Anaes Vivas · Anaesthetic adjuncts

Data viva — the GABA-A receptor and the benzodiazepine binding site

A data viva on the GABA-A receptor diagram — the three binding sites; the benzodiazepine at the alpha-gamma interface increasing the FREQUENCY (more frequent shorter bursts) versus the barbiturate increasing the DURATION (fewer longer bursts); the ceiling effect (the benzodiazepine cannot open the channel directly); the flumazenil as the competitive antagonist (displaces, no intrinsic effect); the clinical translation to the midazolam, the diazepam, the lorazepam and the remimazolam; and the remimazolam as the ester-hydrolysed ultra-short agent with the constant context-sensitive half-time.