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Related Concept Videos

General Anesthesia: Overview01:24

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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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Parenteral Anesthetics: Overview01:24

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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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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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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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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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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.
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[Shivering associated with general anesthesia using remifentanil].

Kenichiro Koda, Takayuki Kitamura, Megumi Tagami

    Masui. the Japanese Journal of Anesthesiology
    |September 27, 2014
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    Summary
    This summary is machine-generated.

    Post-operative shivering after remifentanil anesthesia is common and has two types: thermoregulatory and non-thermoregulatory. A multimodal approach is likely needed to prevent shivering, addressing both hypothermia and opioid withdrawal.

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    Area of Science:

    • Anesthesiology
    • Pharmacology

    Background:

    • General anesthesia with remifentanil frequently causes post-operative shivering.
    • Shivering is categorized as thermoregulatory (due to hypothermia) or non-thermoregulatory (due to opioid withdrawal or pain).
    • General anesthesia can alter thermoregulatory thresholds, potentially exaggerating shivering even without hypothermia.

    Purpose of the Study:

    • To explore the mechanisms of post-operative shivering following remifentanil anesthesia.
    • To identify strategies for preventing both thermoregulatory and non-thermoregulatory shivering.

    Main Methods:

    • Review of mechanisms of thermoregulatory and non-thermoregulatory shivering.
    • Discussion of potential preventive treatments including patient warming, NSAIDs, opioid transition, and other pharmacological agents.

    Main Results:

    • Thermoregulatory shivering can be exacerbated by altered temperature thresholds post-anesthesia.
    • Non-thermoregulatory shivering is linked to remifentanil's rapid offset causing opioid withdrawal and to post-operative pain.
    • Patient warming and NSAIDs may prevent thermoregulatory shivering; opioid transition and agents like magnesium, ketamine, and pethidine may prevent non-thermoregulatory shivering.

    Conclusions:

    • The complex mechanisms of post-operative shivering after remifentanil anesthesia necessitate a multimodal prevention strategy.
    • Addressing both thermoregulatory and non-thermoregulatory components is crucial for effective management.