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Anesthetic agents and perioperative medications
medication Under reviewAnesthetic agents and perioperative medications are prescription drugs used to induce and maintain anesthesia, control pain, stabilize vital signs, and manage chronic conditions around the time of surgery. Anesthetic agents include general anesthetics given intravenously or by inhalation, regional and local anesthetics that numb specific areas, and adjunct drugs such as opioids, benzodiazepines, and neuromuscular blockers. Perioperative medications more broadly include a wide range of chronic therapies (for example beta blockers, ACE inhibitors, anticoagulants, antiplatelets, inhalers, and acid-suppressive drugs) that may be continued, adjusted, or temporarily withheld to balance bleeding risk, hemodynamic stability, and disease control. These medications work primarily by altering nervous system signaling, cardiovascular tone, coagulation, and organ-specific functions. General anesthetics reduce central nervous system activity so that patients become unconscious and unresponsive to pain, while local and regional anesthetics block nerve conduction in restricted areas of the body. Perioperative cardiovascular drugs help optimize heart rate, blood pressure, and rhythm; acid-suppressive agents reduce gastric acidity and volume; bronchodilators support lung function; and other classes mitigate stress responses, reduce nausea, or prevent thrombosis. For healthy individuals, their main application is to enable safe, pain-free surgery and recovery while minimizing short-term complications such as hypotension, arrhythmias, pulmonary events, and postoperative nausea and confusion.
Research summary
Research in healthy human volunteers and low‑risk surgical patients shows that modern anesthetic techniques are generally safe, with serious complications being rare when care is provided by trained professionals in appropriate settings. Comparative studies and large clinical series in mostly non-frail populations have characterized common transient effects such as postoperative sleepiness, dizziness, sore throat, and mild confusion, as well as more serious but uncommon events like allergic reactions, cardiovascular instability, or malignant hyperthermia in genetically susceptible individuals. These studies support the use of tailored anesthetic regimens to match procedure type, patient risk profile, and perioperative medication use. Perioperative medication management has been studied extensively in clinical cohorts, randomized trials, and guideline development projects that include many otherwise healthy adults undergoing elective surgery. Evidence supports continuing certain drugs, such as beta blockers and inhaled bronchodilators, to reduce cardiovascular or pulmonary complications, while some medications, such as ACE inhibitors, ARBs, and nonsteroidal anti-inflammatory drugs, are sometimes withheld because of increased risk of perioperative hypotension or bleeding. Ongoing research focuses on optimizing drug selection and timing, integrating safety systems to reduce medication errors, and refining protocols for specific patient groups, though most data apply to patients with medical comorbidities rather than purely healthy volunteers.
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Guideline for Preoperative Medication Management: Effects of Ibuprofen on Platelet Function in Healthy Individuals
Froedtert & the Medical College of Wisconsin Authors
Anesthesia: What It Is, Side Effects, Risks & Types
Cleveland Clinic Staff
Ultrasound-guided Interscalene Block as a Safer Alternative to General Anesthesia in a Patient with Ankylosing Spondylitis Undergoing Proximal Humerus Fracture Fixation.
Mayo Clinic Staff
Perioperative Medication Management for Surgical Patients
ESMED Editorial Group
Analysing and improving preoperative medication management in cardiac surgery.
Froedtert & the Medical College of Wisconsin Authors
Patient Safety of Perioperative Medication Through the Lens of Human Factors Engineering: Narrative Review
Alander JT, Joseph JW, et al.
Perioperative Medication Management for Patients with Diabetes: Oral Agents, Insulins, Noninsulin Injectables, and Diabetes Devices.
UpToDate Editorial Team
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Research (7 studies)
Patient Safety of Perioperative Medication Through the Lens of Human Factors Engineering: Narrative Review
Alander JT, Joseph JW, et al.
Ultrasound-guided Interscalene Block as a Safer Alternative to General Anesthesia in a Patient with Ankylosing Spondylitis Undergoing Proximal Humerus Fracture Fixation.
Mayo Clinic Staff
Perioperative Medication Management for Patients with Diabetes: Oral Agents, Insulins, Noninsulin Injectables, and Diabetes Devices.
UpToDate Editorial Team
Anesthesia: What It Is, Side Effects, Risks & Types
Cleveland Clinic Staff
Perioperative Medication Management for Surgical Patients
ESMED Editorial Group
Analysing and improving preoperative medication management in cardiac surgery.
Froedtert & the Medical College of Wisconsin Authors
Guideline for Preoperative Medication Management: Effects of Ibuprofen on Platelet Function in Healthy Individuals
Froedtert & the Medical College of Wisconsin Authors
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