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aria-hidden="true" ><span class="vector-icon mw-ui-icon-appearance mw-ui-icon-wikimedia-appearance"></span> <span class="vector-dropdown-label-text">Appearance</span> </label> <div class="vector-dropdown-content"> <div id="vector-appearance-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <div id="p-vector-user-menu-notifications" class="vector-menu mw-portlet emptyPortlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> </ul> </div> </div> <div id="p-vector-user-menu-overflow" class="vector-menu mw-portlet" > <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li id="pt-sitesupport-2" class="user-links-collapsible-item mw-list-item user-links-collapsible-item"><a data-mw="interface" href="https://donate.wikimedia.org/wiki/Special:FundraiserRedirector?utm_source=donate&utm_medium=sidebar&utm_campaign=C13_en.wikipedia.org&uselang=en" class=""><span>Donate</span></a> </li> <li id="pt-createaccount-2" 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data-event-name="pinnable-header.vector-toc.pin">move to sidebar</button> <button class="vector-pinnable-header-toggle-button vector-pinnable-header-unpin-button" data-event-name="pinnable-header.vector-toc.unpin">hide</button> </div> <ul class="vector-toc-contents" id="mw-panel-toc-list"> <li id="toc-mw-content-text" class="vector-toc-list-item vector-toc-level-1"> <a href="#" class="vector-toc-link"> <div class="vector-toc-text">(Top)</div> </a> </li> <li id="toc-Local_anesthetics" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Local_anesthetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">1</span> <span>Local anesthetics</span> </div> </a> <button aria-controls="toc-Local_anesthetics-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle Local anesthetics subsection</span> </button> <ul id="toc-Local_anesthetics-sublist" class="vector-toc-list"> <li id="toc-Ester-based" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Ester-based"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.1</span> <span>Ester-based</span> </div> </a> <ul id="toc-Ester-based-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Amide-Based" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Amide-Based"> <div class="vector-toc-text"> <span class="vector-toc-numb">1.2</span> <span>Amide-Based</span> </div> </a> <ul id="toc-Amide-Based-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-General_anesthetics" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#General_anesthetics"> <div class="vector-toc-text"> <span class="vector-toc-numb">2</span> <span>General anesthetics</span> </div> </a> <button aria-controls="toc-General_anesthetics-sublist" class="cdx-button cdx-button--weight-quiet cdx-button--icon-only vector-toc-toggle"> <span class="vector-icon mw-ui-icon-wikimedia-expand"></span> <span>Toggle General anesthetics subsection</span> </button> <ul id="toc-General_anesthetics-sublist" class="vector-toc-list"> <li id="toc-Inhaled_agents" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Inhaled_agents"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.1</span> <span>Inhaled agents</span> </div> </a> <ul id="toc-Inhaled_agents-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Intravenous_agents_(non-opioid)" class="vector-toc-list-item vector-toc-level-2"> <a class="vector-toc-link" href="#Intravenous_agents_(non-opioid)"> <div class="vector-toc-text"> <span class="vector-toc-numb">2.2</span> <span>Intravenous agents (non-opioid)</span> </div> </a> <ul id="toc-Intravenous_agents_(non-opioid)-sublist" class="vector-toc-list"> </ul> </li> </ul> </li> <li id="toc-Intravenous_opioid_analgesic_agents" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Intravenous_opioid_analgesic_agents"> <div class="vector-toc-text"> <span class="vector-toc-numb">3</span> <span>Intravenous opioid analgesic agents</span> </div> </a> <ul id="toc-Intravenous_opioid_analgesic_agents-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Muscle_relaxants" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Muscle_relaxants"> <div class="vector-toc-text"> <span class="vector-toc-numb">4</span> <span>Muscle relaxants</span> </div> </a> <ul id="toc-Muscle_relaxants-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-Intravenous_reversal_agents" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#Intravenous_reversal_agents"> <div class="vector-toc-text"> <span class="vector-toc-numb">5</span> <span>Intravenous reversal agents</span> </div> </a> <ul id="toc-Intravenous_reversal_agents-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-References" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#References"> <div class="vector-toc-text"> <span class="vector-toc-numb">6</span> <span>References</span> </div> </a> <ul id="toc-References-sublist" class="vector-toc-list"> </ul> </li> <li id="toc-External_links" class="vector-toc-list-item vector-toc-level-1 vector-toc-list-item-expanded"> <a class="vector-toc-link" href="#External_links"> <div class="vector-toc-text"> <span class="vector-toc-numb">7</span> <span>External links</span> </div> </a> <ul id="toc-External_links-sublist" class="vector-toc-list"> </ul> </li> </ul> </div> </div> </nav> </div> </div> <div class="mw-content-container"> <main id="content" class="mw-body"> <header class="mw-body-header vector-page-titlebar"> <nav aria-label="Contents" class="vector-toc-landmark"> <div id="vector-page-titlebar-toc" class="vector-dropdown vector-page-titlebar-toc vector-button-flush-left" > <input type="checkbox" id="vector-page-titlebar-toc-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-vector-page-titlebar-toc" class="vector-dropdown-checkbox " aria-label="Toggle the table of contents" > <label id="vector-page-titlebar-toc-label" for="vector-page-titlebar-toc-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--icon-only " aria-hidden="true" ><span class="vector-icon mw-ui-icon-listBullet mw-ui-icon-wikimedia-listBullet"></span> <span class="vector-dropdown-label-text">Toggle the table of contents</span> </label> <div class="vector-dropdown-content"> <div id="vector-page-titlebar-toc-unpinned-container" class="vector-unpinned-container"> </div> </div> </div> </nav> <h1 id="firstHeading" class="firstHeading mw-first-heading"><span class="mw-page-title-main">Anesthetic</span></h1> <div id="p-lang-btn" class="vector-dropdown mw-portlet mw-portlet-lang" > <input type="checkbox" id="p-lang-btn-checkbox" role="button" aria-haspopup="true" data-event-name="ui.dropdown-p-lang-btn" class="vector-dropdown-checkbox mw-interlanguage-selector" aria-label="Go to an article in another language. Available in 38 languages" > <label id="p-lang-btn-label" for="p-lang-btn-checkbox" class="vector-dropdown-label cdx-button cdx-button--fake-button cdx-button--fake-button--enabled cdx-button--weight-quiet cdx-button--action-progressive mw-portlet-lang-heading-38" aria-hidden="true" ><span class="vector-icon mw-ui-icon-language-progressive mw-ui-icon-wikimedia-language-progressive"></span> <span class="vector-dropdown-label-text">38 languages</span> </label> <div class="vector-dropdown-content"> <div class="vector-menu-content"> <ul class="vector-menu-content-list"> <li class="interlanguage-link interwiki-ar mw-list-item"><a href="https://ar.wikipedia.org/wiki/%D9%85%D8%AE%D8%AF%D8%B1" title="مخدر – Arabic" lang="ar" hreflang="ar" data-title="مخدر" data-language-autonym="العربية" data-language-local-name="Arabic" class="interlanguage-link-target"><span>العربية</span></a></li><li class="interlanguage-link interwiki-azb mw-list-item"><a href="https://azb.wikipedia.org/wiki/%D8%A7%D9%88%D8%B1%DA%A9_%DA%A9%D8%A6%DA%86%DB%8C%D8%B1%D8%AF%D9%86" title="اورک کئچیردن – South Azerbaijani" lang="azb" hreflang="azb" data-title="اورک کئچیردن" data-language-autonym="تۆرکجه" data-language-local-name="South Azerbaijani" class="interlanguage-link-target"><span>تۆرکجه</span></a></li><li class="interlanguage-link interwiki-bn mw-list-item"><a href="https://bn.wikipedia.org/wiki/%E0%A6%85%E0%A6%AC%E0%A7%87%E0%A6%A6%E0%A6%A8%E0%A6%BF%E0%A6%95" title="অবেদনিক – Bangla" lang="bn" hreflang="bn" data-title="অবেদনিক" data-language-autonym="বাংলা" data-language-local-name="Bangla" class="interlanguage-link-target"><span>বাংলা</span></a></li><li class="interlanguage-link interwiki-de mw-list-item"><a href="https://de.wikipedia.org/wiki/An%C3%A4sthetikum" title="Anästhetikum – German" lang="de" hreflang="de" data-title="Anästhetikum" data-language-autonym="Deutsch" data-language-local-name="German" class="interlanguage-link-target"><span>Deutsch</span></a></li><li class="interlanguage-link interwiki-es mw-list-item"><a href="https://es.wikipedia.org/wiki/Anest%C3%A9sico" title="Anestésico – Spanish" lang="es" hreflang="es" data-title="Anestésico" data-language-autonym="Español" data-language-local-name="Spanish" class="interlanguage-link-target"><span>Español</span></a></li><li class="interlanguage-link interwiki-fa mw-list-item"><a href="https://fa.wikipedia.org/wiki/%D8%A8%DB%8C%D9%87%D9%88%D8%B4%E2%80%8C%DA%A9%D9%86%D9%86%D8%AF%D9%87" title="بیهوش‌کننده – Persian" lang="fa" hreflang="fa" data-title="بیهوش‌کننده" data-language-autonym="فارسی" data-language-local-name="Persian" class="interlanguage-link-target"><span>فارسی</span></a></li><li class="interlanguage-link interwiki-ko mw-list-item"><a href="https://ko.wikipedia.org/wiki/%EB%A7%88%EC%B7%A8%EC%A0%9C" title="마취제 – Korean" lang="ko" hreflang="ko" data-title="마취제" data-language-autonym="한국어" data-language-local-name="Korean" class="interlanguage-link-target"><span>한국어</span></a></li><li class="interlanguage-link interwiki-hi mw-list-item"><a href="https://hi.wikipedia.org/wiki/%E0%A4%A8%E0%A4%BF%E0%A4%B6%E0%A5%8D%E0%A4%9A%E0%A5%87%E0%A4%A4%E0%A4%95" title="निश्चेतक – Hindi" lang="hi" hreflang="hi" data-title="निश्चेतक" data-language-autonym="हिन्दी" data-language-local-name="Hindi" class="interlanguage-link-target"><span>हिन्दी</span></a></li><li class="interlanguage-link interwiki-hr mw-list-item"><a href="https://hr.wikipedia.org/wiki/Anestetik" title="Anestetik – Croatian" lang="hr" hreflang="hr" data-title="Anestetik" data-language-autonym="Hrvatski" data-language-local-name="Croatian" class="interlanguage-link-target"><span>Hrvatski</span></a></li><li class="interlanguage-link interwiki-it mw-list-item"><a href="https://it.wikipedia.org/wiki/Anestetico" title="Anestetico – Italian" lang="it" hreflang="it" data-title="Anestetico" data-language-autonym="Italiano" data-language-local-name="Italian" class="interlanguage-link-target"><span>Italiano</span></a></li><li class="interlanguage-link interwiki-he mw-list-item"><a href="https://he.wikipedia.org/wiki/%D7%AA%D7%A8%D7%95%D7%A4%D7%95%D7%AA_%D7%9C%D7%94%D7%A8%D7%93%D7%9E%D7%94" title="תרופות להרדמה – Hebrew" lang="he" hreflang="he" data-title="תרופות להרדמה" data-language-autonym="עברית" data-language-local-name="Hebrew" class="interlanguage-link-target"><span>עברית</span></a></li><li class="interlanguage-link interwiki-ky mw-list-item"><a href="https://ky.wikipedia.org/wiki/%D0%90%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D1%82%D0%B8%D0%BA%D1%82%D0%B5%D1%80" title="Анестетиктер – Kyrgyz" lang="ky" hreflang="ky" data-title="Анестетиктер" data-language-autonym="Кыргызча" data-language-local-name="Kyrgyz" class="interlanguage-link-target"><span>Кыргызча</span></a></li><li class="interlanguage-link interwiki-lt mw-list-item"><a href="https://lt.wikipedia.org/wiki/Anestetikas" title="Anestetikas – Lithuanian" lang="lt" hreflang="lt" data-title="Anestetikas" data-language-autonym="Lietuvių" data-language-local-name="Lithuanian" class="interlanguage-link-target"><span>Lietuvių</span></a></li><li class="interlanguage-link interwiki-ml mw-list-item"><a href="https://ml.wikipedia.org/wiki/%E0%B4%85%E0%B4%A8%E0%B4%B8%E0%B5%8D%E0%B4%A4%E0%B4%BF%E0%B4%95%E0%B4%82" title="അനസ്തികം – Malayalam" lang="ml" hreflang="ml" data-title="അനസ്തികം" data-language-autonym="മലയാളം" data-language-local-name="Malayalam" class="interlanguage-link-target"><span>മലയാളം</span></a></li><li class="interlanguage-link interwiki-mr mw-list-item"><a href="https://mr.wikipedia.org/wiki/%E0%A4%B8%E0%A4%82%E0%A4%B5%E0%A5%87%E0%A4%A6%E0%A4%A8%E0%A4%BE%E0%A4%B9%E0%A4%BE%E0%A4%B0%E0%A4%95" title="संवेदनाहारक – Marathi" lang="mr" hreflang="mr" data-title="संवेदनाहारक" data-language-autonym="मराठी" data-language-local-name="Marathi" class="interlanguage-link-target"><span>मराठी</span></a></li><li class="interlanguage-link interwiki-arz mw-list-item"><a href="https://arz.wikipedia.org/wiki/%D9%85%D8%AE%D8%AF%D8%B1" title="مخدر – Egyptian Arabic" lang="arz" hreflang="arz" data-title="مخدر" data-language-autonym="مصرى" data-language-local-name="Egyptian Arabic" class="interlanguage-link-target"><span>مصرى</span></a></li><li class="interlanguage-link interwiki-my mw-list-item"><a href="https://my.wikipedia.org/wiki/%E1%80%99%E1%80%B1%E1%80%B7%E1%80%86%E1%80%B1%E1%80%B8%E1%80%91%E1%80%AF%E1%80%B6%E1%80%86%E1%80%B1%E1%80%B8" title="မေ့ဆေးထုံဆေး – Burmese" lang="my" hreflang="my" data-title="မေ့ဆေးထုံဆေး" data-language-autonym="မြန်မာဘာသာ" data-language-local-name="Burmese" class="interlanguage-link-target"><span>မြန်မာဘာသာ</span></a></li><li class="interlanguage-link interwiki-nl mw-list-item"><a href="https://nl.wikipedia.org/wiki/Anesthetica" title="Anesthetica – Dutch" lang="nl" hreflang="nl" data-title="Anesthetica" data-language-autonym="Nederlands" data-language-local-name="Dutch" class="interlanguage-link-target"><span>Nederlands</span></a></li><li class="interlanguage-link interwiki-ja mw-list-item"><a href="https://ja.wikipedia.org/wiki/%E9%BA%BB%E9%85%94%E8%96%AC" title="麻酔薬 – Japanese" lang="ja" hreflang="ja" data-title="麻酔薬" data-language-autonym="日本語" data-language-local-name="Japanese" class="interlanguage-link-target"><span>日本語</span></a></li><li class="interlanguage-link interwiki-no mw-list-item"><a href="https://no.wikipedia.org/wiki/Anestetikum" title="Anestetikum – Norwegian Bokmål" lang="nb" hreflang="nb" data-title="Anestetikum" data-language-autonym="Norsk bokmål" data-language-local-name="Norwegian Bokmål" class="interlanguage-link-target"><span>Norsk bokmål</span></a></li><li class="interlanguage-link interwiki-uz mw-list-item"><a href="https://uz.wikipedia.org/wiki/Anesteziyalovchi_moddalar" title="Anesteziyalovchi moddalar – Uzbek" lang="uz" hreflang="uz" data-title="Anesteziyalovchi moddalar" data-language-autonym="Oʻzbekcha / ўзбекча" data-language-local-name="Uzbek" class="interlanguage-link-target"><span>Oʻzbekcha / ўзбекча</span></a></li><li class="interlanguage-link interwiki-pl mw-list-item"><a href="https://pl.wikipedia.org/wiki/Anestetyki" title="Anestetyki – Polish" lang="pl" hreflang="pl" data-title="Anestetyki" data-language-autonym="Polski" data-language-local-name="Polish" class="interlanguage-link-target"><span>Polski</span></a></li><li class="interlanguage-link interwiki-pt badge-Q70893996 mw-list-item" title=""><a href="https://pt.wikipedia.org/wiki/Anest%C3%A9sico" title="Anestésico – Portuguese" lang="pt" hreflang="pt" data-title="Anestésico" data-language-autonym="Português" data-language-local-name="Portuguese" class="interlanguage-link-target"><span>Português</span></a></li><li class="interlanguage-link interwiki-ro mw-list-item"><a href="https://ro.wikipedia.org/wiki/Anestezic" title="Anestezic – Romanian" lang="ro" hreflang="ro" data-title="Anestezic" data-language-autonym="Română" data-language-local-name="Romanian" class="interlanguage-link-target"><span>Română</span></a></li><li class="interlanguage-link interwiki-ru mw-list-item"><a href="https://ru.wikipedia.org/wiki/%D0%90%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D1%82%D0%B8%D0%BA%D0%B8" title="Анестетики – Russian" lang="ru" hreflang="ru" data-title="Анестетики" data-language-autonym="Русский" data-language-local-name="Russian" class="interlanguage-link-target"><span>Русский</span></a></li><li class="interlanguage-link interwiki-sk mw-list-item"><a href="https://sk.wikipedia.org/wiki/Anestetikum" title="Anestetikum – Slovak" lang="sk" hreflang="sk" data-title="Anestetikum" data-language-autonym="Slovenčina" data-language-local-name="Slovak" class="interlanguage-link-target"><span>Slovenčina</span></a></li><li class="interlanguage-link interwiki-sl mw-list-item"><a href="https://sl.wikipedia.org/wiki/Anestetik" title="Anestetik – Slovenian" lang="sl" hreflang="sl" data-title="Anestetik" data-language-autonym="Slovenščina" data-language-local-name="Slovenian" class="interlanguage-link-target"><span>Slovenščina</span></a></li><li class="interlanguage-link interwiki-sr mw-list-item"><a href="https://sr.wikipedia.org/wiki/%D0%90%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D1%82%D0%B8%D0%BA" title="Анестетик – Serbian" lang="sr" hreflang="sr" data-title="Анестетик" data-language-autonym="Српски / srpski" data-language-local-name="Serbian" class="interlanguage-link-target"><span>Српски / srpski</span></a></li><li class="interlanguage-link interwiki-sh mw-list-item"><a href="https://sh.wikipedia.org/wiki/Anestetik" title="Anestetik – Serbo-Croatian" lang="sh" hreflang="sh" data-title="Anestetik" data-language-autonym="Srpskohrvatski / српскохрватски" data-language-local-name="Serbo-Croatian" class="interlanguage-link-target"><span>Srpskohrvatski / српскохрватски</span></a></li><li class="interlanguage-link interwiki-fi mw-list-item"><a href="https://fi.wikipedia.org/wiki/Anestesia-aineet" title="Anestesia-aineet – Finnish" lang="fi" hreflang="fi" data-title="Anestesia-aineet" data-language-autonym="Suomi" data-language-local-name="Finnish" class="interlanguage-link-target"><span>Suomi</span></a></li><li class="interlanguage-link interwiki-sv badge-Q70893996 mw-list-item" title=""><a href="https://sv.wikipedia.org/wiki/Bed%C3%B6vningsmedel" title="Bedövningsmedel – Swedish" lang="sv" hreflang="sv" data-title="Bedövningsmedel" data-language-autonym="Svenska" data-language-local-name="Swedish" class="interlanguage-link-target"><span>Svenska</span></a></li><li class="interlanguage-link interwiki-tl mw-list-item"><a href="https://tl.wikipedia.org/wiki/Gamot_na_pampamanhid" title="Gamot na pampamanhid – Tagalog" lang="tl" hreflang="tl" data-title="Gamot na pampamanhid" data-language-autonym="Tagalog" data-language-local-name="Tagalog" class="interlanguage-link-target"><span>Tagalog</span></a></li><li class="interlanguage-link interwiki-th mw-list-item"><a href="https://th.wikipedia.org/wiki/%E0%B8%A2%E0%B8%B2%E0%B8%8A%E0%B8%B2" title="ยาชา – Thai" lang="th" hreflang="th" data-title="ยาชา" data-language-autonym="ไทย" data-language-local-name="Thai" class="interlanguage-link-target"><span>ไทย</span></a></li><li class="interlanguage-link interwiki-tr mw-list-item"><a href="https://tr.wikipedia.org/wiki/Anestezik" title="Anestezik – Turkish" lang="tr" hreflang="tr" data-title="Anestezik" data-language-autonym="Türkçe" data-language-local-name="Turkish" class="interlanguage-link-target"><span>Türkçe</span></a></li><li class="interlanguage-link interwiki-uk mw-list-item"><a href="https://uk.wikipedia.org/wiki/%D0%90%D0%BD%D0%B5%D1%81%D1%82%D0%B5%D1%82%D0%B8%D0%BA%D0%B8" title="Анестетики – Ukrainian" lang="uk" hreflang="uk" data-title="Анестетики" data-language-autonym="Українська" data-language-local-name="Ukrainian" class="interlanguage-link-target"><span>Українська</span></a></li><li class="interlanguage-link interwiki-ur mw-list-item"><a href="https://ur.wikipedia.org/wiki/%D9%85%D8%AE%D8%AF%D8%B1" title="مخدر – Urdu" lang="ur" hreflang="ur" data-title="مخدر" data-language-autonym="اردو" data-language-local-name="Urdu" class="interlanguage-link-target"><span>اردو</span></a></li><li class="interlanguage-link interwiki-zh-yue mw-list-item"><a href="https://zh-yue.wikipedia.org/wiki/%E9%BA%BB%E9%86%89%E8%97%A5" title="麻醉藥 – Cantonese" lang="yue" hreflang="yue" data-title="麻醉藥" data-language-autonym="粵語" data-language-local-name="Cantonese" class="interlanguage-link-target"><span>粵語</span></a></li><li class="interlanguage-link interwiki-zh mw-list-item"><a href="https://zh.wikipedia.org/wiki/%E9%BA%BB%E9%86%89%E8%97%A5" title="麻醉藥 – Chinese" lang="zh" hreflang="zh" data-title="麻醉藥" data-language-autonym="中文" data-language-local-name="Chinese" class="interlanguage-link-target"><span>中文</span></a></li> </ul> <div class="after-portlet after-portlet-lang"><span class="wb-langlinks-edit wb-langlinks-link"><a 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dir="ltr"><div class="shortdescription nomobile noexcerpt noprint searchaux" style="display:none">Drug that causes anesthesia</div> <style data-mw-deduplicate="TemplateStyles:r1236090951">.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}</style><div role="note" class="hatnote navigation-not-searchable">Not to be confused with <a href="/wiki/Aesthetics" title="Aesthetics">aesthetics</a> or <a href="/wiki/Analgesic" title="Analgesic">analgesic</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">"Anesthetics" redirects here. For the practice of using anesthetic drugs and anesthesia, see <a href="/wiki/Anesthesiology" title="Anesthesiology">Anesthesiology</a>.</div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">This article is about anesthetics, drugs that provide anesthesia. For the 2019 album by Mark Morton, see <a href="/wiki/Anesthetic_(album)" title="Anesthetic (album)">Anesthetic (album)</a>.</div> <p class="mw-empty-elt"> </p> <figure class="mw-default-size mw-halign-right" typeof="mw:File/Thumb"><a href="/wiki/File:Erythroxylum_novogranatense_var._Novogranatense_(retouched).jpg" class="mw-file-description"><img src="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg/220px-Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg/330px-Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/c/c7/Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg/440px-Erythroxylum_novogranatense_var._Novogranatense_%28retouched%29.jpg 2x" data-file-width="800" data-file-height="600" /></a><figcaption>Leaves of the <a href="/wiki/Coca" title="Coca">coca</a> plant (<i>Erythroxylum novogranatense</i> var. <i>Novogranatense</i>), from which <a href="/wiki/Cocaine" title="Cocaine">cocaine</a>, a naturally occurring local anesthetic, is derived.<sup id="cite_ref-1" class="reference"><a href="#cite_note-1"><span class="cite-bracket">[</span>1<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-2" class="reference"><a href="#cite_note-2"><span class="cite-bracket">[</span>2<span class="cite-bracket">]</span></a></sup></figcaption></figure> <p>An <b>anesthetic</b> (<a href="/wiki/American_English" title="American English">American English</a>) or <b>anaesthetic</b> (<a href="/wiki/British_English" title="British English">British English</a>; <a href="/wiki/American_and_British_English_spelling_differences#Miscellaneous_spelling_differences" title="American and British English spelling differences">see spelling differences</a>) is a <a href="/wiki/Drug" title="Drug">drug</a> used to induce <a href="/wiki/Anesthesia" title="Anesthesia">anesthesia</a> ⁠— ⁠in other words, to result in a temporary loss of <a href="/wiki/Sense" title="Sense">sensation</a> or <a href="/wiki/Awareness" title="Awareness">awareness</a>. They may be divided into two broad classes: <a href="/wiki/General_anesthetic" class="mw-redirect" title="General anesthetic">general anesthetics</a>, which result in a reversible loss of <a href="/wiki/Consciousness" title="Consciousness">consciousness</a>, and <a href="/wiki/Local_anesthetic" title="Local anesthetic">local anesthetics</a>, which cause a reversible loss of sensation for a limited region of the body without necessarily affecting consciousness.<sup id="cite_ref-3" class="reference"><a href="#cite_note-3"><span class="cite-bracket">[</span>3<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_4-0" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside <a href="/wiki/Anesthesiology" title="Anesthesiology">anesthesiology</a>, but others are used commonly in various fields of healthcare. Combinations of anesthetics are sometimes used for their <a href="/wiki/Synergy" title="Synergy">synergistic</a> and <a href="/wiki/Drug_interaction#Synergy_and_antagonism" title="Drug interaction">additive</a> therapeutic effects. Adverse effects, however, may also be increased.<sup id="cite_ref-Hendrickx-2008_5-0" class="reference"><a href="#cite_note-Hendrickx-2008-5"><span class="cite-bracket">[</span>5<span class="cite-bracket">]</span></a></sup> Anesthetics are distinct from <a href="/wiki/Analgesics" class="mw-redirect" title="Analgesics">analgesics</a>, which block only sensation of <a href="/wiki/Pain" title="Pain">painful</a> stimuli.<sup id="cite_ref-6" class="reference"><a href="#cite_note-6"><span class="cite-bracket">[</span>6<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_4-1" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Analgesics are typically used in conjunction with anesthetics to control pre-, intra-, and postoperative pain.