Intravenous Anesthetic Agents: Opioids, Non-Opioids

Intravenous anesthetic agents are drugs used to induce and maintain anesthesia during surgical procedures. They are administered through an intravenous line, allowing the anesthesiologist to control the depth and duration of anesthesia rapidly. Intravenous anesthetics are also used for sedation, which is necessary for various medical procedures such as endoscopy, radiological investigations, and minor surgical procedures.

Let’s learn more about this important anesthesia topic for NEET PG exam preparation.

Classification

• They are divided into two groups
  • Opioids
  • Non-opioids

Opioids

• Only used for analgesic property in GA because of side effect
  • Prolonged Respiratory 
  • Depression 
  • CVS stability 
• Can be used as sole anesthetic only for major CVS compromised patients.
• It includes
  • Morphine
  • Fentanyl
  • Sufentanyl
  • Alfentanil
  • Remifentanil 
    • BEST
    • Unique metabolism, by non-specific esterase
    • Ultrashort acting, 3-5 mins half-life (Use it as infusion)

Non-Opioids

Effect on CNS

Effect on CVS

Effect on respiratory system

• They all blunt respiratory drive
• Ketamine: Best Bronchodilator
• Bronchial asthma: Ketamine > Propofol 

• Hepatic/Renal: No effect on hepatic and renal system, though all drugs are metabolized by them.
• Only propofol has an extrahepatic extrarenal route of metabolism. In case of liver and kidney dysfunctions, propofol can be preferred compared to the rest of the IV anesthetic drugs.

Agent of choice

Contraindication of use of Intravenous anesthetic Agent

Side effects

Previous Year Questions

Q. Which of the following inhalational agents is the induction agent of choice in children? (FMGE 2018)

• Methoxyflurane
• Sevoflurane
• Desflurane
• D. Isoflurane

Q. Which of the following drug is used for hypotensive anesthesia? (FMGE June 2018)

• Isoflurane
• Nitroglycerine
• Both 1 and 2
• Dantrolene

Q. Drugs does not cause cardiac depression? (NEET Jan 2019)

• Propofol
• Ketamine
• Etomidate
• Thiopentone

Q. Maximum airway irritation caused by? (NEET Jan 2019)

• Desflurane
• Enflurane
• Sevoflurane
• Halothane

Q. Intravenous agent does not causes pain? (NEET Jan 2019)

• Methohexital
• Propofol
• Ketamine
• Etomidate

Q. On repeated use, which of the following inhalational antiesthetic agents can cause hepatitis? (FMGE June 2019)

• Isoflurane
• Halothane
• Sevoflurane
• Ether

Q. Which of the following anesthetic agents causes postoperative delirium and hallucinations? (FMGE Dec 2020)

• Ketamine
• Propofol
• Thiopentone
• Etomidate

Q. Which of the following is contraindicated in acute intermittent porphyria? 

(FMGE Aug 2020)

• Sodium Thiopentone
• Propofol
• Ketamine
• Etomidate

Q. Which of the following is used for day care surgery? (FMGE Dec 2020)

• Ketamine
• Thiopentone
• Propofol
• Etomidate

Q. A patient in OT was given anesthesia (isoflurane, halothane etc) and suddenly developed lung collapse and hypotension. What is the reason for it? (FMGE June 2021)

• ARDS
• Pleural effusion
• Pulmonary oedema
• Pneumothorax

Q. Which of the following agent can be used as sole agent for induction and intubation? (INI-CET Nov 2021)

• Sevoflurane
• Isoflurane
• Halothane
• Desflurane

Q. Which of the inhalational anesthetic uses special vaporizer?

(FMGE June 2022)

• Desflurane
• Sevoflurane
• Isoflurane
• Halothane

Q. A known case of asthmatic bronchitis reported to hospital with breathlessness, palpitation with oxygen saturation of 88%. Hospital has no ventilator. All of the following can be given to the patient except? (FMGE June 2022)

• Hydrocortisone IV
• MgSO₄
• Oxygen
• Leukotriene Antagonist 

Intravenous anesthetic agents is a high-yield topic for the NEET PG exam. To study this topic effectively, download the PrepLadder app and learn from engaging video lectures by expert medical faculty.