Newer Propofol, Ketamine, and Etomidate Derivatives and Delivery Systems Relevant to Anesthesia Practice

Publication date: Available online 23 August 2018Source: Best Practice & Research Clinical AnaesthesiologyAuthor(s): N. Hulsman, M.W. Hollmann, B. PreckelAbstractDrug discovery is the cornerstone of developments in the field of anesthesia. Each year new drugs enter the market and possibly change clinical practice. The development of new anesthetics can be divided into two groups. One strategy is the discovery of a new type of drugs, a unique molecular structure with better clinical properties and lesser side effects than the already existing drugs. Another strategy is changing the molecular structure of current clinically available anesthetics in order to create new drugs with better pharmacokinetic and pharmacodynamic properties. In this review we will describe the current developments of frequently used anesthetics such as propofol, etomidate and ketamine. Alfaxalone is an old anesthetic with favorable properties, such hemodynamic and respiratory stability, but lacking a propriate vehicle. New formulations with recently developed solvents together with this old anesthetic are created. Next to drug development there is also a constantly search for better delivery systems for the already available anesthetics. Following open-loop systems like TIVA, new closed loop systems have entered the market. The SEDASYS®-Computer-Assisted Personalized Sedation System, an automatic closed loop delivery system providing propofol sedation for endoscopic procedures will be discussed.
Source: Best Practice and Research Clinical Anaesthesiology - Category: Anesthesiology Source Type: research