<b><sup id="cite_ref-:0_4-2" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></b> </p> <meta property="mw:PageProp/toc" /> <div class="mw-heading mw-heading2"><h2 id="Local_anesthetics">Local anesthetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=1" title="Edit section: Local anesthetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Local_anesthetic" title="Local anesthetic">Local anesthetic</a></div> <div class="mw-heading mw-heading3"><h3 id="Ester-based">Ester-based</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=2" title="Edit section: Ester-based"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Benzocaine" title="Benzocaine">Benzocaine</a></li> <li><a href="/wiki/Cocaine" title="Cocaine">Cocaine</a> (historical)</li> <li><a href="/wiki/Procaine" title="Procaine">Procaine</a></li> <li><a href="/wiki/Tetracaine" title="Tetracaine">Tetracaine</a> (sometimes called <a href="/wiki/Amethocaine" class="mw-redirect" title="Amethocaine">Amethocaine</a>)</li></ul> <div class="mw-heading mw-heading3"><h3 id="Amide-Based">Amide-Based</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=3" title="Edit section: Amide-Based"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Bupivacaine" title="Bupivacaine">Bupivacaine</a></li> <li><a href="/wiki/Cinchocaine" title="Cinchocaine">Cinchocaine</a>(<a href="/wiki/International_Nonproprietary_Name" class="mw-redirect" title="International Nonproprietary Name">INN</a>/<a href="/wiki/British_Approved_Name" title="British Approved Name">BAN</a>)/<a href="/wiki/Dibucaine" class="mw-redirect" title="Dibucaine">Dibucaine</a>(<a href="/wiki/United_States_Adopted_Name" title="United States Adopted Name">USAN</a>)</li> <li><a href="/wiki/Etidocaine" title="Etidocaine">Etidocaine</a></li> <li><a href="/wiki/Levobupivacaine" title="Levobupivacaine">Levobupivacaine</a></li> <li><a href="/wiki/Lidocaine" title="Lidocaine">Lidocaine</a></li> <li><a href="/wiki/Mepivacaine" title="Mepivacaine">Mepivacaine</a></li> <li><a href="/wiki/Prilocaine" title="Prilocaine">Prilocaine</a></li> <li><a href="/wiki/Ropivacaine" title="Ropivacaine">Ropivacaine</a></li></ul> <p>Local anesthetic agents prevent the transmission of nerve impulses without causing unconsciousness. They act by reversibly binding to fast <a href="/wiki/Sodium_channels" class="mw-redirect" title="Sodium channels">sodium channels</a> from within <a href="/wiki/Nerve_fiber" class="mw-redirect" title="Nerve fiber">nerve fibers</a>, thereby preventing sodium from entering the fibres, stabilising the cell membrane and preventing <a href="/wiki/Action_potential" title="Action potential">action potential</a> propagation. Each of the local anesthetics has the suffix "–caine" in their names. </p><p>Local anesthetics can be either <a href="/wiki/Ester" title="Ester">ester</a>- or <a href="/wiki/Amide" title="Amide">amide</a>-based. Ester local anesthetics are generally unstable in solution and fast-acting, are rapidly metabolised by <a href="/wiki/Cholinesterase" title="Cholinesterase">cholinesterases</a> in the <a href="/wiki/Blood_plasma" title="Blood plasma">blood plasma</a> and <a href="/wiki/Liver" title="Liver">liver</a>,<sup id="cite_ref-:0_4-3" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> and more commonly induce <a href="/wiki/Allergic_reaction" class="mw-redirect" title="Allergic reaction">allergic reactions</a>. Amide local anesthetics are generally heat-stable, with a long shelf life (around two years). Amides have a slower onset and longer half-life than ester anesthetics,<sup id="cite_ref-:0_4-4" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> and are usually <a href="/wiki/Racemic" class="mw-redirect" title="Racemic">racemic</a> mixtures, with the exception of levobupivacaine (which is S(-) -bupivacaine)<sup id="cite_ref-:0_4-5" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> and ropivacaine (S(-)-ropivacaine). Although general rules exist for onset and duration of anesthesia between <a href="/wiki/Ester" title="Ester">ester</a>- or <a href="/wiki/Amide" title="Amide">amide</a>-based local anesthetics, these are properties are ultimately dependent on myriad factors including the lipid solubility of the agent, the concentration of the solution, and the <a href="/wiki/PKa" class="mw-redirect" title="PKa">p<i>K</i><sub>a</sub></a>.<sup id="cite_ref-:0_4-6" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Amides are generally used within regional and epidural or spinal techniques,<sup id="cite_ref-:0_4-7" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> due to their longer duration of action, which provides adequate analgesia for surgery, labor, and symptomatic relief. Some esters, such as <a href="/wiki/Benzocaine" title="Benzocaine">benzocaine</a> and <a href="/wiki/Tetracaine" title="Tetracaine">tetracaine</a>, are found in topical formulations to be absorbed through the skin.<sup id="cite_ref-:0_4-8" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p><p>Only <a href="/wiki/Preservative" title="Preservative">preservative</a>-free local anesthetic agents may be injected <a href="/wiki/Intrathecal" class="mw-redirect" title="Intrathecal">intrathecally</a>. </p><p><a href="/wiki/Pethidine" title="Pethidine">Pethidine</a> also has local anesthetic properties, in addition to its opioid effects.<sup id="cite_ref-7" class="reference"><a href="#cite_note-7"><span class="cite-bracket">[</span>7<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="General_anesthetics">General anesthetics</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=4" title="Edit section: General anesthetics"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <figure class="mw-default-size" typeof="mw:File/Thumb"><a href="/wiki/File:Fluranebottles.jpg" class="mw-file-description"><img alt="Bottles of sevoflurane, isoflurane, enflurane and desflurane, the most common fluorinated ether (flurane) inhalation anesthetics." src="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Fluranebottles.jpg/220px-Fluranebottles.jpg" decoding="async" width="220" height="165" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/commons/thumb/1/18/Fluranebottles.jpg/330px-Fluranebottles.jpg 1.5x, //upload.wikimedia.org/wikipedia/commons/thumb/1/18/Fluranebottles.jpg/440px-Fluranebottles.jpg 2x" data-file-width="2848" data-file-height="2134" /></a><figcaption>Bottles of sevoflurane, isoflurane, enflurane and desflurane, the most common fluorinated ether (flurane) inhalation anesthetics. Fluranes are color-coded – sevoflurane is marked yellow, isoflurane purple, enflurane orange and desflurane blue. The notches visible below the bottle caps are unique to each agent, ensuring that a vaporizer can only be filled with the correct agent.<sup id="cite_ref-:1_8-0" class="reference"><a href="#cite_note-:1-8"><span class="cite-bracket">[</span>8<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-:0_4-9" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup></figcaption></figure> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/General_anaesthetic" title="General anaesthetic">General anaesthetic</a></div> <div class="mw-heading mw-heading3"><h3 id="Inhaled_agents">Inhaled agents</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=5" title="Edit section: Inhaled agents"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Inhalational_anaesthetic" class="mw-redirect" title="Inhalational anaesthetic">Inhalational anaesthetic</a></div> <ul><li><a href="/wiki/Desflurane" title="Desflurane">Desflurane</a> (common)</li> <li><a href="/wiki/Enflurane" title="Enflurane">Enflurane</a> (largely discontinued)</li> <li><a href="/wiki/Halothane" title="Halothane">Halothane</a> (inexpensive, discontinued)</li> <li><a href="/wiki/Isoflurane" title="Isoflurane">Isoflurane</a> (common)</li> <li><a href="/wiki/Methoxyflurane" title="Methoxyflurane">Methoxyflurane</a></li> <li><a href="/wiki/Nitrous_oxide" title="Nitrous oxide">Nitrous oxide</a></li> <li><a href="/wiki/Sevoflurane" title="Sevoflurane">Sevoflurane</a> (common)</li> <li><a href="/wiki/Xenon#Anesthesia" title="Xenon">Xenon</a> (rarely used)</li></ul> <p><a href="/wiki/Volatile_anaesthetic" class="mw-redirect" title="Volatile anaesthetic">Volatile agents</a> are typically organic liquids that evaporate readily. They are given by inhalation for induction or maintenance of general anesthesia. Nitrous oxide and xenon are gases, so they are not considered volatile agents. The ideal volatile anesthetic should be non-flammable, non-explosive, and lipid-soluble. It should possess low blood gas solubility, have no <a href="/wiki/Organ_(biology)" title="Organ (biology)">end-organ</a> (heart, liver, kidney) toxicity or side-effects, should not be metabolized, and should not irritate the respiratory pathways.<sup class="noprint Inline-Template Template-Fact" style="white-space:nowrap;">[<i><a href="/wiki/Wikipedia:Citation_needed" title="Wikipedia:Citation needed"><span title="This claim needs references to reliable sources. (February 2022)">citation needed</span></a></i>]</sup> </p><p>No anaesthetic agent currently in use meets all these requirements, nor can any anaesthetic agent be considered completely <i>safe</i>. There are inherent risks and drug interactions that are specific to each and every patient.<sup id="cite_ref-9" class="reference"><a href="#cite_note-9"><span class="cite-bracket">[</span>9<span class="cite-bracket">]</span></a></sup> The agents in widespread current use are <a href="/wiki/Isoflurane" title="Isoflurane">isoflurane</a>, <a href="/wiki/Desflurane" title="Desflurane">desflurane</a>, <a href="/wiki/Sevoflurane" title="Sevoflurane">sevoflurane</a>, and nitrous oxide. Nitrous oxide is a common <a href="/wiki/Adjuvant" title="Adjuvant">adjuvant</a> gas, making it one of the most long-lived drugs still in current use. Because of its low potency, it cannot produce anesthesia on its own but is frequently combined with other agents. Halothane, an agent introduced in the 1950s, has been almost completely replaced in modern anesthesia practice by newer agents because of its shortcomings.<sup id="cite_ref-town_10-0" class="reference"><a href="#cite_note-town-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> Partly because of its side effects, enflurane never gained widespread popularity.<sup id="cite_ref-town_10-1" class="reference"><a href="#cite_note-town-10"><span class="cite-bracket">[</span>10<span class="cite-bracket">]</span></a></sup> </p><p>In theory, any inhaled anesthetic agent can be used for induction of general anesthesia. However, most of the halogenated anesthetics are irritating to the airway, perhaps leading to coughing, laryngospasm and overall difficult inductions. If induction needs to be conducted with an inhaled anesthetic agent, <a href="/wiki/Sevoflurane" title="Sevoflurane">sevoflurane</a> is often used due to a relatively low pungency, rapid increase in alveolar concentration, and a higher blood solubility than other agents. These properties allow for a less irritating and quicker induction as well as a rapid emergence from anesthesia compared to other inhaled agents.<sup id="cite_ref-:0_4-10" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> All of the volatile agents can be used alone or in combination with other medications to maintain anesthesia (nitrous oxide is not potent enough to be used as a sole agent). </p><p>Volatile agents are frequently compared in terms of potency, which is inversely proportional to the <a href="/wiki/Minimum_alveolar_concentration" title="Minimum alveolar concentration">minimum alveolar concentration</a>. Potency is directly related to lipid solubility. This is known as the <a href="/wiki/Minimum_alveolar_concentration" title="Minimum alveolar concentration">Meyer-Overton hypothesis</a>. However, certain pharmacokinetic properties of volatile agents have become another point of comparison. Most important of those properties is known as the <a href="/wiki/Blood/gas_partition_coefficient" class="mw-redirect" title="Blood/gas partition coefficient">blood/gas partition coefficient</a>. This concept refers to the relative solubility of a given agent in blood. Those agents with a lower blood solubility (i.e., a lower blood–gas partition coefficient; e.g., desflurane) give the anesthesia provider greater rapidity in titrating the depth of anesthesia, and permit a more rapid emergence from the anesthetic state upon discontinuing their administration. In fact, newer volatile agents (e.g., sevoflurane, desflurane) have been popular not due to their potency (minimum alveolar concentration), but due to their versatility for a faster emergence from anesthesia, thanks to their lower blood–gas partition coefficient. </p> <div class="mw-heading mw-heading3"><h3 id="Intravenous_agents_(non-opioid)"><span id="Intravenous_agents_.28non-opioid.29"></span>Intravenous agents (non-opioid)</h3><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=6" title="Edit section: Intravenous agents (non-opioid)"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While there are many drugs that can be used intravenously to produce anesthesia or sedation, the most common are: </p> <ul><li><a href="/wiki/Barbiturate" title="Barbiturate">Barbiturates</a> <ul><li><a href="/wiki/Amobarbital" title="Amobarbital">Amobarbital</a> (<a href="/wiki/Trade_name" title="Trade name">trade name</a>: Amytal)</li> <li><a href="/wiki/Methohexital" title="Methohexital">Methohexital</a> (trade name: Brevital)</li> <li><a href="/wiki/Thiamylal" title="Thiamylal">Thiamylal</a> (trade name: Surital)</li> <li><a href="/wiki/Sodium_thiopental" title="Sodium thiopental">Thiopental</a> (trade name: Penthothal, referred to as <i>thiopentone</i> in the UK)</li></ul></li> <li><a href="/wiki/Benzodiazepines" class="mw-redirect" title="Benzodiazepines">Benzodiazepines</a> <ul><li><a href="/wiki/Diazepam" title="Diazepam">Diazepam</a></li> <li><a href="/wiki/Lorazepam" title="Lorazepam">Lorazepam</a></li> <li><a href="/wiki/Midazolam" title="Midazolam">Midazolam</a></li></ul></li> <li><a href="/wiki/Etomidate" title="Etomidate">Etomidate</a></li> <li><a href="/wiki/Ketamine" title="Ketamine">Ketamine</a></li> <li><a href="/wiki/Propofol" title="Propofol">Propofol</a></li></ul> <p>Among the barbiturates mentioned above, <a href="/wiki/Sodium_thiopental" title="Sodium thiopental">thiopental</a> and <a href="/wiki/Methohexital" title="Methohexital">methohexital</a> are ultra-short-acting and are used to induce and maintain anesthesia.