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General anesthesia: Maintenance and emergence

Adam King, MD
Liza M Weavind, MBBCh, FCCM, MMHC
Section Editor
Girish P Joshi, MB, BS, MD, FFARCSI
Deputy Editor
Nancy A Nussmeier, MD, FAHA


Additional agents are necessary to maintain the anesthetic state immediately after induction of general anesthesia, as most induction agents have a brief duration of action. This topic will discuss use of inhalation and intravenous (IV) agents during maintenance, as well as discontinuation and/or reversal of anesthetics to allow emergence when surgery concludes. Induction of general anesthesia is discussed separately. (See "General anesthesia: Induction" and "General anesthesia: Intravenous induction agents".)


Anesthetic goals during maintenance include:

Stage III surgical anesthesia (ie, unconsciousness, amnesia, immobility, unresponsive to surgical stimulation) (table 1).

Adequate analgesia during alterations in the degree of noxious surgical stimulation.

Physiologic homeostasis (eg, hemodynamic stability, oxygenation, ventilation, temperature).

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Literature review current through: Nov 2017. | This topic last updated: Nov 29, 2017.
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