ABSTRACT
This chapter discusses the most commonly used intravenous anesthetic agents and their anesthetic implications in patients undergoing brain tumor surgery. It describes the mechanism of action, pharmacokinetics and systemic effects of the anesthetic agents. In the chapter, the considered anesthetic agents are barbiturates, propofol, etomidate and ketamine. The formulation of barbiturates involves their preparation as sodium salts mixed with 6" anhydrous sodium carbonate by weight and then reconstituted with either water or normal saline to produce 2.5" solution of thiopental. A recently developed form of propofol, fospropofol, does not cause pain on intravenous administration like the traditional one. Many of the studies have reported the favorable effect of burst suppression by propofol. Etomidate is used because of its limited suppression of ventilation, lack of histamine release, and protection from myocardial and cerebral ischemia. Ketamine can be administered through many routes: intravenous, intramuscular, oral, and per-rectal (PR).
