propofol + fentanyl + isoflurane + sevoflurane

This is a combination of four anesthetic agents—propofol, fentanyl, isoflurane, and sevoflurane—used for the induction and maintenance of general anesthesia. - Propofol is an intravenous sedative-hypnotic agent that acts primarily as a positive allosteric modulator of the GABA-A receptor, producing rapid onset and short duration sedation or anesthesia[4][6][8]. - Fentanyl is a potent synthetic opioid analgesic that acts as an agonist at the mu-opioid receptor to provide profound analgesia[6][8][9]. - Isoflurane and sevoflurane are volatile inhalational anesthetics; both act by enhancing inhibitory neurotransmission via GABA-A receptors in the central nervous system. Sevoflurane has a lower blood/gas partition coefficient than isoflurane, leading to faster induction and emergence from anesthesia[3]. Both are used for maintenance of general anesthesia during surgical procedures[3]. The combination leverages synergistic effects among hypnotics (propofol), opioids (fentanyl), and volatile agents (isoflurane/sevoflurane) to achieve balanced anesthesia with reduced doses of each component, minimizing side effects while providing effective hypnosis, analgesia, amnesia, muscle relaxation, and hemodynamic stability[2][7].