<sup id="cite_ref-miller2_11-0" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> However, though they produce unconsciousness, they provide no <a href="/wiki/Analgesia" class="mw-redirect" title="Analgesia">analgesia</a> (pain relief) and must be used with other agents.<sup id="cite_ref-miller2_11-1" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Benzodiazepines can be used for <a href="/wiki/Sedation" title="Sedation">sedation</a> before or after surgery and can be used to induce and maintain general anesthesia.<sup id="cite_ref-miller2_11-2" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> When benzodiazepines are used to induce general anesthesia, midazolam is preferred.<sup id="cite_ref-miller2_11-3" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Benzodiazepines are also used for sedation during procedures that do not require general anesthesia.<sup id="cite_ref-miller2_11-4" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Like barbiturates, benzodiazepines have no pain-relieving properties.<sup id="cite_ref-miller2_11-5" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p><p>Among the barbiturates mentioned above, <a href="/wiki/Sodium_thiopental" title="Sodium thiopental">thiopental</a> and <a href="/wiki/Methohexital" title="Methohexital">methohexital</a> are ultra-short-acting and are used to induce and maintain anesthesia is one of the most commonly used intravenous drugs employed to induce and maintain general anesthesia.<sup id="cite_ref-miller2_11-6" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> It can also be used for sedation during procedures or in the <a href="/wiki/Intensive_care_unit" title="Intensive care unit">ICU</a>.<sup id="cite_ref-miller2_11-7" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Like the other agents mentioned above, it renders patients unconscious without producing pain relief.<sup id="cite_ref-miller2_11-8" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Compared to other IV agents, etomidate causes minimal depression of the cardiopulmonary system. Additionally, etomidate results in a reduction in intracranial pressure and cerebral blood flow.<sup id="cite_ref-:0_4-11" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Because of these favorable physiological effects, was a favored agent in the ICU. However, etomidate has since been shown to produce adrenocortical suppression, resulting in decreased use to avoid an increased mortality rate in severely ill patients.<sup id="cite_ref-:0_4-12" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Ketamine is infrequently used in anesthesia because of the unpleasant experiences that sometimes occur on emergence from anesthesia, which include "vivid <a href="/wiki/Dream" title="Dream">dreaming</a>, extracorporeal experiences, and <a href="/wiki/Illusion" title="Illusion">illusions</a>."<sup id="cite_ref-12" class="reference"><a href="#cite_note-12"><span class="cite-bracket">[</span>12<span class="cite-bracket">]</span></a></sup> When it is used, it is often paired with a benzodiazepine such as <a href="/wiki/Midazolam" title="Midazolam">midazolam</a> for amnesia and sedation.<sup id="cite_ref-:0_4-13" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> However, like etomidate it is frequently used in emergency settings and with sick patients because it produces fewer adverse physiological effects.<sup id="cite_ref-miller2_11-9" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Unlike the intravenous anesthetic drugs previously mentioned, ketamine produces profound pain relief, even in doses lower than those that induce general anesthesia.<sup id="cite_ref-miller2_11-10" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Also unlike the other anesthetic agents in this section, patients who receive ketamine alone appear to be in a <a href="/wiki/Catalepsy" title="Catalepsy">cataleptic</a> state, unlike other states of anesthesia that resemble normal <a href="/wiki/Sleep" title="Sleep">sleep</a>. Ketamine-anesthetized patients have profound analgesia but keep their eyes open and maintain many reflexes.<sup id="cite_ref-miller2_11-11" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Intravenous_opioid_analgesic_agents">Intravenous opioid analgesic agents</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=7" title="Edit section: Intravenous opioid analgesic agents"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <p>While opioids can produce unconsciousness, they do so unreliably and with significant side effects.<sup id="cite_ref-13" class="reference"><a href="#cite_note-13"><span class="cite-bracket">[</span>13<span class="cite-bracket">]</span></a></sup><sup id="cite_ref-pmid8466061_14-0" class="reference"><a href="#cite_note-pmid8466061-14"><span class="cite-bracket">[</span>14<span class="cite-bracket">]</span></a></sup> So, while they are rarely used to induce anesthesia, they are frequently used along with other agents such as intravenous non-opioid anesthetics or inhalational anesthetics.<sup id="cite_ref-miller2_11-12" class="reference"><a href="#cite_note-miller2-11"><span class="cite-bracket">[</span>11<span class="cite-bracket">]</span></a></sup> Furthermore, they are used to relieve pain of patients before, during, or after surgery. The following opioids have short onset and duration of action and are frequently used during general anesthesia: </p> <ul><li><a href="/wiki/Alfentanil" title="Alfentanil">Alfentanil</a></li> <li><a href="/wiki/Fentanyl" title="Fentanyl">Fentanyl</a></li> <li><a href="/wiki/Remifentanil" title="Remifentanil">Remifentanil</a></li> <li><a href="/wiki/Sufentanil" title="Sufentanil">Sufentanil</a>, which is not available in Australia.</li></ul> <p>The following agents have longer onset and duration of action and are frequently used for post-operative pain relief: </p> <ul><li><a href="/wiki/Buprenorphine" title="Buprenorphine">Buprenorphine</a></li> <li><a href="/wiki/Butorphanol" title="Butorphanol">Butorphanol</a></li> <li><a href="/wiki/Diamorphine" class="mw-redirect" title="Diamorphine">Diamorphine</a>, also known as heroin, not available for use as an analgesic in any country but the UK.</li> <li><a href="/wiki/Hydromorphone" title="Hydromorphone">Hydromorphone</a></li> <li><a href="/wiki/Levorphanol" title="Levorphanol">Levorphanol</a></li> <li><a href="/wiki/Pethidine" title="Pethidine">Pethidine</a>, also called meperidine in North America.</li> <li><a href="/wiki/Methadone" title="Methadone">Methadone</a></li> <li><a href="/wiki/Morphine" title="Morphine">Morphine</a></li> <li><a href="/wiki/Codeine" title="Codeine">Codeine</a></li> <li><a href="/wiki/Nalbuphine" title="Nalbuphine">Nalbuphine</a></li> <li><a href="/wiki/Oxycodone" title="Oxycodone">Oxycodone</a>, not available intravenously in U.S.</li> <li><a href="/wiki/Oxymorphone" title="Oxymorphone">Oxymorphone</a></li> <li><a href="/wiki/Pentazocine" title="Pentazocine">Pentazocine</a></li></ul> <div class="mw-heading mw-heading2"><h2 id="Muscle_relaxants">Muscle relaxants</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=8" title="Edit section: Muscle relaxants"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236090951"><div role="note" class="hatnote navigation-not-searchable">Main article: <a href="/wiki/Neuromuscular_blocking_drugs" class="mw-redirect" title="Neuromuscular blocking drugs">Neuromuscular blocking drugs</a></div> <p>Muscle relaxants do not render patients unconscious or relieve pain. Instead, they are sometimes used after a patient is rendered unconscious (induction of anesthesia) to facilitate <a href="/wiki/Intubation" title="Intubation">intubation</a> or surgery by paralyzing skeletal muscle.<sup id="cite_ref-:0_4-14" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup>These agents fall into two categories: depolarizing agents, which depolarize the <a href="/wiki/Motor_end_plate" class="mw-redirect" title="Motor end plate">motor end plate</a> to prevent further stimulation, and non-depolarizing agents, which prevent acetylcholine receptor activation through competitive inhibition.<sup id="cite_ref-:0_4-15" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <ul><li>Depolarizing muscle relaxants <ul><li><a href="/wiki/Succinylcholine" class="mw-redirect" title="Succinylcholine">Succinylcholine</a> (also known as <b>suxamethonium</b> in the UK, New Zealand, Australia and other countries, "Celokurin" or "celo" for short in Europe)</li> <li><a href="/wiki/Decamethonium" title="Decamethonium">Decamethonium</a></li></ul></li> <li>Non-depolarizing muscle relaxants <ul><li>Short acting <ul><li><a href="/wiki/Mivacurium" class="mw-redirect" title="Mivacurium">Mivacurium</a></li> <li><a href="/wiki/Rapacuronium" class="mw-redirect" title="Rapacuronium">Rapacuronium</a></li></ul></li> <li>Intermediate acting <ul><li><a href="/wiki/Atracurium" class="mw-redirect" title="Atracurium">Atracurium</a></li> <li><a href="/wiki/Cisatracurium" class="mw-redirect" title="Cisatracurium">Cisatracurium</a></li> <li><a href="/wiki/Rocuronium" class="mw-redirect" title="Rocuronium">Rocuronium</a></li> <li><a href="/wiki/Vecuronium" class="mw-redirect" title="Vecuronium">Vecuronium</a></li></ul></li> <li>Long acting <ul><li><a href="/wiki/Alcuronium" class="mw-redirect" title="Alcuronium">Alcuronium</a></li> <li><a href="/wiki/Doxacurium" class="mw-redirect" title="Doxacurium">Doxacurium</a></li> <li><a href="/wiki/Gallamine" class="mw-redirect" title="Gallamine">Gallamine</a></li> <li><a href="/wiki/Metocurine" title="Metocurine">Metocurine</a></li> <li><a href="/wiki/Pancuronium" class="mw-redirect" title="Pancuronium">Pancuronium</a></li> <li><a href="/wiki/Pipecuronium" class="mw-redirect" title="Pipecuronium">Pipecuronium</a></li> <li><a href="/wiki/Tubocurarine" class="mw-redirect" title="Tubocurarine">Tubocurarine</a></li></ul></li></ul></li></ul> <p>A potential complication where neuromuscular blockade is employed is '<a href="/wiki/Anesthesia_awareness" title="Anesthesia awareness">anesthesia awareness</a>'.<sup id="cite_ref-:0_4-16" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> In this situation, patients paralyzed may awaken during their anesthesia, due to an inappropriate decrease in the level of drugs providing sedation or pain relief. If this is missed by the anesthesia provider, the patient may be aware of their surroundings, but be incapable of moving or communicating that fact. Neurological monitors are increasingly available that may help decrease the incidence of awareness. Most of these monitors use proprietary algorithms monitoring brain activity via evoked potentials. Additionally, anesthesia providers often have steps they follow to help prevent awareness, such as ensuring all equipment is working properly, monitoring that drugs are being delivered during surgery, and asking a series of questions (the Brice questions) to help detect awareness after surgery.<sup id="cite_ref-:0_4-17" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> If there is any suspicion of patient awareness, close follow-up and mental health professionals can help manage or avoid any traumatic stress associated with the awareness.<sup id="cite_ref-:0_4-18" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> Certain procedures, such as <a href="/wiki/Endoscopy" title="Endoscopy">endoscopies</a> or <a href="/wiki/Colonoscopy" title="Colonoscopy">colonoscopies</a>, are managed a technique called <a href="/wiki/Conscious_sedation" class="mw-redirect" title="Conscious sedation">conscious sedation</a> or <a href="/wiki/Procedural_sedation_and_analgesia" title="Procedural sedation and analgesia">monitored anesthesia care</a>. These cases are performed with regional anesthetics and a "twilight sleep" achieved through sedation with propofol and analgesics, and patients may remember perioperative events.<sup id="cite_ref-:0_4-19" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> When this technique is used, patients should be advised that this is management is distinct from general anesthesia to help combat any belief or fear that they were "awake" during anesthesia.