Abstrato

Theory and practise of multimodal general anaesthesia.

John Greek

The most widely used management technique in anaesthesia care, balanced general anaesthesia, involves combining the delivery of various medications to produce the anaesthetic state. This strategy was created by anaesthesiologists to avoid relying solely on ether to maintain general anaesthesia. The chance of the intended effects and the likelihood of the adverse effects are increased and decreased, respectively, by the fact that balanced general anaesthesia consumes less of each drug than if it were provided alone. The current practise of balanced general anaesthesia relies nearly entirely on opioids to control nociception intraoperatively and pain postoperatively. Opioids are the most powerful anti-nociceptive drugs; however they can have negative side effects. In addition, the opioid pandemic in the US has been exacerbated by an overuse of opioids. Balanced general anaesthesia procedures are now employing more drugs to induce the anaesthetic state as a result of worries about opioid overuse. These methods, referred to as "multimodal general anaesthesia" may involve the use of additional medications, such as dexmedetomidine and magnesium, both of which have less precise targets for the central nervous system. The idea is to optimise desired results while reducing negative effects by using more medicines in smaller doses. Although this method appears to maximise the benefit-to-side effect ratio, no logical method for selecting the drug combinations has been offered. The main justification for putting a patient under a state of general anaesthesia is nociception brought on by surgery. Therefore, any sensible plan of action should concentrate on postoperative pain management and intraoperative nociception control.