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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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Stages of General Anesthesia01:22

Stages of General Anesthesia

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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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General Anesthesia: Overview01:24

General Anesthesia: Overview

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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.
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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Sedatives and Hypnotics: Overview01:23

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Sedatives are drugs that alleviate anxiety, while hypnotics induce sleep. Both classes of medication suppress neuronal activity, leading to a calming effect for sedatives and facilitating sleep for hypnotics.
Sedative-hypnotics are categorized into barbiturates, benzodiazepines (BZDs), and non-benzodiazepines or Z-drugs. These drugs work by suppressing central nervous system activity, and this suppression is dose-dependent. Older sedative medications, like barbiturates, follow a linear curve in...
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Sedatives and Hypnotics Drugs: Miscellaneous Agents01:17

Sedatives and Hypnotics Drugs: Miscellaneous Agents

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Sedatives and Hypnotics Drugs: Benzodiazepines01:19

Sedatives and Hypnotics Drugs: Benzodiazepines

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Benzodiazepines have both sedative and hypnotic properties. They include compounds such as diazepam (Valium) and alprazolam (Xanax). Structurally, their cores are similar, consisting of the fusion of a benzene ring and a diazepine ring, but they share a common mechanism of action in the central nervous system (CNS).
Benzodiazepines work by enhancing the effects of the inhibitory neurotransmitter GABA. They bind to the GABAA receptor, increasing its affinity for GABA, which opens chloride...
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Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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Adult procedural sedation: an update.

Massimo Lamperti1

  • 1Anesthesiology Institute, Cleveland Clinic, Abu Dhabi, Al Maryah Island, Abu Dhabi, UAE.

Current Opinion in Anaesthesiology
|September 11, 2015
PubMed
Summary

Procedural sedation is evolving, with ongoing debate about propofol use by non-anesthesiologists. New alternatives like dexmedetomidine offer improved safety, highlighting the need for specialized training for proceduralists.

Area of Science:

  • Anesthesiology and Critical Care Medicine
  • Pharmacology and Therapeutics
  • Patient Safety and Quality Improvement

Background:

  • The demand for procedural sedation is increasing, necessitating specialized training for healthcare providers.
  • Propofol is widely used but has limitations, especially when administered by non-anesthesiologists due to potential side effects.
  • Recent literature explores alternative sedatives to improve safety and tolerability.

Purpose of the Study:

  • To provide an overview of current procedural sedation practices and evidence.
  • To review emerging alternative drugs for procedural sedation.
  • To discuss the evolving role and training requirements for procedural sedation providers.

Main Methods:

  • Literature review of published studies on procedural sedation.

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  • Analysis of evidence supporting the use of various sedative agents.
  • Examination of ongoing research and future trends in procedural sedation.

    • Main Results:

    • Propofol remains a primary choice, with some studies showing reduced adverse events when used by non-anesthesiologists.
    • Dexmedetomidine is a favored alternative due to its safety profile, including hemodynamic stability and minimal respiratory depression.
    • Other agents like remifentanil, fospropofol, ketofol, and remimazolam are under investigation, but require further evidence for widespread adoption.

    Conclusions:

    • Debate continues regarding propofol administration by non-anesthesiologists.
    • Exploring alternative sedatives and analgesics is crucial for safe procedural sedation.
    • Establishing a clear curriculum for the 'sedationalist' role outside the operating room is a future priority.