Abstract：
Balanced anesthesia relies on the simultaneous administration of different drugs to attain an anesthetic state. The classic triad of anesthesia is a combination of a hypnotic, an analgesic, and a neuromuscular blocker. It is predominantly the analgesic pillar of this triad that became more and more supported by adjuvant therapy. The aim of this approach is to evolve into an opioid-sparing technique to cope with undesirable side effects of the opioids and is fueled by the opioid epidemic. The optimal strategy for balanced general anesthesia in ambulatory surgery must aim for a transition to a multimodal analgesic regimen dealing with acute postoperative pain and ideally reduce the most common adverse effects patients are faced with at home; sore throat, delayed awakening, memory disturbances, headache, nausea and vomiting, and negative behavioral changes. Over the years, this continuum of \"multimodal general anesthesia\" adopted many drugs with different modes of action. This review focuses on the most recent evidence on the different adjuvants that entered clinical practice and gives an overview of the different mechanisms of action, the potential as opioid-sparing or hypnotic-sparing drugs, and the applicability specifically in ambulatory surgery.
摘要：
平衡麻醉依赖于不同药物的同时施用以达到麻醉状态。麻醉的经典三合会是催眠的组合，镇痛药,和神经肌肉阻滞剂.主要是该三联症的镇痛支柱越来越受到辅助治疗的支持。这种方法的目的是发展成一种阿片类药物节省技术，以应对阿片类药物的不良副作用，并受到阿片类药物流行的推动。在门诊手术中平衡全身麻醉的最佳策略必须旨在过渡到处理急性术后疼痛的多模式镇痛方案，并理想地减少患者在家中面临的最常见的不良反应;喉咙痛，延迟觉醒,内存干扰，头痛,恶心和呕吐，和消极的行为变化。多年来,这种“多模式全身麻醉”的连续体采用了许多具有不同作用模式的药物。这篇综述集中在进入临床实践的不同佐剂的最新证据，并概述了不同的作用机制。作为阿片类药物或催眠药物的潜力，以及在门诊手术中的适用性。