<sup id="cite_ref-:0_4-20" class="reference"><a href="#cite_note-:0-4"><span class="cite-bracket">[</span>4<span class="cite-bracket">]</span></a></sup> </p> <div class="mw-heading mw-heading2"><h2 id="Intravenous_reversal_agents">Intravenous reversal agents</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=9" title="Edit section: Intravenous reversal agents"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <ul><li><a href="/wiki/Flumazenil" title="Flumazenil">Flumazenil</a>, reverses the effects of benzodiazepines</li> <li><a href="/wiki/Naloxone" title="Naloxone">Naloxone</a>, reverses the effects of opioids</li> <li><a href="/wiki/Neostigmine" title="Neostigmine">Neostigmine</a>, helps to reverse the effects of non-depolarizing muscle relaxants</li> <li><a href="/wiki/Sugammadex" title="Sugammadex">Sugammadex</a>, helps to reverse the effects of non-depolarizing muscle relaxants</li></ul> <div class="mw-heading mw-heading2"><h2 id="References">References</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a href="/w/index.php?title=Anesthetic&action=edit&section=10" title="Edit section: References"><span>edit</span></a><span class="mw-editsection-bracket">]</span></span></div> <style data-mw-deduplicate="TemplateStyles:r1239543626">.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}</style><div class="reflist"> <div class="mw-references-wrap mw-references-columns"><ol class="references"> <li id="cite_note-1"><span class="mw-cite-backlink"><b><a href="#cite_ref-1">^</a></b></span> <span class="reference-text"><style data-mw-deduplicate="TemplateStyles:r1238218222">.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("//upload.wikimedia.org/wikipedia/commons/6/65/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("//upload.wikimedia.org/wikipedia/commons/d/d6/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("//upload.wikimedia.org/wikipedia/commons/a/aa/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("//upload.wikimedia.org/wikipedia/commons/4/4c/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}</style><cite id="CITEREFGoldberg1984" class="citation journal cs1">Goldberg, MF (1984). <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar_lookup?journal=Arch+Ophthalmol.&title=Cocaine:+the+first+local+anesthetic+and+the+%27third+scourge+of+humanity%27.+A+centennial+melodrama.&author=MF+Goldberg&volume=102&issue=10&publication_year=1984&pages=1443-7&pmid=6385930&">"Cocaine: The First Local Anesthetic and the'Third Scourge of Humanity': A Centennial Melodrama"</a>. <i>Archives of Ophthalmology</i>. <b>102</b> (10): 1443–1447. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchopht.1984.01040031163009">10.1001/archopht.1984.01040031163009</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/6385930">6385930</a> – via jamanetwork.com.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Archives+of+Ophthalmology&rft.atitle=Cocaine%3A+The+First+Local+Anesthetic+and+the%27Third+Scourge+of+Humanity%27%3A+A+Centennial+Melodrama&rft.volume=102&rft.issue=10&rft.pages=1443-1447&rft.date=1984&rft_id=info%3Adoi%2F10.1001%2Farchopht.1984.01040031163009&rft_id=info%3Apmid%2F6385930&rft.aulast=Goldberg&rft.aufirst=MF&rft_id=https%3A%2F%2Fscholar.google.com%2Fscholar_lookup%3Fjournal%3DArch%2BOphthalmol.%26title%3DCocaine%3A%2Bthe%2Bfirst%2Blocal%2Banesthetic%2Band%2Bthe%2B%2527third%2Bscourge%2Bof%2Bhumanity%2527.%2BA%2Bcentennial%2Bmelodrama.%26author%3DMF%2BGoldberg%26volume%3D102%26issue%3D10%26publication_year%3D1984%26pages%3D1443-7%26pmid%3D6385930%26&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-2"><span class="mw-cite-backlink"><b><a href="#cite_ref-2">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKarch1998" class="citation book cs1">Karch, SB (1998). <a rel="nofollow" class="external text" href="https://scholar.google.com/scholar_lookup?title=A+brief+history+of+cocaine.&author=SB.+Karch&publication_year=1998&"><i>A brief history of cocaine</i></a>. CRC press.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=A+brief+history+of+cocaine.&rft.pub=CRC+press&rft.date=1998&rft.aulast=Karch&rft.aufirst=SB&rft_id=https%3A%2F%2Fscholar.google.com%2Fscholar_lookup%3Ftitle%3DA%2Bbrief%2Bhistory%2Bof%2Bcocaine.%26author%3DSB.%2BKarch%26publication_year%3D1998%26&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-3"><span class="mw-cite-backlink"><b><a href="#cite_ref-3">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWollweber2000" class="citation encyclopaedia cs1">Wollweber, Hartmund (2000). "Anesthetics, General". <i><a href="/wiki/Ullmann%27s_Encyclopedia_of_Industrial_Chemistry" title="Ullmann's Encyclopedia of Industrial Chemistry">Ullmann's Encyclopedia of Industrial Chemistry</a></i>. Weinheim: Wiley-VCH. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14356007.a02_289">10.1002/14356007.a02_289</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-3527306732" title="Special:BookSources/978-3527306732"><bdi>978-3527306732</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Anesthetics%2C+General&rft.btitle=Ullmann%27s+Encyclopedia+of+Industrial+Chemistry&rft.place=Weinheim&rft.pub=Wiley-VCH&rft.date=2000&rft_id=info%3Adoi%2F10.1002%2F14356007.a02_289&rft.isbn=978-3527306732&rft.aulast=Wollweber&rft.aufirst=Hartmund&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-:0-4"><span class="mw-cite-backlink">^ <a href="#cite_ref-:0_4-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-:0_4-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-:0_4-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-:0_4-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-:0_4-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-:0_4-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-:0_4-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-:0_4-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-:0_4-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-:0_4-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-:0_4-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-:0_4-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-:0_4-12"><sup><i><b>m</b></i></sup></a> <a href="#cite_ref-:0_4-13"><sup><i><b>n</b></i></sup></a> <a href="#cite_ref-:0_4-14"><sup><i><b>o</b></i></sup></a> <a href="#cite_ref-:0_4-15"><sup><i><b>p</b></i></sup></a> <a href="#cite_ref-:0_4-16"><sup><i><b>q</b></i></sup></a> <a href="#cite_ref-:0_4-17"><sup><i><b>r</b></i></sup></a> <a href="#cite_ref-:0_4-18"><sup><i><b>s</b></i></sup></a> <a href="#cite_ref-:0_4-19"><sup><i><b>t</b></i></sup></a> <a href="#cite_ref-:0_4-20"><sup><i><b>u</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFButterworthMackeyWasnick2013" class="citation book cs1">Butterworth, John; Mackey, David; Wasnick, John (2013). <i>Morgan & Mikhail's Clinical Anesthesiology</i> (5th ed.). <a href="/wiki/McGraw_Hill_Education" title="McGraw Hill Education">McGraw Hill Education</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-0-07-171405-1" title="Special:BookSources/978-0-07-171405-1"><bdi>978-0-07-171405-1</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Morgan+%26+Mikhail%27s+Clinical+Anesthesiology&rft.edition=5th&rft.pub=McGraw+Hill+Education&rft.date=2013&rft.isbn=978-0-07-171405-1&rft.aulast=Butterworth&rft.aufirst=John&rft.au=Mackey%2C+David&rft.au=Wasnick%2C+John&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-Hendrickx-2008-5"><span class="mw-cite-backlink"><b><a href="#cite_ref-Hendrickx-2008_5-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFHendrickxEgerSonnerShafer2008" class="citation journal cs1">Hendrickx, JF.; Eger, EI.; Sonner, JM.; Shafer, SL. (August 2008). <a rel="nofollow" class="external text" href="http://www.anesthesia-analgesia.org/content/107/2/494.long">"Is synergy the rule? A review of anesthetic interactions producing hypnosis and immobility"</a>. <i>Anesth Analg</i>. <b>107</b> (2): 494–506. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1213%2Fane.0b013e31817b859e">10.1213/ane.0b013e31817b859e</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18633028">18633028</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:8125002">8125002</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Anesth+Analg&rft.atitle=Is+synergy+the+rule%3F+A+review+of+anesthetic+interactions+producing+hypnosis+and+immobility.&rft.volume=107&rft.issue=2&rft.pages=494-506&rft.date=2008-08&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A8125002%23id-name%3DS2CID&rft_id=info%3Apmid%2F18633028&rft_id=info%3Adoi%2F10.1213%2Fane.0b013e31817b859e&rft.aulast=Hendrickx&rft.aufirst=JF.&rft.au=Eger%2C+EI.&rft.au=Sonner%2C+JM.&rft.au=Shafer%2C+SL.&rft_id=http%3A%2F%2Fwww.anesthesia-analgesia.org%2Fcontent%2F107%2F2%2F494.long&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-6"><span class="mw-cite-backlink"><b><a href="#cite_ref-6">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.nal.usda.gov/animal-health-and-welfare/animal-use-alternatives/reducing-animals-pain-and-distress">"Reducing Animals' Pain and Distress | National Agricultural Library"</a>. <i>www.nal.usda.gov</i>. 2022<span class="reference-accessdate">. Retrieved <span class="nowrap">28 January</span> 2023</span>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=unknown&rft.jtitle=www.nal.usda.gov&rft.atitle=Reducing+Animals%27+Pain+and+Distress+%7C+National+Agricultural+Library&rft.date=2022&rft_id=https%3A%2F%2Fwww.nal.usda.gov%2Fanimal-health-and-welfare%2Fanimal-use-alternatives%2Freducing-animals-pain-and-distress&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-7"><span class="mw-cite-backlink"><b><a href="#cite_ref-7">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFLattaGinsbergBarkin2001" class="citation journal cs1">Latta, KS; Ginsberg, B; Barkin, RL (2001). "Meperidine: a critical review". <i><a href="/wiki/American_Journal_of_Therapeutics" title="American Journal of Therapeutics">American Journal of Therapeutics</a></i>. <b>9</b> (1): 53–68. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00045391-200201000-00010">10.1097/00045391-200201000-00010</a>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11782820">11782820</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:23410891">23410891</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=American+Journal+of+Therapeutics&rft.atitle=Meperidine%3A+a+critical+review.&rft.volume=9&rft.issue=1&rft.pages=53-68&rft.date=2001&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A23410891%23id-name%3DS2CID&rft_id=info%3Apmid%2F11782820&rft_id=info%3Adoi%2F10.1097%2F00045391-200201000-00010&rft.aulast=Latta&rft.aufirst=KS&rft.au=Ginsberg%2C+B&rft.au=Barkin%2C+RL&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-:1-8"><span class="mw-cite-backlink"><b><a href="#cite_ref-:1_8-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFWollweber2000" class="citation encyclopaedia cs1">Wollweber, Hartmund (2000). "Anesthetics, General". <i><a href="/wiki/Ullmann%27s_Encyclopedia_of_Industrial_Chemistry" title="Ullmann's Encyclopedia of Industrial Chemistry">Ullmann's Encyclopedia of Industrial Chemistry</a></i>. Weinheim: Wiley-VCH. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14356007.a02_289">10.1002/14356007.a02_289</a>. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/978-3527306732" title="Special:BookSources/978-3527306732"><bdi>978-3527306732</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=bookitem&rft.atitle=Anesthetics%2C+General&rft.btitle=Ullmann%27s+Encyclopedia+of+Industrial+Chemistry&rft.place=Weinheim&rft.pub=Wiley-VCH&rft.date=2000&rft_id=info%3Adoi%2F10.1002%2F14356007.a02_289&rft.isbn=978-3527306732&rft.aulast=Wollweber&rft.aufirst=Hartmund&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-9"><span class="mw-cite-backlink"><b><a href="#cite_ref-9">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFKrøigaardGarveyMennéHusum2005" class="citation journal cs1">Krøigaard, M.; Garvey, LH.; Menné, T.; Husum, B. (October 2005). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fbja%2Faei198">"Allergic reactions in anaesthesia: are suspected causes confirmed on subsequent testing?"</a>. <i>Br J Anaesth</i>. <b>95</b> (4): 468–71. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fbja%2Faei198">10.1093/bja/aei198</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16100238">16100238</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Br+J+Anaesth&rft.atitle=Allergic+reactions+in+anaesthesia%3A+are+suspected+causes+confirmed+on+subsequent+testing%3F&rft.volume=95&rft.issue=4&rft.pages=468-71&rft.date=2005-10&rft_id=info%3Adoi%2F10.1093%2Fbja%2Faei198&rft_id=info%3Apmid%2F16100238&rft.aulast=Kr%C3%B8igaard&rft.aufirst=M.&rft.au=Garvey%2C+LH.&rft.au=Menn%C3%A9%2C+T.&rft.au=Husum%2C+B.&rft_id=https%3A%2F%2Fdoi.org%2F10.1093%252Fbja%252Faei198&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-town-10"><span class="mw-cite-backlink">^ <a href="#cite_ref-town_10-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-town_10-1"><sup><i><b>b</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFTownsend2004" class="citation book cs1">Townsend, Courtney (2004). <i>Sabiston Textbook of Surgery</i>. Philadelphia: Saunders. Chapter 17 – Anesthesiology Principles, Pain Management, and Conscious Sedation. