Genel Anestezikler
Özet
Bu metin, genel anestezi kavramını, evrelerini ve genel anestezik ilaçların sınıflandırılması ile temel özelliklerini detaylı bir şekilde incelemektedir. Dioscorides tarafından tarihte ilk kez kullanılan anestezi terimi, duyarsızlık anlamına gelmekte olup günümüzde genel anestezi, bilinç ve duyu kaybı, amnezi, analjezi ile kas gevşemesini içeren geçici nörolojik değişiklikleri ifade eder. Genel anestezi süreci sırasıyla indüksiyon, idame ve yaşamsal fonksiyonların tamamen yerine gelerek uyanmanın sağlandığı üç ana evreden oluşmaktadır. İdeal bir genel anestezik ajan düşük toksisite, hızlı ve sorunsuz indüksiyon, geri döndürülebilir etki, yeterli kas gevşemesi ve solunum ile dolaşım sistemleri üzerinde minimal baskılayıcı etki göstermelidir. Genel anestezik ilaçlar uygulama yollarına göre inhalasyon ve intravenöz anestezikler olarak iki temel grupta toplanır. İnhalasyon anestezikleri gaz (nitröz oksit, ksenon) ve volatil sıvı (desfluran, izofluran, sevofluran, halotan) formlarında bulunur ve etki güçleri Minimum Alveoler Konsantrasyon (MAK) değeriyle belirlenir. İntravenöz anestezikler ise barbitüratlar (tiopental sodyum), benzodiazepinler (midazolam, diazepam), dissosiatif anestezi sağlayan ketamin, hipnotik ajanı propofol ve imidazol türevi etomidat gibi çeşitli kimyasal yapılardan oluşur. Her bir ajanın merkezi sinir sistemi, kardiyovasküler sistem, karaciğer ve böbrekler üzerinde özgün etki ve yan etki profilleri mevcuttur.
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