Narcotics are commonly used in the administration of general anesthesia. Which of the following statement(s) is/are true concerning this class of agents

d. Acutely injured hypovolemic patients are at significant risk for decreased blood pressure with the use of narcotic analgesics

Narcotics and synthetic analogues belong in the class of drugs called opioids. Narcotics produce profound analgesia and respiratory depression. They have no amnesic properties, no myocardial depressive effects, and no muscle relaxant properties. Narcotics may produce significant hemodynamic effects indirectly through the release of histamine and/or blunting of the patient’s sympathetic vascular tone due to analgesic properties. Acutely injured patients may be hypovolemic and in pain, with high sympathetic tone and peripheral resistance. Therefore, such patients can experience a dramatic drop in systemic blood pressure with minimal doses of opioids. All opioids can be reversed with naloxone. Naloxone reversal, however, can be dangerous because the agent acutely reverses not only the analgesic effects of the opioid but also analgesics effects of native opioids. Naloxone treatment has been associated with acute pulmonary edema and myocardial ischemia and should not be used electively to reverse the effects of narcotic. Propofol is a lipid-soluble substitute isopropyl phenol non-narcotic agent that produces rapid induction of anesthesia followed by awakening in four to eight minutes.