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-7216-5368-5" title="Special:BookSources/0-7216-5368-5"><bdi>0-7216-5368-5</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Sabiston+Textbook+of+Surgery&rft.place=Philadelphia&rft.pages=Chapter+17+-+Anesthesiology+Principles%2C+Pain+Management%2C+and+Conscious+Sedation&rft.pub=Saunders&rft.date=2004&rft.isbn=0-7216-5368-5&rft.aulast=Townsend&rft.aufirst=Courtney&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-miller2-11"><span class="mw-cite-backlink">^ <a href="#cite_ref-miller2_11-0"><sup><i><b>a</b></i></sup></a> <a href="#cite_ref-miller2_11-1"><sup><i><b>b</b></i></sup></a> <a href="#cite_ref-miller2_11-2"><sup><i><b>c</b></i></sup></a> <a href="#cite_ref-miller2_11-3"><sup><i><b>d</b></i></sup></a> <a href="#cite_ref-miller2_11-4"><sup><i><b>e</b></i></sup></a> <a href="#cite_ref-miller2_11-5"><sup><i><b>f</b></i></sup></a> <a href="#cite_ref-miller2_11-6"><sup><i><b>g</b></i></sup></a> <a href="#cite_ref-miller2_11-7"><sup><i><b>h</b></i></sup></a> <a href="#cite_ref-miller2_11-8"><sup><i><b>i</b></i></sup></a> <a href="#cite_ref-miller2_11-9"><sup><i><b>j</b></i></sup></a> <a href="#cite_ref-miller2_11-10"><sup><i><b>k</b></i></sup></a> <a href="#cite_ref-miller2_11-11"><sup><i><b>l</b></i></sup></a> <a href="#cite_ref-miller2_11-12"><sup><i><b>m</b></i></sup></a></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFMiller2005" class="citation book cs1">Miller, Ronald (2005). <span class="id-lock-registration" title="Free registration required"><a rel="nofollow" class="external text" href="https://archive.org/details/millersanesthesi0006unse"><i>Miller's Anesthesia</i></a></span>. New York: Elsevier/Churchill Livingstone. <a href="/wiki/ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <a href="/wiki/Special:BookSources/0-443-06656-6" title="Special:BookSources/0-443-06656-6"><bdi>0-443-06656-6</bdi></a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Abook&rft.genre=book&rft.btitle=Miller%27s+Anesthesia&rft.place=New+York&rft.pub=Elsevier%2FChurchill+Livingstone&rft.date=2005&rft.isbn=0-443-06656-6&rft.aulast=Miller&rft.aufirst=Ronald&rft_id=https%3A%2F%2Farchive.org%2Fdetails%2Fmillersanesthesi0006unse&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-12"><span class="mw-cite-backlink"><b><a href="#cite_ref-12">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFGarfieldGarfieldStoneHopkins1972" class="citation journal cs1">Garfield, JM; Garfield, FB; Stone, JG; Hopkins, D; Johns, LA (1972). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-197204000-00006">"A comparison of psychologic responses to ketamine and thiopental-nitrous oxide-halothane anesthesia"</a>. <i>Anesthesiology</i>. <b>36</b> (4): 329–338. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-197204000-00006">10.1097/00000542-197204000-00006</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/5020642">5020642</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:2526481">2526481</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Anesthesiology&rft.atitle=A+comparison+of+psychologic+responses+to+ketamine+and+thiopental-nitrous+oxide-halothane+anesthesia&rft.volume=36&rft.issue=4&rft.pages=329-338&rft.date=1972&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A2526481%23id-name%3DS2CID&rft_id=info%3Apmid%2F5020642&rft_id=info%3Adoi%2F10.1097%2F00000542-197204000-00006&rft.aulast=Garfield&rft.aufirst=JM&rft.au=Garfield%2C+FB&rft.au=Stone%2C+JG&rft.au=Hopkins%2C+D&rft.au=Johns%2C+LA&rft_id=https%3A%2F%2Fdoi.org%2F10.1097%252F00000542-197204000-00006&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-13"><span class="mw-cite-backlink"><b><a href="#cite_ref-13">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFPhilbinRosowSchneiderKoski1990" class="citation journal cs1">Philbin, DM; Rosow, CE; Schneider, RC; Koski, G; D'ambra, MN (1990). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-199007000-00002">"Fentanyl and sufentanil anesthesia revisited: how much is enough?"</a>. <i>Anesthesiology</i>. <b>73</b> (1): 5–11. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-199007000-00002">10.1097/00000542-199007000-00002</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/2141773">2141773</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Anesthesiology&rft.atitle=Fentanyl+and+sufentanil+anesthesia+revisited%3A+how+much+is+enough%3F&rft.volume=73&rft.issue=1&rft.pages=5-11&rft.date=1990&rft_id=info%3Adoi%2F10.1097%2F00000542-199007000-00002&rft_id=info%3Apmid%2F2141773&rft.aulast=Philbin&rft.aufirst=DM&rft.au=Rosow%2C+CE&rft.au=Schneider%2C+RC&rft.au=Koski%2C+G&rft.au=D%27ambra%2C+MN&rft_id=https%3A%2F%2Fdoi.org%2F10.1097%252F00000542-199007000-00002&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> <li id="cite_note-pmid8466061-14"><span class="mw-cite-backlink"><b><a href="#cite_ref-pmid8466061_14-0">^</a></b></span> <span class="reference-text"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1238218222"><cite id="CITEREFStreisandBaileyLeMaireAshburn1993" class="citation journal cs1">Streisand JB, Bailey PL, LeMaire L, Ashburn MA, Tarver SD, Varvel J, Stanley TH (April 1993). <a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-199304000-00003">"Fentanyl-induced rigidity and unconsciousness in human volunteers. Incidence, duration, and plasma concentrations"</a>. <i>Anesthesiology</i>. <b>78</b> (4): 629–34. <a href="/wiki/Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<span class="id-lock-free" title="Freely accessible"><a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-199304000-00003">10.1097/00000542-199304000-00003</a></span>. <a href="/wiki/PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/8466061">8466061</a>. <a href="/wiki/S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:32056642">32056642</a>.</cite><span title="ctx_ver=Z39.88-2004&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.jtitle=Anesthesiology&rft.atitle=Fentanyl-induced+rigidity+and+unconsciousness+in+human+volunteers.+Incidence%2C+duration%2C+and+plasma+concentrations&rft.volume=78&rft.issue=4&rft.pages=629-34&rft.date=1993-04&rft_id=https%3A%2F%2Fapi.semanticscholar.org%2FCorpusID%3A32056642%23id-name%3DS2CID&rft_id=info%3Apmid%2F8466061&rft_id=info%3Adoi%2F10.1097%2F00000542-199304000-00003&rft.aulast=Streisand&rft.aufirst=JB&rft.au=Bailey%2C+PL&rft.au=LeMaire%2C+L&rft.au=Ashburn%2C+MA&rft.au=Tarver%2C+SD&rft.au=Varvel%2C+J&rft.au=Stanley%2C+TH&rft_id=https%3A%2F%2Fdoi.org%2F10.1097%252F00000542-199304000-00003&rfr_id=info%3Asid%2Fen.wikipedia.org%3AAnesthetic" class="Z3988"></span></span> </li> </ol></div></div> <div class="mw-heading mw-heading2"><h2 id="External_links">External links</h2><span class="mw-editsection"><span class="mw-editsection-bracket">[</span><a 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abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}</style><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Ancient_anaesthesia" title="Template:Ancient anaesthesia"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Ancient_anaesthesia" title="Template talk:Ancient anaesthesia"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Ancient_anaesthesia" title="Special:EditPage/Template:Ancient anaesthesia"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Ancient_anaesthesia" style="font-size:114%;margin:0 4em"><a href="/wiki/History_of_general_anesthesia" title="History of general anesthesia">Ancient anaesthesia</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Plants / animals</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i><a href="/wiki/Aconitum" title="Aconitum">Aconitum</a></i> (aconite)</li> <li><i><a href="/wiki/Atropa_belladonna" title="Atropa belladonna">Atropa belladonna</a></i> (belladonna)</li> <li><a href="/wiki/Cannabis_(drug)" title="Cannabis (drug)">Cannabis</a> <ul><li><a href="/wiki/Medical_cannabis" title="Medical cannabis">medical use</a></li></ul></li> <li><a href="/wiki/Castoreum" title="Castoreum">Castoreum</a></li> <li><a href="/wiki/Coca" title="Coca">Coca</a></li> <li><i><a href="/wiki/Conium" title="Conium">Conium</a></i> (hemlock)</li> <li><i><a href="/wiki/Datura_innoxia" title="Datura innoxia">Datura innoxia</a></i> (thorn-apple)</li> <li><i><a href="/wiki/Datura_metel" title="Datura metel">Datura metel</a></i> (devil's trumpet)</li> <li><i><a href="/wiki/Hyoscyamus_niger" title="Hyoscyamus niger">Hyoscyamus niger</a></i> (henbane)</li> <li><a href="/wiki/Lactucarium" title="Lactucarium">Lactucarium</a></li> <li><i><a href="/wiki/Mandragora_officinarum" title="Mandragora officinarum">Mandragora officinarum</a></i> (mandrake)</li> <li><a href="/wiki/Opium" title="Opium">Opium</a></li> <li><i><a href="/wiki/Saussurea" title="Saussurea">Saussurea</a></i> (saw-wort)</li> <li><a href="/wiki/Willow" title="Willow">Willow</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Preparations</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Beer" title="Beer">Beer</a></li> <li><a href="/wiki/Wine" title="Wine">Wine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Compounds</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alcohol_(drug)" title="Alcohol (drug)">Ethanol</a> (<a href="/wiki/Alcohols_(medicine)" title="Alcohols (medicine)">medical use</a>)</li> <li><a href="/wiki/Aconitine" title="Aconitine">Aconitine</a></li> <li><a href="/wiki/Atropine" title="Atropine">Atropine</a></li> <li><a href="/wiki/Cocaine" title="Cocaine">Cocaine</a></li> <li><a href="/wiki/Coniine" title="Coniine">Coniine</a></li> <li><a href="/wiki/Hyoscine" class="mw-redirect" title="Hyoscine">Hyoscine</a></li> <li><a href="/wiki/Tetrahydrocannabinol" title="Tetrahydrocannabinol">Δ9-THC</a></li> <li><a href="/wiki/Hyoscyamine" title="Hyoscyamine">Hyoscyamine</a></li> <li><a href="/wiki/Morphine" title="Morphine">Morphine</a></li> <li><a href="/wiki/Salicylic_acid" title="Salicylic acid">Salicylate</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">People</th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Al-Zahrawi" title="Al-Zahrawi">Abulcasis</a></li> <li><a href="/wiki/Ibn_Zuhr" title="Ibn Zuhr">Avenzoar</a></li> <li><a href="/wiki/Avicenna" title="Avicenna">Avicenna</a></li> <li><a href="/wiki/Aulus_Cornelius_Celsus" title="Aulus Cornelius Celsus">Celsus</a></li> <li><a href="/wiki/Pedanius_Dioscorides" title="Pedanius Dioscorides">Dioscorides</a></li> <li><a href="/wiki/Galen" title="Galen">Galen</a></li> <li><a href="/wiki/Hippocrates" title="Hippocrates">Hippocrates</a></li> <li><a href="/wiki/Abu_Bakr_al-Razi" title="Abu Bakr al-Razi">Rhazes</a></li> <li><a href="/wiki/Sabuncuoglu_Sherefeddin" class="mw-redirect" title="Sabuncuoglu Sherefeddin">Sabuncuoğlu</a></li> <li><a href="/wiki/Sushruta_Samhita" title="Sushruta Samhita">Sushrutha</a></li> <li><a href="/wiki/Theophrastus" title="Theophrastus">Theophrastus</a></li> <li><a href="/wiki/Zhang_Zhongjing" title="Zhang Zhongjing">Zhang</a></li></ul> </div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="General_anesthetics_(N01A)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:General_anesthetics" title="Template:General anesthetics"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:General_anesthetics" title="Template talk:General anesthetics"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:General_anesthetics" title="Special:EditPage/Template:General anesthetics"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="General_anesthetics_(N01A)" style="font-size:114%;margin:0 4em"><a href="/wiki/General_anaesthetic" title="General anaesthetic">General anesthetics</a> (<a href="/wiki/ATC_code_N01#N01A" title="ATC code N01">N01A</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Inhalational_anesthetic" title="Inhalational anesthetic">Inhalational</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chloroform" title="Chloroform">Chloroform</a><sup>‡</sup></li> <li><a href="/wiki/Cyclopropane" title="Cyclopropane">Cyclopropane</a><sup>‡</sup></li> <li><a href="/wiki/Desflurane" title="Desflurane">Desflurane</a></li> <li><a href="/wiki/Diethyl_ether" title="Diethyl ether">Diethyl ether</a><sup>‡</sup></li> <li><a href="/wiki/Enflurane" title="Enflurane">Enflurane</a></li> <li><a href="/wiki/Ethylene" title="Ethylene">Ethylene</a><sup>‡</sup></li> <li><a href="/wiki/Fluroxene" title="Fluroxene">Fluroxene</a><sup>‡</sup></li> <li><a href="/wiki/Halothane" title="Halothane">Halothane</a><sup>#</sup></li> <li><a href="/wiki/Isoflurane" title="Isoflurane">Isoflurane</a><sup>#</sup></li> <li><a href="/wiki/Methoxyflurane" title="Methoxyflurane">Methoxyflurane</a></li> <li><a href="/wiki/Methoxypropane" title="Methoxypropane">Methoxypropane</a><sup>‡</sup></li> <li><a href="/wiki/Nitrous_oxide" title="Nitrous oxide">Nitrous oxide</a><sup>#</sup></li> <li><a href="/wiki/Sevoflurane" title="Sevoflurane">Sevoflurane</a></li> <li><a href="/wiki/Trichloroethylene" title="Trichloroethylene">Trichloroethylene</a><sup>‡</sup></li> <li><a href="/wiki/Divinyl_ether" title="Divinyl ether">Vinyl ether</a><sup>‡</sup></li> <li><a href="/wiki/Xenon" title="Xenon">Xenon</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/General_anaesthetic#Injection" title="General anaesthetic">Injection</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Phenols" title="Phenols">Phenols</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ciprofol" title="Ciprofol">Ciprofol</a><sup>†</sup></li> <li><a