Anesthetics

Anesthetics are used in medicine to permit surgical procedures without pain or consciousness. They are of two types: local and general. A local anesthetic is usually injected near nerves to prevent pain in a limited area, such as a Novocaine injection to anesthetize a tooth. General anesthetics are administered to the whole body and depress the CNS to such an extent that major surgery can be performed without killing the patient from the shock resulting from procedures that otherwise would be unendurable. General anesthetics were developed in the mid-nineteenth century by doctors experimenting, usually on themselves, with the organic solvents available at the time. These experiments were sometimes done by groups of people who inhaled the vapors and described the effects, or passed out. Later, careful experimental work identified volatile chemicals that are used to save lives by permitting surgery that would otherwise be impossible to perform, and that are safe to use and have relatively low toxicity.

Some anesthetics can be given by injection. Short-acting anesthetics are used for brief procedures in medicine and dentistry where inhalation anesthesia is inappropriate or difficult, or for starting anesthesia before longer-acting agents are given to the patient. Drugs used for this purpose include barbiturates such as sodium methohexital and so dium thiopental, and benzodiazepines such as midazolam. Fentanyl and related compounds are used for a longer duration of action. A dissociative anesthetic, ketamine, is used for treating burn patients and small children. These agents affect the brain in a more selective way than other anesthetics, so that there is more muscle tone and better circulation in the head and neck. A related veterinary drug, phencyclidine (PCP), has a longer duration of action; when given to humans, however, it has produced terrifying hallucinations upon recovery. It is subject to abuse.

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