Evidence that central nervous system depression by 1,4-butanediol is mediated through a metabolite, gamma-hydroxybutyrate

Opioid agonists are frequently used to provide anesthesia in combination with sedatives and hypnotic agents and manage postoperative acute pain. There are many different opioid agents available that differ in their potency, onset and duration of action, metabolism, drug interactions, and side-effect profile. All opioids have distinct effects upon various organ systems, including central nervous system depression, respiratory depression, and decreased gastrointestinal motility. Fentanyl and fentanyl-derived agents (alfentanil, sufentanil, remifentanil) are most frequently used in the intraoperative period due to their quick onset and duration of action, allowing them to be easily titrated and discontinued at the completion of a procedure. Oral opioids with moderate durations of action, such as oxycodone, hydrocodone, and morphine, are commonly used for acute pain management in the postoperative setting. When oral analgesics cannot be used, intravenous patient-controlled analgesia is another option for pain management. This review contains 5 figures, 11 tables, and 59 references. Key Words: analgesia, anesthesia, central nervous system depression, fentanyl, morphine, opioid agonist, pain management, patient-controlled analgesia, perioperative, respiratory depression

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Evaluation of Bispectral Index (BIS) as an Indicator of Central Nervous System Depression in Horses Anesthetized with Propofol

Journal of Veterinary Medical Science ◽

10.1292/jvms.001465 ◽

2009 ◽

Vol 71 (11) ◽

pp. 1465-1471 ◽

Cited By ~ 13

Author(s):

Kazuto YAMASHITA ◽

Natsuki AKASHI ◽

Yumiko KATAYAMA ◽

Yosuke UCHIDA ◽

Mohammed A. UMAR ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Bispectral Index ◽

Central Nervous System Depression

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Central nervous system depression from ingestion of nonprescription eyedrops

The American Journal of Emergency Medicine ◽

10.1016/0735-6757(84)90007-x ◽

1984 ◽

Vol 2 (3) ◽

pp. 217-218 ◽

Cited By ~ 21

Author(s):

Wendy Klein-Schwartz ◽

Richard Gorman ◽

Gary M. Oderda ◽

Azam Baig

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Depression

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Flumazenil Counteracts Intrathecal Baclofen-induced Central Nervous System Depression in Tetanus

Anesthesiology ◽

10.1097/00000542-199206000-00027 ◽

1992 ◽

Vol 76 (6) ◽

pp. 1051-1053 ◽

Cited By ~ 28

Author(s):

J. M. SAISSY ◽

M. VITRIS ◽

J. DEMAZIÈRE ◽

M. SECK ◽

L. MARCOUX ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Intrathecal Baclofen ◽

Central Nervous System Depression

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Synthesis and Central Nervous System Depression Properties of 3-[(1′-Pyrazolyl)phenyl]sydnones

Archiv der Pharmazie ◽

10.1002/ardp.19813140605 ◽

1981 ◽

Vol 314 (6) ◽

pp. 503-507 ◽

Cited By ~ 5

Author(s):

Shambhuling B. Havanur ◽

Bharati V. Badami ◽

Gurubasav S. Puranik

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Depression

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Swift Onset of Central Nervous System Depression and Asystole Followingan Overdose of Guaifenesin

Journal of Analytical Toxicology ◽

10.1093/jat/bkt030 ◽

2013 ◽

Vol 37 (5) ◽

pp. 318-319 ◽

Cited By ~ 4

Author(s):

M. Okic ◽

T. Johnson ◽

J. A. Crifasi ◽

C. Long ◽

E. K. Mitchell

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Central Nervous System Depression

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A Bioassay Model for Testing the Incapacitating Effects of Exposure To Combustion Product Atmospheres Using Cynomolgus Monkeys

Journal of Fire Sciences ◽

10.1177/073490418400200104 ◽

1984 ◽

Vol 2 (1) ◽

pp. 20-36 ◽

Cited By ~ 20

Author(s):

David A. Purser

Keyword(s):

Central Nervous System ◽

Carbon Monoxide ◽

Nervous System ◽

Cardiac Function ◽

Conduction Velocity ◽

Hydrogen Cyanide ◽

Nerve Conduction ◽

Nerve Conduction Velocity ◽

Central Nervous System Depression ◽

Physiological Tests

A bioassay model has been developed to test the time course and degree of in capacitation produced by exposures to thermal decomposition products from polymeric materials. A battery of physiological tests was used during separate exposures to atmospheres of carbon monoxide, hydrogen cyanide, hypoxia, hypercapnia and heated air. Each atmosphere was designed to simulate one aspect of the conditions commonly encountered in fires. Measurements were made of the animals' respiration, cardiac function and respiratory blood gases. Neurological function was monitored by measurements of the elec troencephalogram, auditory cortical evoked potentials and peripheral nerve con duction velocity. Hypoxia (10% oxygen) caused muscle weakness, a decrease in nerve conduction velocity, abnormal cardiac function accompanied by a fall in blood pressure and central nervous system depression. At 1000 ppm carbon monoxide, venous carboxyhaemoglobin levels reached 30%. There was a reduc tion of nerve conduction velocity and in some cases severe central nervous system depression. At 60 ppm hydrogen cyanide had a slight depressive effect on the central nervous system, while at 80-150 ppm severe central nervous system depression and incapacitation occurred. The main result of 5% carbon dioxide exposure was a three-fold increase in respiratory minute volume. It is concluded that the model is capable of detecting early physiological signs of in capacitation induced by fire conditions. It is suggested that exposures to a com bination of hydrogen cyanide and carbon monoxide with accompanying changes in cerebral blood flow during attempts to escape from fires may be a cause of col lapse and subsequent death.

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