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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

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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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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

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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...
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Analgesia and Pain Management01:25

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Skeletal Muscle Relaxants: Therapeutic Uses01:31

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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

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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...
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Local Anesthetics: Differential Sensitivity of Nerve Fibers01:24

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Local anesthetics (LAs) block the sodium channels of nerve trunks, sensory nerve endings, and neuromuscular junctions. Although LAs can block all kinds of nerves, the sensitivity of nerve fibers differs according to nerve types and structures. LAs are known to block myelinated fibers faster than unmyelinated ones. Also, they block pain or sensory neurons at low concentrations without affecting the motor neurons involved in muscle contractions. This helps relieve labor pain without affecting the...
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A Preterm Rat Model for Pain Studies
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Pain management in newborns.

Richard W Hall1, Kanwaljeet J S Anand2

  • 1Department of Pediatrics/Neonatology, University of Arkansas Hospital, 4305 West Markham Street, Little Rock, AR 72205, USA.

Clinics in Perinatology
|December 3, 2014
PubMed
Summary
This summary is machine-generated.

Effective pain management for newborns is crucial for improving clinical and neurodevelopmental outcomes. This involves validated assessment tools and therapeutic approaches, including nonpharmacologic and pharmacologic methods.

Keywords:
AnalgesiaInfant-newbornNICUPainSedationStress

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Area of Science:

  • Neonatal care
  • Pediatric pain management
  • Neurodevelopmental outcomes

Background:

  • Effective pain management is a standard of care for preterm/term newborns.
  • Pain assessment in neonates utilizes context-specific, validated, and objective methods, acknowledging current tool limitations.
  • Therapeutic strategies aim to reduce invasive procedures and manage neonatal pain through pharmacologic, behavioral, or environmental interventions.

Purpose of the Study:

  • To review current standards of care for neonatal pain management.
  • To highlight the importance of effective pain management for clinical and neurodevelopmental outcomes in newborns.
  • To discuss various therapeutic approaches for managing neonatal pain.

Main Methods:

  • Review of nonpharmacologic approaches including kangaroo care, facilitated tucking, and non-nutritive sucking for procedural pain or adjunctive therapy.
  • Discussion of pharmacologic agents such as local/topical anesthetics, opioids, NSAIDs/acetaminophen, and sedatives/anesthetics for moderate/severe pain or distress.
  • Integration of these methods into Neonatal Intensive Care Unit (NICU) protocols.

Main Results:

  • Nonpharmacologic methods are effective for procedural pain and as adjunctive therapies.
  • Pharmacologic agents are essential for managing moderate to severe pain and distress in newborns.
  • A multimodal approach combining various strategies is key to comprehensive neonatal pain management.

Conclusions:

  • Optimizing neonatal pain management through validated assessments and therapeutic interventions is vital for improved patient outcomes.
  • Both nonpharmacologic and pharmacologic strategies play critical roles in a comprehensive neonatal pain management plan.
  • Continued research and protocol refinement are necessary to address the complexities of neonatal pain.