href="/wiki/Fospropofol" title="Fospropofol">Fospropofol</a></li> <li><a href="/wiki/Propofol" title="Propofol">Propofol</a><sup>#</sup></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Barbiturate" title="Barbiturate">Barbiturates</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amobarbital" title="Amobarbital">Amobarbital</a></li> <li><a href="/wiki/Hexobarbital" title="Hexobarbital">Hexobarbital</a></li> <li><a href="/wiki/Methohexital" title="Methohexital">Methohexital</a></li> <li><a href="/wiki/Narcobarbital" title="Narcobarbital">Narcobarbital</a></li> <li><a href="/wiki/Thiamylal" title="Thiamylal">Thiamylal</a></li> <li><a href="/wiki/Sodium_thiopental" title="Sodium thiopental">Thiopental</a><sup>#</sup></li> <li><a href="/wiki/Thiotetrabarbital" title="Thiotetrabarbital">Thiotetrabarbital</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Benzodiazepine" title="Benzodiazepine">Benzodiazepines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Midazolam" title="Midazolam">Midazolam</a><sup>#</sup></li> <li><a href="/wiki/Diazepam" title="Diazepam">Diazepam</a><sup>#</sup></li> <li><a href="/wiki/Lorazepam" title="Lorazepam">Lorazepam</a><sup>#</sup></li> <li><a href="/wiki/Remimazolam" title="Remimazolam">Remimazolam</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Opioid" title="Opioid">Opioids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Morphine" title="Morphine">Morphine</a><sup>#</sup></li> <li><a href="/wiki/Oxycodone" title="Oxycodone">Oxycodone</a></li> <li><a href="/wiki/Anileridine" title="Anileridine">Anileridine</a><sup>‡</sup></li> <li><a href="/wiki/Embutramide" title="Embutramide">Embutramide</a><sup>‡</sup></li> <li><a href="/wiki/Fentanyl" title="Fentanyl">Fentanyl</a><sup>#</sup></li> <li><a href="/wiki/Alfentanil" title="Alfentanil">Alfentanil</a></li> <li><a href="/wiki/Phenoperidine" title="Phenoperidine">Phenoperidine</a></li> <li><a href="/wiki/Remifentanil" title="Remifentanil">Remifentanil</a>÷</li> <li><a href="/wiki/Sufentanil" title="Sufentanil">Sufentanil</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Arylcyclohexylamine" title="Arylcyclohexylamine">Arylcyclohexylamines</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Esketamine" title="Esketamine">Esketamine</a></li> <li><a href="/wiki/Ketamine" title="Ketamine">Ketamine</a><sup>#</sup></li> <li><a href="/wiki/Phencyclidine" title="Phencyclidine">Phencyclidine</a><sup>‡</sup></li> <li><a href="/wiki/Tiletamine" title="Tiletamine">Tiletamine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Neurosteroid" title="Neurosteroid">Neuroactive steroids</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Alfadolone" title="Alfadolone">Alfadolone</a></li> <li><a href="/wiki/Alfaxalone" title="Alfaxalone">Alfaxalone</a></li> <li><a href="/wiki/Hydroxydione" title="Hydroxydione">Hydroxydione</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Others</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Etomidate" title="Etomidate">Etomidate</a></li> <li><a href="/wiki/Propanidid" title="Propanidid">Propanidid</a><sup>‡</sup></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><td colspan="2" class="navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"></div><div role="navigation" class="navbox" aria-labelledby="Local_anesthetics_(primarily_sodium_channel_blockers)_(N01B)" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Local_anesthetics" title="Template:Local anesthetics"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Local_anesthetics" title="Template talk:Local anesthetics"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Local_anesthetics" title="Special:EditPage/Template:Local anesthetics"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Local_anesthetics_(primarily_sodium_channel_blockers)_(N01B)" style="font-size:114%;margin:0 4em"><a href="/wiki/Local_anesthetic" title="Local anesthetic">Local anesthetics</a> <span style="font-size:85%;">(primarily <a href="/wiki/Sodium_channel_blocker" title="Sodium channel blocker">sodium channel blockers</a>)</span> (<a href="/wiki/ATC_code_N01#N01B" title="ATC code N01">N01B</a>)</div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Ester" title="Ester">Esters</a> by acid</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/4-Aminobenzoic_acid" title="4-Aminobenzoic acid">Aminobenzoic</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Benzocaine" title="Benzocaine">Benzocaine</a></li> <li><a href="/wiki/Benzonatate" title="Benzonatate">Benzonatate</a></li> <li><a href="/wiki/Butacaine" title="Butacaine">Butacaine</a></li> <li><a href="/wiki/Butamben" title="Butamben">Butamben</a></li> <li><a href="/wiki/Chloroprocaine" title="Chloroprocaine">Chloroprocaine</a></li> <li><a href="/wiki/Dimethocaine" title="Dimethocaine">Dimethocaine</a></li> <li><a href="/wiki/Lucaine" class="mw-redirect" title="Lucaine">Lucaine</a></li> <li><a href="/wiki/Meprylcaine" title="Meprylcaine">Meprylcaine</a></li> <li><a href="/wiki/Metabutethamine" title="Metabutethamine">Metabutethamine</a></li> <li><a href="/wiki/Metabutoxycaine" title="Metabutoxycaine">Metabutoxycaine</a></li> <li><a href="/wiki/Nitracaine" title="Nitracaine">Nitracaine</a></li> <li><a href="/wiki/Orthocaine" title="Orthocaine">Orthocaine</a></li> <li><a href="/wiki/Propoxycaine" title="Propoxycaine">Propoxycaine</a></li> <li><a href="/wiki/Procaine" title="Procaine">Procaine (Novocaine)</a></li> <li><a href="/wiki/Proxymetacaine" title="Proxymetacaine">Proxymetacaine</a></li> <li><a href="/wiki/Risocaine" title="Risocaine">Risocaine</a></li> <li><a href="/wiki/Tetracaine" title="Tetracaine">Tetracaine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Benzoic_acid" title="Benzoic acid">Benzoic</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Amylocaine" title="Amylocaine">Amylocaine</a></li> <li><a href="/wiki/Cocaine" title="Cocaine">Cocaine</a></li> <li><a href="/wiki/Cyclomethycaine" title="Cyclomethycaine">Cyclomethycaine</a></li> <li><a href="/wiki/Alpha-Eucaine" class="mw-redirect" title="Alpha-Eucaine">α-Eucaine</a></li> <li><a href="/wiki/Eucaine" title="Eucaine">β-Eucaine</a></li> <li><a href="/wiki/Hexylcaine" title="Hexylcaine">Hexylcaine</a></li> <li><a href="/wiki/Isobucaine" title="Isobucaine">Isobucaine</a></li> <li><a href="/wiki/Piperocaine" title="Piperocaine">Piperocaine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">ArCO2- (not para-amino or Ph)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/w/index.php?title=Amoproxan&action=edit&redlink=1" class="new" title="Amoproxan (page does not exist)">Amoproxan</a> (3,4,5-Trimethoxybenzoyl)</li> <li><a href="/wiki/3-(p-Fluorobenzoyloxy)tropane" title="3-(p-Fluorobenzoyloxy)tropane">3-(p-Fluorobenzoyloxy)tropane</a></li></ul> </div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Amide" title="Amide">Amides</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Articaine" title="Articaine">Articaine</a></li> <li><a href="/wiki/Bupivacaine" title="Bupivacaine">Bupivacaine</a><sup>#</sup>/<a href="/wiki/Levobupivacaine" title="Levobupivacaine">Levobupivacaine</a>/<a href="/wiki/Ropivacaine" title="Ropivacaine">Ropivacaine</a></li> <li><a href="/wiki/Butanilicaine" title="Butanilicaine">Butanilicaine</a></li> <li><a href="/wiki/Articaine" title="Articaine">Carticaine</a></li> <li><a href="/wiki/Cinchocaine" title="Cinchocaine"> Cinchocaine (Dibucaine)</a></li> <li><a href="/wiki/Etidocaine" title="Etidocaine">Etidocaine</a></li> <li><a href="/wiki/Lidocaine" title="Lidocaine">Lidocaine</a><sup>#</sup></li> <li><a href="/wiki/Mepivacaine" title="Mepivacaine">Mepivacaine</a></li> <li><a href="/wiki/Prilocaine" title="Prilocaine">Prilocaine</a></li> <li><a href="/wiki/Trimecaine" title="Trimecaine">Trimecaine</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Combinations</th><td class="navbox-list-with-group navbox-list navbox-odd hlist" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Local_anesthetic_with_vasoconstrictor" class="mw-redirect" title="Local anesthetic with vasoconstrictor">Anesthetic/vasoconstrictor</a></li> <li><a href="/wiki/Bupivacaine/meloxicam" title="Bupivacaine/meloxicam">Bupivacaine/meloxicam</a></li> <li><a href="/wiki/Lidocaine/prilocaine" title="Lidocaine/prilocaine">Lidocaine/prilocaine</a></li> <li><a href="/wiki/Topical_tac" title="Topical tac">TAC</a></li> <li><a href="/wiki/Iontocaine" title="Iontocaine">Iontocaine</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2" style="background:transparent;padding:0;"><div><div class="hlist"> <ul><li><sup>#</sup><a href="/wiki/WHO_Model_List_of_Essential_Medicines" title="WHO Model List of Essential Medicines">WHO-EM</a></li> <li><sup>‡</sup><a href="/wiki/List_of_withdrawn_drugs" title="List of withdrawn drugs">Withdrawn</a> from market</li> <li><a href="/wiki/Clinical_trial" title="Clinical trial">Clinical trials</a>: <ul><li><sup>†</sup><a href="/wiki/Phases_of_clinical_research#Phase_III" title="Phases of clinical research">Phase III</a></li> <li><sup>§</sup>Never to phase III</li></ul></li></ul> </div></div></td></tr></tbody></table></div> <div class="navbox-styles"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1236075235"></div><div role="navigation" class="navbox" aria-labelledby="Major_chemical_drug_groups_–_based_upon_the_Anatomical_Therapeutic_Chemical_Classification_System" style="padding:3px"><table class="nowraplinks hlist mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1129693374"><link rel="mw-deduplicated-inline-style" href="mw-data:TemplateStyles:r1239400231"><div class="navbar plainlinks hlist navbar-mini"><ul><li class="nv-view"><a href="/wiki/Template:Major_drug_groups" title="Template:Major drug groups"><abbr title="View this template">v</abbr></a></li><li class="nv-talk"><a href="/wiki/Template_talk:Major_drug_groups" title="Template talk:Major drug groups"><abbr title="Discuss this template">t</abbr></a></li><li class="nv-edit"><a href="/wiki/Special:EditPage/Template:Major_drug_groups" title="Special:EditPage/Template:Major drug groups"><abbr title="Edit this template">e</abbr></a></li></ul></div><div id="Major_chemical_drug_groups_–_based_upon_the_Anatomical_Therapeutic_Chemical_Classification_System" style="font-size:114%;margin:0 4em">Major chemical drug groups – based upon the <a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">Anatomical Therapeutic Chemical Classification System</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_gastrointestinal_tract" class="mw-redirect" title="Human gastrointestinal tract">gastrointestinal tract</a><br />/ <a href="/wiki/Metabolism" title="Metabolism">metabolism</a> (<a href="/wiki/ATC_code_A" title="ATC code A">A</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>stomach acid</i> <ul><li><a href="/wiki/Antacid" title="Antacid">Antacids</a></li> <li><a href="/wiki/H2_antagonist" class="mw-redirect" title="H2 antagonist">H<sub>2</sub> antagonists</a></li> <li><a href="/wiki/Proton-pump_inhibitor" title="Proton-pump inhibitor">Proton-pump inhibitors</a></li></ul></li> <li><a href="/wiki/Antiemetic" title="Antiemetic">Antiemetics</a></li> <li><a href="/wiki/Laxative" title="Laxative">Laxatives</a></li> <li><a href="/wiki/Antidiarrhoeal" class="mw-redirect" title="Antidiarrhoeal">Antidiarrhoeals</a> / <a href="/wiki/Antipropulsive" title="Antipropulsive">Antipropulsives</a></li> <li><a href="/wiki/Anti-obesity_medication" title="Anti-obesity medication">Anti-obesity drugs</a></li> <li><a href="/wiki/Diabetes_medication" title="Diabetes medication">Diabetes medication</a></li> <li><a href="/wiki/Vitamin" title="Vitamin">Vitamins</a></li> <li><a href="/wiki/Dietary_mineral" class="mw-redirect" title="Dietary mineral">Dietary minerals</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Blood" title="Blood">blood</a> and blood<br />forming organs (<a href="/wiki/ATC_code_B" title="ATC code B">B</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antithrombotic" title="Antithrombotic">Antithrombotics</a> <ul><li><a href="/wiki/Antiplatelet_drug" title="Antiplatelet drug">Antiplatelets</a></li> <li><a href="/wiki/Anticoagulant" title="Anticoagulant">Anticoagulants</a></li> <li><a href="/wiki/Thrombolytic_drug" class="mw-redirect" title="Thrombolytic drug">Thrombolytics / fibrinolytics</a></li></ul></li> <li><a href="/wiki/Antihemorrhagic" title="Antihemorrhagic">Antihemorrhagics</a> <ul><li><a href="/wiki/Platelet" title="Platelet">Platelets</a></li> <li><a href="/wiki/Coagulation" title="Coagulation">Coagulants</a></li> <li><a href="/wiki/Antifibrinolytic" title="Antifibrinolytic">Antifibrinolytics</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Circulatory_system" title="Circulatory system">cardiovascular<br />system</a> (<a href="/wiki/ATC_code_C" title="ATC code C">C</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><i>cardiac therapy / <a href="/wiki/Antianginal" title="Antianginal">antianginals</a></i> <ul><li><a href="/wiki/Cardiac_glycoside" title="Cardiac glycoside">Cardiac glycosides</a></li> <li><a