Abstract
This review relates how the introduction of the short-acting narcotic alfentanil and the short-acting sedative-hypnotic propofol have expanded our capabilities both for providing conscious sedation and for administering general anesthesia for short surgical procedures. The rapid onset and limited distribution of alfentanil enable it to provide intense intraoperative analgesia without prolonged respiratory depression. The rapid elimination of propofol permits rapid titration to effect and provides recovery times significantly faster than those following thiopental. The review then focuses on the combined use of opioids and sedatives for conscious sedation. Use of these agents in concert results in potentiation of beneficial, as well as untoward, effects. Their use requires careful titration and vigilant monitoring.
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