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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...

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.

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...

Local Anesthetics: Clinical Application as Spinal Anesthesia

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...

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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...

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Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Spinal Sonography for Ultrasound-Guided Lumbar Neuraxial Anesthesia

Published on: January 31, 2025

[Obstetric anesthesia: from historical perspective to current practice--preface and comments].

Yoshitsugu Yamada¹

¹Department of Anesthesiology, Graduate School of Medicine, The University of Tokyo, Tokyo 113-8655.

Masui. the Japanese Journal of Anesthesiology

|March 17, 2010

Summary

Japan faces obstetric care challenges due to obstetrician shortages. Anesthesiologists play a crucial role in improving maternal and child safety through team-based approaches in labor and delivery.

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Area of Science:

Obstetrics and Gynecology
Anesthesiology
Healthcare Management

Context:

Significant social issues in Japan's obstetric care, particularly concerning labor and delivery.
Media attention highlights a critical shortage of obstetricians, attributed to demanding work hours and high-stress hospital environments.
Increasing societal demand underscores the importance of anesthesiologists' contributions to obstetric care.

Purpose:

To provide a comprehensive overview of anesthesiologists' roles in obstetric care.
To cover essential aspects from historical context to current practice standards in obstetric anesthesia.
To emphasize the need for a coordinated team approach in obstetric care.

Summary:

This special issue addresses the critical shortage of obstetricians in Japan and the increasing demand for obstetric anesthesia services.
Articles delve into the historical perspectives and current practice standards of anesthesiologists in labor and delivery.
The importance of collaboration among obstetricians, anesthesiologists, pediatricians, and nurses is highlighted to enhance care quality and safety.

Impact:

Establishing effective team-based systems through interdisciplinary communication is vital.
Improved collaboration among healthcare professionals will lead to higher quality and safer care for mothers and newborns.
Addressing the shortage of obstetricians and optimizing the roles of anesthesiologists can mitigate current challenges in obstetric services.