Significant developments in the 1990s

Abstract

The 1990s advanced safety, control and understanding of clinical anesthesia. Two new, poorly soluble inhaled anesthetics, sevoflurane and desflurane allowed a more precise control over the anesthetic state. Sevoflurane did so without cardiorespiratory stimulation. Both protected the heart from hypoxia. An older anesthetic, isoflurane, could reverse mental depression. We learned that all these anesthetics acted on central pattern generators in the ventral spinal cord to make patients immobile despite ongoing surgery. We also learned that the Meyer-Overton theory correlating lipophilicity and anesthetic potency didn't always work, indirectly suggesting that inhaled anesthetics operated on proteins. Two new muscle relaxants, recuronium and cis-atracurium added to safety by acting more rapidly and for shorter times.