Balanced Anesthesia with Inhalational Anesthetic Agents

An anesthetic plan based on the concept of balanced anesthesia may proceed as follows. First, since anesthetic partial pressure for an inhalational agent in the brain is not attained rapidly, patients are usually anesthetized with an IV agent. A bolus of an IV anesthetic provides unconsciousness long enough to establish the anesthetic brain tension of most of the inhalational drugs. Second, a supplemental analgesic (i.e., an opioid or the inhalational gas N2O) is required because halogenated hydrocarbons exhibit varying and often inadequate degrees of analgesia, so patients may respond to strongly noxious surgical manipulations with movement and reflex cardiovascular changes. Third, since the neuromuscular

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