I am an intern doctor in hospital, please create a very much compact table of mostly used anesthesia drugs used in anesthesia department along with their uses in short clinically and contraindications in very short
Here's a compact clinical reference table for commonly used anesthesia drugs:
Anesthesia Drug Quick Reference
šµ Induction Agents
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Propofol | IV induction & TIVA, sedation for procedures/ICU | Egg/soy allergy, hypovolemia, severe cardiac depression |
| Ketamine | Induction in hemodynamically unstable pts, pediatric, emergency | Uncontrolled HTN, raised ICP, ischemic heart disease, psychiatric disorders |
| Thiopental | Rapid sequence induction, neuroprotection | Porphyria, airway obstruction, no IV access |
| Etomidate | Induction in cardiovascular compromise | Adrenal insufficiency, sepsis (single dose OK cautiously) |
| Midazolam | Premedication, sedation, anxiolysis, anticonvulsant | Acute narrow-angle glaucoma, severe respiratory depression |
š¢ Volatile (Inhalational) Agents
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Sevoflurane | Induction & maintenance (esp. pediatric), smooth emergence | Malignant hyperthermia (MH) susceptibility, known nephrotoxic risk |
| Isoflurane | Maintenance, neuro/cardiac surgery | MH susceptibility, severe hypovolemia |
| Desflurane | Maintenance, fast wake-up (day surgery) | MH susceptibility, airway irritant - avoid for induction |
| Nitrous Oxide (NāO) | Adjunct analgesia, reduces MAC of other agents | Pneumothorax, bowel obstruction, middle ear surgery, B12 deficiency, raised ICP |
š“ Opioids
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Fentanyl | Intraoperative analgesia, blunts intubation response | Severe respiratory depression, MAO inhibitor use |
| Morphine | Post-op analgesia, chronic pain | Raised ICP, renal failure (active metabolite), bronchospasm |
| Remifentanil | TIVA infusion, context-sensitive rapid offset | No bolus (chest wall rigidity), requires multimodal plan post-op |
| Sufentanil | Cardiac surgery, high-dose opioid techniques | Same as fentanyl; caution in respiratory compromise |
| Tramadol | Mild-moderate post-op pain | Seizure disorder, MAO inhibitor use, CYP2D6 poor metabolizers |
š” Neuromuscular Blocking Agents (NMBAs)
| Drug | Type | Clinical Use | Contraindications |
|---|---|---|---|
| Succinylcholine | Depolarizing | RSI, short intubations | Hyperkalemia, burn/crush injury >48h, MH, pseudocholinesterase deficiency, denervation injuries |
| Rocuronium | Non-depolarizing | RSI (with sugammadex reversal), intubation, relaxation | MH susceptibility (safe), myasthenia gravis (dose ā) |
| Atracurium | Non-depolarizing | Intubation, renal/hepatic failure pts (Hofmann elimination) | Histamine release - caution in asthma/allergy |
| Vecuronium | Non-depolarizing | Intermediate relaxation | Caution in hepatic failure, myasthenia gravis |
| Cisatracurium | Non-depolarizing | ICU/OR, renal/hepatic failure | Rare - hypersensitivity |
š£ Reversal Agents
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Neostigmine | Reversal of non-depolarizing NMBAs | Intestinal/urinary obstruction; always give with glycopyrrolate |
| Sugammadex | Rapid reversal of rocuronium/vecuronium | Renal failure (caution), toremifene interaction |
| Flumazenil | Reversal of benzodiazepines | Seizure disorder, benzodiazepine-dependent pts |
| Naloxone | Reversal of opioid overdose | Opioid-dependent pts (acute withdrawal), caution in cardiac pts |
āŖ Local Anesthetics
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Lignocaine (Lidocaine) | Spinal, epidural, peripheral nerve blocks, IV (antiarrhythmic) | Amide allergy, severe heart block |
| Bupivacaine | Spinal/epidural/peripheral blocks, long-duration | High-dose IV (cardiotoxic), obstetric IV bolus |
| Ropivacaine | Epidural/peripheral blocks, lower cardiotoxicity | Amide allergy |
| Levobupivacaine | Similar to bupivacaine, safer cardiac profile | Amide allergy |
š¤ Adjuncts / Others
| Drug | Clinical Use | Contraindications |
|---|---|---|
| Dexmedetomidine | Sedation without respiratory depression, awake fiberoptic | Bradycardia, heart block, severe hepatic failure |
| Atropine | Bradycardia, antisialagogue (premedication) | Tachycardia, angle-closure glaucoma |
| Glycopyrrolate | Antisialagogue, with neostigmine reversal | Tachyarrhythmia, glaucoma |
| Dexamethasone | PONV prophylaxis, airway edema | Diabetics (transient hyperglycemia - monitor), systemic infection |
| Ondansetron | PONV treatment/prophylaxis | QT prolongation, serotonin syndrome risk |
| Ephedrine | Intraop hypotension (spinal anesthesia) | Hypertension, MAO inhibitor use |
| Phenylephrine | Vasopressor for spinal hypotension | Bradycardia (reflex), severe hypertension |
| Magnesium Sulfate | Adjunct analgesia, eclampsia, bronchospasm | Renal failure, heart block |
| Ketrolac / NSAIDs | Multimodal post-op analgesia | Renal impairment, peptic ulcer, coagulopathy, cardiac surgery |
Key clinical tips:
- Always have sugammadex available when using rocuronium for RSI
- Propofol infusion syndrome - avoid high doses >4 mg/kg/h for >48h in ICU
- Succinylcholine is still preferred for RSI when can't intubate/can't oxygenate scenario is NOT anticipated AND no contraindications exist
- Bupivacaine cardiotoxicity is treated with 20% Intralipid emulsion therapy
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