodynamic response to orotracheal intubation. Br J Anaesth 1998; 80 (4): 467–9
Upton RN, Ludbrook GL. A model of the kinetics and dynamics of induction of anaesthesia in sheep: variable estimation for thiopental and comparison with propofol. Br J Anaesth 1999; 82 (6): 890–9
Ludbrook GL, Upton RN. A physiological model of induction of anaesthesia with propofol in sheep: 2. Model analysis and implications for dose requirements. Br J Anaesth 1997; 79 (4): 505–13
Minto CF, Power I. New opioid analgesics: an update. Int Anesthesiol Clin 1997; 35 (2): 49–65
Iamaroon A, Pitimana-Aree S, Prechawai C, et al. Endotracheal intubation with thiopental/succinylcholine or sevoflurane-nitrous oxide anesthesia in adults: a comparative study. Anesth Analg 2001; 92 (2): 523–8
Cros AM, Chopin F, Lopez C, et al. Anesthesia induction with sevoflurane in adult patients with predictive signs of difficult intubation. Ann Fr Anesth Reanim 2002; 21 (4): 249–55
Favier JC, Da Conceicao M, Genco G, et al. Fiberoptic intubation in adult patients with predictive signs of difficult intubation: inhalational induction using sevoflurane and an endoscopic facial mask. Ann Fr Anesth Reanim 2003; 22 (2): 96–102
Joo HS, Perks WJ, Belo SE. Sevoflurane with remifentanil allows rapid tracheal intubation without neuromuscular blocking agents. Can J Anaesth 2001; 48 (7): 646–50
Sivalingam P, Kandasamy R, Dhakshinamoorthi P, et al. Tracheal intubation without muscle relaxant: a technique using sevoflurane vital capacity induction and alfentanil. Anaesth Intensive Care 2001; 29 (4): 383–7
Sparr HJ, Giesinger S, Ulmer H, et al. Influence of induction technique on intubating conditions after rocuronium in adults: comparison with rapid-sequence induction using thiopentone and suxamethonium. Br J Anaesth 1996; 77 (3): 339–42
Upton RN, Ludbrook GL. A physiological model of induction of anaesthesia with propofol in sheep: 1. Structure and estimation of variables. Br J Anaesth 1997; 79 (4): 497–504
Upton RN, Ludbrook GL, Grant C. The cerebral and systemic kinetics of thiopentone and propofol in halothane anaesthetized sheep. Anaesth Intensive Care 2001; 29 (2): 117–23
Mirakhur RK, Shepherd WF, Elliott P. Intraocular pressure changes during rapid sequence induction of anaesthesia: comparison of propofol and thiopentone in combination with vecuronium. Br J Anaesth 1988; 60 (4): 379–83
Zimmerman AA, Funk KJ, Tidwell JL. Propofol and alfentanil prevent the increase in intraocular pressure caused by succinylcholine and endotracheal intubation during a rapid sequence induction of anesthesia. Anesth Analg 1996; 83 (4): 814–7
Scott H, Bateman C, Price M. The use of remifentanil in general anaesthesia for caesarean section in a patient with mitral valve disease. Anaesthesia 1998; 53 (7): 695–7
Johannsen EK, Munro AJ. Remifentanil in emergency caesarean section in pre-eclampsia complicated by thrombocytopenia and abnormal liver function. Anaesth Intensive Care 1999; 27 (5): 527–9
Orme RM, Grange CS, Ainsworth QP, et al. General anaesthesia using remifentanil for caesarean section in parturients with critical aortic stenosis: a series of four cases. Int J Obstet Anesth 2004; 13 (3): 183–7
Kee WD, Khaw KS, Ma KC, et al. Maternal and neonatal effects of remifentanil at induction of general anesthesia for cesarean delivery: a randomized, double-blind, controlled trial. Anesthesiology 2006; 104 (1): 14–20
