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Related Concept Videos

General Anesthesia: Overview01:24

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...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy
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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...
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.
Stages of General Anesthesia01:22

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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...
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Aneurysm IV: Nursing Management

Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...

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Non-Intubated Video-Assisted Thoracoscopic Surgery
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Published on: May 26, 2023

Anaesthesia for bariatric surgery.

Roman Schumann1

  • 1Tufts Medical Center, Department of Anaesthesiology, Tufts University School of Medicine, 800 Washington St., Boston, MA 02111, USA. rschumann@tuftsmedicalcenter.org

Best Practice & Research. Clinical Anaesthesiology
|April 27, 2011
PubMed
Summary
This summary is machine-generated.

This review provides evidence-based anesthetic guidelines for bariatric surgery patients, focusing on airway management, pain control, and the safety of outpatient procedures for sleep apnea patients. Key recommendations include specific patient positioning and positive end-expiratory pressure (PEEP) use.

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Published on: June 25, 2013

Area of Science:

  • Anesthesiology
  • Bariatric Surgery
  • Sleep Medicine

Background:

  • Limited comprehensive systematic reviews exist for anesthetic care in bariatric surgery.
  • Existing evidence often relies on expert opinion rather than robust studies.
  • Bariatric patients frequently present with comorbidities like sleep-disordered breathing.

Purpose of the Study:

  • To systematically review and summarize evidence on anesthetic care for bariatric surgical patients.
  • To provide recommendations on pre-anesthesia evaluation, intraoperative management, and postoperative care.
  • To assess the feasibility and safety of outpatient bariatric surgery.

Main Methods:

  • Systematic literature review of studies concerning anesthetic care in bariatric surgery.
  • Analysis of evidence regarding pre-anesthesia evaluation, airway management, anesthesia maintenance, and pain control.
  • Evaluation of clinical-care pathways and outpatient bariatric surgery feasibility.

Main Results:

  • Recommended anesthetic induction includes a 'ramped' position and positive end-expiratory pressure (PEEP).
  • Intraoperative hypoxemia management involves PEEP and recruitment maneuvers; critical airway management at emergence is highlighted.
  • Multimodal, opioid-sparing analgesia incorporating local anesthetics and NSAIDs is advised.
  • Bariatric clinical-care pathways appear beneficial.
  • Outpatient bariatric surgery may be safe for select procedures with strict adherence to protocols, despite sleep apnea prevalence.

Conclusions:

  • Evidence-based anesthetic guidelines are crucial for bariatric surgery patients.
  • Specific techniques like PEEP and careful airway management improve intraoperative and emergence safety.
  • Multimodal analgesia and clinical pathways enhance patient outcomes.
  • Outpatient bariatric surgery requires careful patient selection and adherence to safety protocols.