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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.
Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
Inhalational Anesthetics: Overview01:20

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...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
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...

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Recent advances in pediatric anesthesia.

Josef Holzki1

  • 1Emeritus, Department of Paediatric Anaesthesia, Children's Hospital Cologne, Germany.

Korean Journal of Anesthesiology
|July 1, 2011
PubMed
Summary

Pediatric anesthesia has seen significant progress, but this advancement came at a considerable cost to patient health and survival. Experienced anesthesiologists reflect on the painful reality behind decades of pediatric anesthesia development.

Area of Science:

  • Anesthesiology
  • Pediatric Medicine

Background:

  • Medical advancements are often celebrated with pride.
  • However, a retrospective view of pediatric anesthesia reveals a history marked by patient harm and mortality.
  • This critical perspective is often overlooked in celebratory accounts of progress.

Purpose of the Study:

  • To provide a realistic and critical reflection on the historical progress of pediatric anesthesia.
  • To highlight the often-unacknowledged patient costs associated with advancements in the field.
  • To ensure that the negative consequences of past developments are not forgotten.

Main Methods:

  • Retrospective analysis of decades of clinical experience in pediatric anesthesia.
  • Qualitative reflection on patient outcomes and the evolution of anesthetic practices.
Keywords:
Advances pediatric regional intravenous anesthesia

Related Experiment Videos

  • Literature review focusing on the documented and undocumented impacts of anesthetic advancements.

    • Main Results:

    • Progress in pediatric anesthesia has been associated with significant patient morbidity and mortality.
    • The human cost of these advancements is substantial and often underreported.
    • Decades of practice reveal a painful reality behind the celebrated progress.

    Conclusions:

    • A critical and realistic appraisal of pediatric anesthesia history is essential.
    • The experiences of seasoned anesthesiologists highlight the need to acknowledge patient suffering as a consequence of medical progress.
    • Future advancements must prioritize patient safety and learn from past adverse outcomes.