href="/wiki/Antiarrhythmic_agent" title="Antiarrhythmic agent">Antiarrhythmics</a></li> <li><a href="/wiki/Cardiac_stimulant" title="Cardiac stimulant">Cardiac stimulants</a></li></ul></li> <li><a href="/wiki/Antihypertensive_drug" class="mw-redirect" title="Antihypertensive drug">Antihypertensives</a></li> <li><a href="/wiki/Diuretic" title="Diuretic">Diuretics</a></li> <li><a href="/wiki/Vasodilation" title="Vasodilation">Vasodilators</a></li> <li><a href="/wiki/Beta_blocker" title="Beta blocker">Beta blockers</a></li> <li><a href="/wiki/Calcium_channel_blocker" title="Calcium channel blocker">Calcium channel blockers</a></li> <li><i><a href="/wiki/Renin%E2%80%93angiotensin_system" title="Renin–angiotensin system">renin–angiotensin system</a></i> <ul><li><a href="/wiki/ACE_inhibitor" title="ACE inhibitor">ACE inhibitors</a></li> <li><a href="/wiki/Angiotensin_II_receptor_antagonist" class="mw-redirect" title="Angiotensin II receptor antagonist">Angiotensin II receptor antagonists</a></li> <li><a href="/wiki/Renin_inhibitor" title="Renin inhibitor">Renin inhibitors</a></li></ul></li> <li><a href="/wiki/Hypolipidemic_agent" class="mw-redirect" title="Hypolipidemic agent">Antihyperlipidemics</a> <ul><li><a href="/wiki/Statin" title="Statin">Statins</a></li> <li><a href="/wiki/Fibrate" title="Fibrate">Fibrates</a></li> <li><a href="/wiki/Bile_acid_sequestrant" title="Bile acid sequestrant">Bile acid sequestrants</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_skin" title="Human skin">skin</a> (<a href="/wiki/ATC_code_D" title="ATC code D">D</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Emollient" class="mw-redirect" title="Emollient">Emollients</a></li> <li><a href="/wiki/Cicatrizant" class="mw-redirect" title="Cicatrizant">Cicatrizants</a></li> <li><a href="/wiki/Antipruritic" title="Antipruritic">Antipruritics</a></li> <li><a href="/wiki/Antipsoriatic" class="mw-redirect" title="Antipsoriatic">Antipsoriatics</a></li> <li><a href="/wiki/ATC_code_D09" title="ATC code D09">Medicated dressings</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Genitourinary_system" title="Genitourinary system">genitourinary<br />system</a> (<a href="/wiki/ATC_code_G" title="ATC code G">G</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hormonal_contraception" title="Hormonal contraception">Hormonal contraception</a></li> <li><a href="/wiki/Fertility_medication" title="Fertility medication">Fertility agents</a></li> <li><a href="/wiki/Selective_estrogen_receptor_modulator" title="Selective estrogen receptor modulator">Selective estrogen receptor modulators</a></li> <li><a href="/wiki/Sex_steroid" class="mw-redirect" title="Sex steroid">Sex hormones</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Endocrine_system" title="Endocrine system">endocrine<br />system</a> (<a href="/wiki/ATC_code_H" title="ATC code H">H</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Hypothalamic%E2%80%93pituitary_hormone" title="Hypothalamic–pituitary hormone">Hypothalamic–pituitary hormones</a></li> <li><a href="/wiki/Corticosteroid" title="Corticosteroid">Corticosteroids</a> <ul><li><a href="/wiki/Glucocorticoid" title="Glucocorticoid">Glucocorticoids</a></li> <li><a href="/wiki/Mineralocorticoid" title="Mineralocorticoid">Mineralocorticoids</a></li></ul></li> <li><a href="/wiki/Sex_steroid" class="mw-redirect" title="Sex steroid">Sex hormones</a></li> <li><a href="/wiki/Thyroid_hormone" class="mw-redirect" title="Thyroid hormone">Thyroid hormones</a> / <a href="/wiki/Antithyroid_agent" title="Antithyroid agent">Antithyroid agents</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Infection" title="Infection">infections</a> and<br /><a href="https://en.wiktionary.org/wiki/infestation" class="extiw" title="wikt:infestation">infestations</a> (<a href="/wiki/ATC_code_J" title="ATC code J">J</a>, <a href="/wiki/ATC_code_P" title="ATC code P">P</a>, <a href="/wiki/ATCvet_code_QI" title="ATCvet code QI">QI</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antimicrobial" title="Antimicrobial">Antimicrobials</a>: <a href="/wiki/Antibacterial" class="mw-redirect" title="Antibacterial">Antibacterials</a> (<a href="/wiki/Antimycobacterial" title="Antimycobacterial">Antimycobacterials</a>)</li> <li><a href="/wiki/Antifungal_drug" class="mw-redirect" title="Antifungal drug">Antifungals</a></li> <li><a href="/wiki/Antiviral_drug" title="Antiviral drug">Antivirals</a></li> <li><a href="/wiki/Antiparasitic" title="Antiparasitic">Antiparasitics</a> <ul><li><a href="/wiki/Antiprotozoal_agent" class="mw-redirect" title="Antiprotozoal agent">Antiprotozoals</a></li> <li><a href="/wiki/Anthelmintic" title="Anthelmintic">Anthelmintics</a></li> <li><a href="/wiki/Ectoparasiticide" title="Ectoparasiticide">Ectoparasiticides</a></li></ul></li> <li><a href="/wiki/Intravenous_immunoglobulin" class="mw-redirect" title="Intravenous immunoglobulin">Intravenous immunoglobulin</a></li> <li><a href="/wiki/Vaccine" title="Vaccine">Vaccines</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Malignant" class="mw-redirect" title="Malignant">malignant</a> disease<br />(<a href="/wiki/ATC_code_L" title="ATC code L">L01–L02</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Chemotherapy" title="Chemotherapy">Anticancer agents</a> <ul><li><a href="/wiki/Antimetabolite" title="Antimetabolite">Antimetabolites</a></li> <li><a href="/wiki/Alkylating_antineoplastic_agent" title="Alkylating antineoplastic agent">Alkylating</a></li> <li><a href="/wiki/Spindle_poison" title="Spindle poison">Spindle poisons</a></li> <li><a href="/wiki/Antineoplastic" class="mw-redirect" title="Antineoplastic">Antineoplastic</a></li> <li><a href="/wiki/Topoisomerase_inhibitor" title="Topoisomerase inhibitor">Topoisomerase inhibitors</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Immune_system" title="Immune system">immune</a> disease<br />(<a href="/wiki/ATC_code_L" title="ATC code L">L03–L04</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Immunomodulator" class="mw-redirect" title="Immunomodulator">Immunomodulators</a> <ul><li><a href="/wiki/Immunostimulant" title="Immunostimulant">Immunostimulants</a></li> <li><a href="/wiki/Immunosuppressive_drug" title="Immunosuppressive drug">Immunosuppressants</a></li></ul></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Muscle" title="Muscle">muscles</a>, <a href="/wiki/Bone" title="Bone">bones</a>,<br />and <a href="/wiki/Joint" title="Joint">joints</a> (<a href="/wiki/ATC_code_M" title="ATC code M">M</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Anabolic_steroid" title="Anabolic steroid">Anabolic steroids</a></li> <li><a href="/wiki/Anti-inflammatory" title="Anti-inflammatory">Anti-inflammatories</a> <ul><li><a href="/wiki/Non-steroidal_anti-inflammatory_drug" class="mw-redirect" title="Non-steroidal anti-inflammatory drug">Non-steroidal anti-inflammatory drugs</a></li></ul></li> <li><a href="/wiki/Disease-modifying_antirheumatic_drug" title="Disease-modifying antirheumatic drug">Antirheumatics</a></li> <li><a href="/wiki/Corticosteroid" title="Corticosteroid">Corticosteroids</a></li> <li><a href="/wiki/Muscle_relaxant" title="Muscle relaxant">Muscle relaxants</a></li> <li><a href="/wiki/Bisphosphonate" title="Bisphosphonate">Bisphosphonates</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Human_brain" title="Human brain">brain</a> and<br /><a href="/wiki/Nervous_system" title="Nervous system">nervous system</a> (<a href="/wiki/ATC_code_N" title="ATC code N">N</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Analgesic" title="Analgesic">Analgesics</a></li> <li><a class="mw-selflink selflink">Anesthetics</a> <ul><li><a href="/wiki/General_anaesthetic" title="General anaesthetic">General</a></li> <li><a href="/wiki/Local_anesthetic" title="Local anesthetic">Local</a></li></ul></li> <li><a href="/wiki/Anorectic" title="Anorectic">Anorectics</a></li> <li><a href="/wiki/Antihyperkinetic" class="mw-redirect" title="Antihyperkinetic">Anti-ADHD agents</a></li> <li><a href="/wiki/Addiction_medicine" title="Addiction medicine">Antiaddictives</a></li> <li><a href="/wiki/Anticonvulsant" title="Anticonvulsant">Anticonvulsants</a></li> <li><a href="/wiki/Antidementia_drug" class="mw-redirect" title="Antidementia drug">Antidementia agents</a></li> <li><a href="/wiki/Antidepressant" title="Antidepressant">Antidepressants</a></li> <li><a href="/wiki/Antimigraine_drug" title="Antimigraine drug">Antimigraine agents</a></li> <li><a href="/wiki/Management_of_Parkinson%27s_disease#Medication" title="Management of Parkinson's disease">Antiparkinson agents</a></li> <li><a href="/wiki/Antipsychotic" title="Antipsychotic">Antipsychotics</a></li> <li><a href="/wiki/Anxiolytic" title="Anxiolytic">Anxiolytics</a></li> <li><a href="/wiki/Aphrodisiac" title="Aphrodisiac">Aphrodisiacs</a></li> <li><a href="/wiki/Depressant" title="Depressant">Depressants</a></li> <li><a href="/wiki/Entactogen" class="mw-redirect" title="Entactogen">Entactogens</a></li> <li><a href="/wiki/Entheogen" title="Entheogen">Entheogens</a></li> <li><a href="/wiki/Euphoria" title="Euphoria">Euphoriants</a></li> <li><a href="/wiki/Psychedelics,_dissociatives_and_deliriants" class="mw-redirect" title="Psychedelics, dissociatives and deliriants">Hallucinogens</a> <ul><li><a href="/wiki/Psychedelic_drug" title="Psychedelic drug">Psychedelics</a></li> <li><a href="/wiki/Dissociative" title="Dissociative">Dissociatives</a></li> <li><a href="/wiki/Deliriant" title="Deliriant">Deliriants</a></li></ul></li> <li><a href="/wiki/Hypnotic" title="Hypnotic">Hypnotics</a> / <a href="/wiki/Sedative" title="Sedative">Sedatives</a></li> <li><a href="/wiki/Mood_stabilizer" title="Mood stabilizer">Mood stabilizers</a></li> <li><a href="/wiki/Motivation-enhancing_drug" title="Motivation-enhancing drug">Motivation-enhancing drug</a></li> <li><a href="/wiki/Neuroprotective" class="mw-redirect" title="Neuroprotective">Neuroprotectives</a></li> <li><a href="/wiki/Nootropic" title="Nootropic">Nootropics</a></li> <li><a href="/wiki/Neurotoxin" title="Neurotoxin">Neurotoxins</a></li> <li><a href="/wiki/Orexigenic" class="mw-redirect" title="Orexigenic">Orexigenics</a></li> <li><a href="/wiki/Serenic" title="Serenic">Serenics</a></li> <li><a href="/wiki/Stimulant" title="Stimulant">Stimulants</a></li> <li><a href="/wiki/Wakefulness-promoting_agent" title="Wakefulness-promoting agent">Wakefulness-promoting agents</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Respiratory_system" title="Respiratory system">respiratory<br />system</a> (<a href="/wiki/ATC_code_R" title="ATC code R">R</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Decongestant" title="Decongestant">Decongestants</a></li> <li><a href="/wiki/Bronchodilator" title="Bronchodilator">Bronchodilators</a></li> <li><a href="/wiki/Cough_medicine" class="mw-redirect" title="Cough medicine">Cough medicines</a></li> <li><a href="/wiki/H1_antagonist" title="H1 antagonist">H<sub>1</sub> antagonists</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="/wiki/Sense" title="Sense">sensory organs</a> (<a href="/wiki/ATC_code_S" title="ATC code S">S</a>)</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Ophthalmology" title="Ophthalmology">Ophthalmologicals</a></li> <li><a href="/wiki/Otology" title="Otology">Otologicals</a></li></ul> </div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">other <a href="/wiki/Anatomical_Therapeutic_Chemical_Classification_System" title="Anatomical Therapeutic Chemical Classification System">ATC</a> (<a href="/wiki/ATC_code_V" title="ATC code V">V</a>)</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"> <ul><li><a href="/wiki/Antidote" title="Antidote">Antidotes</a></li> <li><a href="/wiki/Contrast_medium" class="mw-redirect" title="Contrast medium">Contrast media</a></li> <li><a href="/wiki/Radiopharmacology" title="Radiopharmacology">Radiopharmaceuticals</a></li> <li><a href="/wiki/Dressing_(medicine)" title="Dressing (medicine)">Dressings</a></li> <li><a href="/wiki/Senotherapeutics" class="mw-redirect" title="Senotherapeutics">Senotherapeutics</a></li></ul> </div></td></tr><tr><td class="navbox-abovebelow" colspan="2"><div> <ul><li><span class="noviewer" typeof="mw:File"><span title="Category"><img alt="" src="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/16px-Symbol_category_class.svg.png" decoding="async" width="16" height="16" class="mw-file-element" srcset="//upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/23px-Symbol_category_class.svg.png 1.5x, //upload.wikimedia.org/wikipedia/en/thumb/9/96/Symbol_category_class.svg/31px-Symbol_category_class.svg.png 2x" data-file-width="180" data-file-height="185" /></span></span> <a href="/wiki/Category:Drugs" title="Category:Drugs">Drugs</a></li> <li><a href="/wiki/Category:Pharmacological_classification_systems" title="Category:Pharmacological classification systems">Pharmacological classification systems</a></li> <li><a href="/wiki/Category:ATC_codes" title="Category:ATC codes">ATC 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