Capogna G, Celleno D, Sebastiani M, et al. Propofol and thiopentone for caesarean section revisited: maternal effects and neonatal outcome. Int J Obstet Anesth 1991; 1 (1): 19–23
Celleno D, Capogna G, Emanuelli M, et al. Which induction drug for cesarean section? A comparison of thiopental sodium, propofol, and midazolam. J Clin Anesth 1993; 5 (4): 284–8
Moore EW, Davies MW. Inhalational versus intravenous induction: a survey of emergency anaesthetic practice in the United Kingdom. Eur J Anaesthesiol 2000; 17 (1): 33–7
Payne K, Moore EW, Elliott RA, et al. Anaesthesia for day case surgery: a survey of paediatric clinical practice in the UK. Eur J Anaesthesiol 2003; 20 (4): 325–30
Brown GW, Patel N, Ellis FR. Comparison of propofol and thiopentone for laryngeal mask insertion. Anaesthesia 1991; 46 (9): 771–2
Scanlon P, Carey M, Power M, et al. Patient response to laryngeal mask insertion after induction of anaesthesia with propofol or thiopentone. Can J Anaesth 1993; 40 (9): 816–8
Koh KF, Chen FG, Cheong KF, et al. Laryngeal mask insertion using thiopental and low dose atracurium: a comparison with propofol. Can J Anaesth 1999; 46 (7): 670–4
Grewal K, Samsoon G. Facilitation of laryngeal mask airway insertion: effects of remifentanil administered before induction with target-controlled propofol infusion. Anaesthesia 2001; 56 (9): 897–901
Lee MP, Kua JS, Chiu WK. The use of remifentanil to facilitate the insertion of the laryngeal mask airway. Anesth Analg 2001; 93 (2): 359–62
Minto CF, Schnider TW, Gregg KM, et al. Using the time of maximum effect site concentration to combine pharmacokinetics and pharmacodynamics. Anesthesiology 2003; 99 (2): 324–33
Ang S, Cheong KF, Ng TI. Alfentanil co-induction for laryngeal mask insertion. Anaesth Intensive Care 1999; 27 (2): 175–8
Drage MP, Nunez J, Vaughan RS, et al. Jaw thrusting as a clinical test to assess the adequate depth of anaesthesia for insertion of the laryngeal mask. Anaesthesia 1996; 51 (12): 1167–70
Muzi M, Robinson BJ, Ebert TJ, et al. Induction of anesthesia and tracheal intubation with sevoflurane in adults. Anesthesiology 1996; 85 (3): 536–43
Nakata Y, Goto T, Saito H, et al. The placement of the cuffed oropharyngeal airway with sevoflurane in adults: a comparison with the laryngeal mask airway. Anesth Analg 1998; 87 (1): 143–6
Plastow SE, Hall JE, Pugh SC. Fentanyl supplementation of sevoflurane induction of anaesthesia. Anaesthesia 2000; 55 (5): 475–8
Siau C, Liu EH. Nitrous oxide does not improve sevoflurane induction of anesthesia in adults. J Clin Anesth 2002; 14 (3): 218–22
Joo HS, Perks WJ. Sevoflurane versus propofol for anesthetic induction: a meta-analysis. Anesth Analg 2000; 91 (1): 213–9
Ti LK, Chow MY, Lee TL. Comparison of sevoflurane with propofol for laryngeal mask airway insertion in adults. Anesth Analg 1999; 88 (4): 908–12
Siddik-Sayyid SM, Aouad MT, Taha SK, et al. A comparison of sevoflurane-propofol versus sevoflurane or propofol for laryngeal mask airway insertion in adults. Anesth Analg 2005; 100 (4): 1204–9
Milde LN, Milde JH, Michenfelder JD. Cerebral functional, metabolic, and hemodynamic effects of etomidate in dogs. Anesthesiology 1985; 63 (4): 371–7
Todd MM, Warner DS, Sokoll MD, et al. A prospective, comparative trial of three anesthetics for elective supratentorial craniotomy: propofol/fentanyl, isoflurane/nitrous oxide, and fentanyl/nitrous oxide. Anesthesiology 1993; 78 (6): 1005–20
