ANESTHETIC DRUG-INTERACTION - AN OVERVIEW

Modern anesthetic techniques involve combinations of intravenous (IV) and inhaled anesthetic drugs that mag produce synergistic (supraadditi ve), additive, or antagonistic interactions. Synergistic interaction i s most likely to occur when two or more drugs produce similar effects by different mechanisms. All of the tested combinations of opioids and IV sedative-hypnotics have been shown to produce synergistic hypnotic effects, and the majority of these interactions are predictable and u seful in daily practice. Opioids benzodiazepines, lidocaine, and alpha -2 agonists can all reduce the requirements for volatile anesthetics, but only the opioids and the alpha-2 agonists produce this effect at c linically acceptable concentrations. The usefulness of a drug-interact ion depends on whether it produces greater efficacy or reduced toxicit y. Surprisingly, these outcomes have only been specifically measured f or a handful of common drug combinations. (C) 1997 by Elsevier Science Inc.