Airway management pharmacology: a narrative review

Airway pharmacology

Abstract

Background and purpose: The selection of anaesthetics and their correct dosage when securing the airway by endotracheal intubation are crucial for patient safety. In this context, different classes of drugs play an essential role. Intravenous anaesthetics, such as propofol, are often used to induce anaesthesia. Knowledge of the pharmacokinetic and pharmacodynamic characteristics of intravenous anaesthetics is extremely important due to the possibility of adequate drug selection in relation to the patient's condition and the side effects produced by these drugs. Ketamine is an anaesthetic that provides dissociative anaesthesia, analgesia and amnesia, and is often used in emergency situations because of its favourable hemodynamic effects. In recent years, the use of ketamine has undergone significant expansion, as has the study of its anaesthetic effects. Muscle relaxants that facilitate intubation and ventilation during anaesthesia are an essential part of the complex process of establishing the airway. These drugs, in combination with hypnotics and opioid analgesics, facilitate endotracheal intubation. Opioid analgesics, such as fentanyl, are necessary drugs to establish an airway, given that endotracheal intubation is one of the most painful interventions in anaesthesia. for analgesia during procedures and immediate postoperative treatment of acute pain. Benzodiazepines are used in elective airway management with the aim of sedation and anxiety reduction.

Conclusions: The correct application of drugs and intubation techniques is directly related to the safety and efficiency of establishing the airway; thus, the quality of healthcare is significantly improved.