Bazin JE. Effects of anesthetic agents on intracranial pressure [in French]. Ann Fr Anesth Reanim 1997; 16 (4): 445–52
Albanese J, Viviand X, Potie F, et al. Sufentanil, fentanyl, and alfentanil in head trauma patients: a study on cerebral hemodynamics. Crit Care Med 1999; 27 (2): 407–11
Steiner LA, Johnston AJ, Chatfield DA, et al. The effects of large dose propofol on cerebrovascular pressure autoregulation in head-injured patients. Anesth Analg 2003; 97 (10): 572–6
Ravussin P, Guinard JP, Ralley F, et al. Effect of propofol on cerebrospinal fluid pressure and cerebral perfusion pressure in patients undergoing craniotomy. Anaesthesia 1988; 43 (3 Suppl.): 37–41
Pinaud M, Lelousque JN, Chetanneau A, et al. Effect of propofol on cerebral hemodynamics and metabolism in patients with brain trauma. Anesthesiology 1990; 73 (3): 404–9
Watts AD, Eliasziw M, Gelb AW. Propofol and hyperventilation for the treatment of increased intracranial pressure in rabbits. Anesth Analg 1998; 87 (3): 564–8
Modica PA, Tempelhoff R. Intracranial pressure during induction of anaesthesia and tracheal intubation with etomidate-induced EEG burst suppression. Can J Anaesth 1992; 39 (3): 236–41
Schwedler M, Miletich DJ, Albrecht RF. Cerebral blood flow and metabolism following ketamine administration. Can Anaesth Soc J 1982; 29 (3): 222–6
Werner C, Kochs E, Rau M, et al. Dose-dependent blood flow velocity changes in the basal cerebral arteries following low-dose ketamine. J Neurosurg Anesthesiol 1990; 2 (2): 86–91
Langsjo JW, Maksimow A, Salmi E, et al. S-ketamine anesthesia increases cerebral blood flow in excess of the metabolic needs in humans. Anesthesiology 2005; 103 (2): 258–68
Strebel S, Lam AM, Matta B, et al. Dynamic and static cerebral autoregulation during isoflurane, desflurane, and propofol anesthesia. Anesthesiology 1995; 83 (1): 66–76
Albanese J, Arnaud S, Rey M, et al. Ketamine decreases intracranial pressure and electroencephalographic activity in traumatic brain injury patients during propofol sedation. Anesthesiology 1997; 87 (6): 1328–34
Sakai K, Cho S, Fukusaki M, et al. The effects of propofol with and without ketamine on human cerebral blood flow velocity and CO(2) response. Anesth Analg 2000; 90 (2): 377–82
Conti A, Iacopino DG, Fodale V, et al. Cerebral haemodynamic changes during propofol-remifentanil or sevoflurane anaesthesia: transcranial Doppler study under bispectral index monitoring. Br J Anaesth 2006; 97 (3): 333–9
Thwaites A, Edmends S, Smith I. Inhalation induction with sevoflurane: a double-blind comparison with propofol. Br J Anaesth 1997; 78 (4): 356–61
Nathan N, Peyclit A, Lahrimi A, et al. Comparison of sevoflurane and propofol for ambulatory anaesthesia in gynaecological surgery. Can J Anaesth 1998; 45 (12): 1148–50
Baker CE, Smith I. Sevoflurane: a comparison between vital capacity and tidal breathing techniques for the induction of anaesthesia and laryngeal mask airway placement. Anaesthesia 1999; 54 (9): 841–4
Luntz SP, Janitz E, Motsch J, et al. Cost-effectiveness and high patient satisfaction in the elderly: sevoflurane versus propofol anaesthesia. Eur J Anaesthesiol 2004; 21 (2): 115–22
Tang J, Chen L, White PF, et al. Recovery profile, costs, and patient satisfaction with propofol and sevoflurane for fast-track office-based anesthesia. Anesthesiology 1999; 91 (1): 253–61
