General anesthetics

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General anesthetics

Highly varied class that includes ether, chloroform, nitrous oxide (laughing gas), desflurane (Suprane®), enflurane (Ethrane®), halothane (Fluothane®), isoflurane (Forane®), propofol (Diprivan®) and sevoflurane (Sevorane®).

Classification	Central nervous system depressant: Refers to a substance that slows mental functions by reducing the brain's overall activity and alertness. Has a calming effect on the user.
Visual description	Most general anesthetics come in liquid form in bottles. Nitrous oxide is different since it is a gas that is sold in a cylinder or cartridges.
Mechanism of action	The exact mechanism of action of general anesthetics is unknown. They do not appear to act on a particular receptor. They most likely inhibit synaptic transmission in the central nervous system. Another proposed mechanism of action is that volatile anesthetics inhibit synaptic transmission by preventing ions from entering or exiting neurons.
Routes of administration	Usually inhaled from a container or a cloth saturated with the substance. Nitrous oxide is different. Balloons are filled with the gas and inhaled.

Effects sought out by the user

The effects are similar to those of alcohol, barbiturates and benzodiazepines. However, they come on much more quickly and are brief. Their effects vary depending on the individual, the product and amount inhaled and how it is inhaled:

Euphoria (with regards to nitrous oxide, euphoria is often accompanied by laughing, hence the nickname "laughing gas")
Loss of inhibition
Transient stimulation followed by drowsiness that occasionally results in a semi-conscious state.

Common toxic effects and caused by high doses

Aggressive behaviour
Confusion
Disorientation
Dizziness
Drowsiness
Generalized muscle weakness
Headache

Irrational behaviour
Nausea
Significantly impaired judgement
Slurred speech
Uncoordinated movements
Vomiting

Toxic effects resulting from overdose

Cardiac arrest
Coma
Convulsions
Death

Decreased heartbeats
Irregular heart rate
Respiratory depression

Effects associated with chronic use

Nitrous oxide:

Amnesia
Ataxia (uncoordinated movements)
Bone marrow depression (blood disorders)
Impotence
Paranoid delusions
Peripheral polyneuropathy (numbness, paralysis) that is reversible when the user quits
Visual hallucinations

Other anesthetic gases (especially halothane):

Kidney damage
Liver damage
Weakened immune system

Tolerance (need to increase the dose to feel the same effect)

Not documented.

Addiction

Psychological dependence affects only 3.7% of those who experiment with these substances.

Withdrawal

Does not appear to be associated with any withdrawal syndrome. However, certain symptoms may occur when a substance is discontinued:

Excessive sweating
Feeling of weightlessness
Irritability
Nausea
Sleep disorders
Tremors

Onset and duration of action
Route of administration	Onset of action	Peak	Duration of action
Intrapulmonary (inhaled)	Almost immediate	N/A	About 15 minutes after stopping inhalation. Residual effects may persist for 1 to 2 hours.

Intoxication management

No antidote available.
Treatment is mainly symptomatic.

Many different street drugs are sold under the same name. Furthermore, nothing guarantees the quantity, purity or even the content of a street drug in spite of the fact that it may, in some cases, look like medication.

If you need help or want to learn more:

Canadian Centre on Substance Use and Addiction

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The patient information leaflets are provided by Vigilance Santé Inc. This content is for information purposes only and does not in any manner whatsoever replace the opinion or advice of your health care professional. Always consult a health care professional before making a decision about your medication or treatment.