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Related Concept Videos

Parenteral Anesthetics: Overview01:24

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.
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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...
Analgesia and Pain Management01:25

Analgesia and Pain Management

Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
One of the advantages of...
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

Spinal anesthetics are given during lower abdomen and limb surgeries to block sensory and motor neurons. They are administered in the mid to low lumbar regions, primarily acting on the cauda equina's nerve roots. The blockade level depends on the local anesthetic (LA) concentration. Usually, low LA concentrations are sufficient to block sensory fibers, while only high LA concentrations block motor fibers. Other factors like injection volume and speed, the patient's posture, and the drug...

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Related Experiment Videos

Pain on injection with microemulsion propofol.

Ji-Yeon Sim1, Soo-Han Lee, Do-Yang Park

  • 1Department of Anesthesiology and Pain Medicine, Asan Medical Centre, University of Ulsan College of Medicine, Seoul, Korea.

British Journal of Clinical Pharmacology
|February 18, 2009
PubMed
Summary

Microemulsion propofol causes more injection pain than lipid emulsion propofol due to higher free propofol concentrations. Pain reduction agents may not work by lowering free propofol levels.

Related Experiment Videos

Area of Science:

  • Anesthesiology
  • Pharmacology

Background:

  • Propofol is a widely used anesthetic agent.
  • Injection pain is a common side effect of propofol administration.
  • Different propofol formulations exist, including microemulsion and lipid emulsion.

Purpose of the Study:

  • To compare the incidence and severity of injection pain between microemulsion propofol and lipid emulsion propofol.
  • To investigate the relationship between injection pain, plasma bradykinin generation, and aqueous free propofol concentrations.

Main Methods:

  • 147 patients were evaluated for injection pain.
  • Aqueous free propofol concentrations were measured using high-performance liquid chromatography.
  • Plasma bradykinin concentrations were measured by radioimmunoassays.

Main Results:

  • Microemulsion propofol caused significantly more frequent (69.7% vs 42.3%) and severe injection pain (median VAS 59 mm vs 24 mm) compared to lipid emulsion propofol.
  • Aqueous free propofol concentration was seven times higher in microemulsion propofol.
  • Microemulsion propofol and PEG660 HS increased plasma bradykinin, while lipid emulsion propofol did not.

Conclusions:

  • Higher aqueous free propofol concentrations in microemulsion propofol are associated with increased injection pain.
  • The plasma kallikrein-kinin system may not be the primary mediator of propofol-induced pain.
  • Agents reducing injection pain may not function by decreasing aqueous free propofol concentrations.