van den Berg AA, Chitty DA, Jones RD, et al. Intravenous or inhaled induction of anesthesia in adults? An audit of preoper-ative patient preferences. Anesth Analg 2005; 100 (5): 1422–4
Moerman N, van Dam FS, Oosting J. Recollections of general anaesthesia: a survey of anaesthesiological practice. Acta Anaesthesiol Scand 1992; 36 (8): 767–71
Macario A, Fleisher LA. Is there value in obtaining a patient’s willingness to pay for a particular anesthetic intervention? Anesthesiology 2006; 104 (5): 906–9
Dwyer R, Bennett HL, Eger EI, et al. Effects of isoflurane and nitrous oxide in subanesthetic concentrations on memory and responsiveness in volunteers. Anesthesiology 1992; 77 (5): 888–98
Tong D, Chung F. Recall after total intravenous anaesthesia due to an equipment misuse. Can J Anaesth 1997; 44 (1): 73–7
Apfel CC, Kranke P, Katz MH, et al. Volatile anaesthetics may be the main cause of early but not delayed postoperative vomiting: a randomized controlled trial of factorial design. Br J Anaesth 2002; 88 (5): 659–68
Habib AS, White WD, Eubanks S, et al. A randomized comparison of a multimodal management strategy versus combination antiemetics for the prevention of postoperative nausea and vomiting. Anesth Analg 2004; 99 (1): 77–81
Lien CA, Hemmings HC, Belmont MR, et al. A comparison: the efficacy of sevoflurane-nitrous oxide or propofol-nitrous oxide for the induction and maintenance of general anesthesia. J Clin Anesth 1996; 8 (8): 639–43
Smith I, Terhoeve PA, Hennart D, et al. A multicentre comparison of the costs of anaesthesia with sevoflurane or propofol. Br J Anaesth 1999; 83 (4): 564–70
Myles PS, Hunt JO, Fletcher H, et al. Part I: propofol, thiopental, sevoflurane, and isoflurane: a randomized, controlled trial of effectiveness. Anesth Analg 2000; 91 (5): 1163–9
Shao X, Li H, White PF, et al. Bisulfite-containing propofol: is it a cost-effective alternative to Diprivan for induction of anesthesia? Anesth Analg 2000; 91 (4): 871–5
Yogendran S, Prabhu A, Hendy A, et al. Vital capacity and patient controlled sevoflurane inhalation result in similar induction characteristics. Can J Anaesth 2005; 52 (1): 45–9
Fleischmann E, Akca O, Wallner T, et al. Onset time, recovery duration, and drug cost with four different methods of inducing general anesthesia. Anesth Analg 1999; 88 (4): 930–5
Pollard BJ, Elliott RA, Moore EW. Anaesthetic agents in adult day case surgery. Eur J Anaesthesiol 2003; 20 (1): 1–9
Kern C, Weber A, Aurilio C, et al. Patient evaluation and comparison of the recovery profile between propofol and thiopentone as induction agents in day surgery. Anaesth Intensive Care 1998; 26 (2): 156–61
Kharasch ED, Karol MD, Lanni C, et al. Clinical sevoflurane metabolism and disposition: I. Sevoflurane and metabolite pharmacokinetics. Anesthesiology 1995; 82 (6): 1369–78
Bailey JM. Context-sensitive half-times and other decrement times of inhaled anesthetics. Anesth Analg 1997; 85 (3): 681–6
Dashfield AK, Birt DJ, Thurlow J, et al. Recovery characteristics using single-breath 8% sevoflurane or propofol for induction of anaesthesia in day-case arthroscopy patients. Anaesthesia 1998; 53 (11): 1062–6
Fish WH, Hobbs AJ, Daniels MV. Comparison of sevoflurane and total intravenous anaesthesia for daycase urological surgery. Anaesthesia 1999; 54 (10): 1002–6
