volatile

The issue of cerebral circulation and oxygen delivery to the brain requires constant vigilance for the clinician in the ICU, the trauma unit and the neurosurgical operation suite. These patients are administered anaesthetic medications that affect cerebral physiology by a lot of different and some times unexplored mechanisms.

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Since the advent of clinical anesthesia, there has been a continuous need for evaluating the depth of anesthesia. Depth of anesthesia was always important in avoiding either overdose (toxicity) or “underdose” (administering less than absolutely necessary). The problem of overdosing has been partly solved by assignment of dedicated and specially trained doctors to provide anesthesia services, by accumulating more than a 100 years of experience in administering anesthesia, by using safer drugs (volatile and intravenous) with extremely smaller toxicity than the older ones and by recognizing and establishing the stages of anesthesia (such as Guedel stages) and the hemodynamic parameters as indirect but useful indices of the depth of anesthesia. The current trend of minimizing expenses of anesthesia calls for tight titration of drug administration.

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