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Parenteral Anesthetics: Overview

Parenteral Anesthetics: Overview

Intravenous anesthetics are drugs administered parenterally to induce anesthesia or sedation. Propofol is a widely used agent formulated as a 1% emulsion in soybean oil, glycerol, and egg phosphatide. It induces rapid anesthesia primarily due to its rapid distribution from the bloodstream to target tissues and is metabolized in the liver. However, it can cause significant pain on injection and hypertriglyceridemia. Fospropofol, a water-based prodrug of propofol, lacks these adverse effects.

Stages of General Anesthesia

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...

Inhalational Anesthetics: Overview

Inhalational Anesthetics: Overview

Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...

General Anesthesia: Overview

General Anesthesia: Overview

Anesthesia is a medical procedure that uses drugs for CNS suppression to enable painless surgeries and procedures. The selection of anesthetics is influenced by their pharmacokinetic properties, side effects, and patient characteristics. Various types of anesthesia include general, local, regional, spinal, and inhalational.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...

Local Anesthetics: Clinical Application as Epidural Anesthesia

Local Anesthetics: Clinical Application as Epidural Anesthesia

Epidural anesthetics are administered in the fat-filled epidural space, the outermost part of the spinal canal. This technique is commonly employed for pain management and anesthesia during lower abdomen and pelvis surgeries or labor and delivery.
Since epidural anesthetics can be infused through an epidural catheter, all types of drugs, including short-acting ones, can be administered. Chloroprocaine and lidocaine are examples of short and long-duration anesthetics, respectively. Bupivacaine...

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal Muscle Relaxants: Therapeutic Uses

Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx as...

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Updated: Jul 13, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation

Guidelines for Elective Pediatric Fiberoptic Intubation

Published on: January 17, 2011

Non-anesthesiologist-provided pediatric procedural sedation: an update.

James H Hertzog¹, Jeana E Havidich

¹Department of Anesthesiology and Critical Care Medicine, Alfred I duPont Hospital for Children, Wilmington, DE, USA. jhertzog@nemours.org

Current Opinion in Anaesthesiology

|July 11, 2007

Summary

Pediatric procedural sedation by non-anesthesiologists is growing. Recent guidelines and multicenter studies offer insights into safer, more efficient sedation systems, emphasizing collaboration for optimal patient care.

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Guidelines for Elective Pediatric Fiberoptic Intubation

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Area of Science:

Pediatric Anesthesiology
Procedural Sedation
Healthcare Quality Improvement

Background:

Pediatric procedural sedation outside the operating room is increasingly managed by non-anesthesiologist providers.
Evidence in this area has historically been limited by small studies.

Purpose of the Study:

To review the past year's literature on pediatric procedural sedation.
To focus on sedation practices performed by non-anesthesiologist healthcare providers.

Main Methods:

Literature review of the past year's publications.
Analysis of guideline revisions, safety initiatives, and study designs.
Evaluation of multicenter studies and specific agents like dexmedetomidine and etomidate.

Main Results:

Despite limited data, recent developments include guideline updates and safety initiatives.
Research is exploring tiered sedation systems and novel agents (dexmedetomidine, etomidate).
A large multicenter study provides valuable data on adverse events in pediatric procedural sedation.

Conclusions:

The practice of pediatric procedural sedation by non-anesthesiologists is expanding.
Developing uniform practices through understanding sedation system elements is crucial.
Collaboration between anesthesiologists and non-anesthesiologists is vital for achieving shared goals in patient care.