Smith I, Thwaites AJ. Target-controlled propofol vs. sevoflurane: a double-blind, randomised comparison in day-case anaesthesia. Anaesthesia 1999; 54 (8): 745–52
Yang H, Choi PT, McChesney J, et al. Induction with sevoflurane-remifentanil is comparable to propofol-fentanyl-rocuronium in PONV after laparoscopic surgery. Can J Anaesth 2004; 51 (7): 660–7
Suttner S, Boldt J, Schmidt C, et al. Cost analysis of target-controlled infusion-based anesthesia compared with standard anesthesia regimens. Anesth Analg 1999; 88 (1): 77–82
Weinger MB. Drug wastage contributes significantly to the cost of routine anesthesia care. J Clin Anesth 2001; 13 (7): 491–7
Odin I, Feiss P. Low flow and economics of inhalational anaesthesia. Best Pract Res Clin Anaesthesiol 2005; 19 (3): 399–413
Nouette-Gaulain K, Lemoine P, Cros AM, et al. Induction of anaesthesia with target-controlled inhalation of sevoflurane in adults with the ZEUS anaesthesia machine. Ann Fr Anesth Reanim 2005; 24 (7): 802–6
Hendrickx JF, Vandeput DM, De Geyndt AM, et al. Maintaining sevoflurane anesthesia during low-flow anesthesia using a single vaporizer setting change after overpressure induction. J Clin Anesth 2000; 12 (4): 303–7
Hendrickx JF, Vandeput DM, De Geyndt AM, et al. Coasting after overpressure induction with sevoflurane. J Clin Anesth 2000; 12 (2): 100–3
Pontone S, Finkel S, Desmonts JM, et al. Is the relative complexity index beta an accurate indicator of the cost of anesthesia? Ann Fr Anesth Reanim 1993; 12 (6): 539–43
Orkin FK. Meaningful cost reduction. Penny wise, pound foolish. Anesthesiology 1995; 83 (6): 1135–7
Friedman DM, Sokal SM, Chang Y, et al. Increasing operating room efficiency through parallel processing. Ann Surg 2006; 243 (1): 10–4
Gan T, Sloan F, Dear Gde L, et al. How much are patients willing to pay to avoid postoperative nausea and vomiting? Anesth Analg. 2001; 92 (2): 393–400
Bishai D, Brice R, Girod I, et al. Conjoint analysis of French and German parents’ willingness to pay for meningococcal vaccine. Pharmacoeconomics 2007; 25 (2): 143–54
Gan TJ, Ing RJ, de L Dear G, et al. How much are patients willing to pay to avoid intraoperative awareness? J Clin Anesth 2003; 15 (2): 108–12
van den Bosch JE, Bonsel GJ, Moons KG, et al. Effect of postoperative experiences on willingness to pay to avoid postoperative pain, nausea, and vomiting. Anesthesiology 2006; 104 (5): 1033–9
Orkin FK. Moving toward value-based anesthesia care. J Clin Anesth 1993; 5 (2): 91–8
Macario A, Chung A, Weinger MB. Variation in practice patterns of anesthesiologists in California for prophylaxis of postoperative nausea and vomiting. J Clin Anesth 2001; 13 (5): 353–60
Elliott RA, Payne K, Moore JK, et al. Clinical and economic choices in anaesthesia for day surgery: a prospective randomised controlled trial. Anaesthesia 2003; 58 (5): 412–21
Acknowledgements
We would especially like to thank Mrs Claire Paillier for her help reviewing the use of English in this review. No sources of funding were used to assist in the preparation of this review. The authors have no conflicts of interest that are directly relevant to the content of this review.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nathan, N., Odin, I. Induction of Anaesthesia. Drugs 67, 701–723 (2007). https://doi.org/10.2165/00003495-200767050-00005
Published:
Issue Date:
DOI: https://doi.org/10.2165/00003495-200767050-00005