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Related Concept Videos

Inhalational Anesthetics: Overview01:20

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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...
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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.
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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.
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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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Optogenetic Activation of Afferent Pathways in Brain Slices and Modulation of Responses by Volatile Anesthetics
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Sevoflurane anesthesia and brain perfusion.

Ossam Rhondali1, Caroline André, Agnès Pouyau

  • 1Department of Pediatric Anesthesia, Hôpital Mère-Enfant, Lyon, France; Department of Pediatric Anesthesia, Hôpital Sainte Justine, Montréal, QC, Canada.

Paediatric Anaesthesia
|September 17, 2014
PubMed
Summary
This summary is machine-generated.

Maintaining mean arterial pressure (MAP) above 35 mmHg during sevoflurane anesthesia is likely safe for infants younger than 6 months. Below this threshold, cerebral blood flow and oxygenation may be compromised, increasing neurological risks.

Keywords:
anesthesiablood pressurebrain oxygenationcerebrovascular circulationdrug effectsinfantinhalationnear-infrared spectroscopytranscranial Doppler

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Area of Science:

  • Pediatric Anesthesiology
  • Neurocritical Care
  • Cerebral Physiology

Background:

  • The safe lower limit of blood pressure during infant anesthesia is not well-defined.
  • Anesthesia-induced hypotension can lead to poor neurological outcomes in infants.
  • Limited data exists on the impact of hypotension on cerebral perfusion in infants under 6 months.

Purpose of the Study:

  • To evaluate the effects of sevoflurane anesthesia and hypotension on brain perfusion in infants younger than 6 months.
  • To compare cerebral blood flow (CBF) and brain oxygenation in this vulnerable population.

Main Methods:

  • Retrospective analysis of data from two previous studies involving infants undergoing sevoflurane anesthesia.
  • Utilized transcranial Doppler (TCD) for cerebral blood flow velocity (CBFV) and near-infrared spectroscopy (NIRS) for regional cerebral oxygen saturation (rSO2c).
  • Compared TCD and NIRS measurements against mean arterial pressure (MAP) levels.

Main Results:

  • Cerebral perfusion, indicated by CBFV and rSO2c, was adequate when MAP exceeded 45 mmHg.
  • Between 35-45 mmHg MAP, CBFV decreased, but rSO2c indicated sufficient oxygen supply.
  • Below 35 mmHg MAP, both CBFV decreased and rSO2c showed minimal change, suggesting reduced cerebral metabolic reserve.

Conclusions:

  • Mean arterial pressure (MAP) serves as a reliable indicator of cerebral perfusion in healthy infants during sevoflurane anesthesia.
  • Maintaining MAP above 35 mmHg appears safe for infants undergoing short procedures.
  • MAP below 35 mmHg may indicate compromised cerebral perfusion and increased risk for neurological complications.