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Related Concept Videos

Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

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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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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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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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Skeletal Muscle Relaxants: Therapeutic Uses01:31

Skeletal Muscle Relaxants: Therapeutic Uses

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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 Surface, Infiltration, and Conduction Block Anesthesia01:30

Local Anesthetics: Clinical Application as Surface, Infiltration, and Conduction Block Anesthesia

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Depending on the target organ, local anesthetics (LAs) can be administered via various routes. In surface anesthesia, LAs are applied directly to the surface of the skin or mucous membranes. It is widely used for topical skin numbing before venipuncture or minor surgical procedures. Commonly used surface local anesthetics are lidocaine or benzocaine sprays or creams. Surface anesthesia occurs within 5 minutes and lasts for about 60 minutes. One of the main disadvantages of topical anesthesia is...
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Related Experiment Video

Updated: Mar 30, 2026

Recording Brain Electromagnetic Activity During the Administration of the Gaseous Anesthetic Agents Xenon and Nitrous Oxide in Healthy Volunteers
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Nitrous oxide-based techniques versus nitrous oxide-free techniques for general anaesthesia.

Rao Sun1, Wen Qin Jia, Peng Zhang

  • 1Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University, Lanzhou City, China.

The Cochrane Database of Systematic Reviews
|November 7, 2015
PubMed
Summary

Nitrous oxide anesthesia increased pulmonary atelectasis but did not affect overall mortality or other major complications. Avoiding nitrous oxide may benefit patients with poor lung function or high risk of nausea.

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Pulmonology

Background:

  • Nitrous oxide has been a widely used anesthetic for over 160 years due to its low cost and cardiorespiratory safety.
  • Concerns exist regarding adverse effects, including compromised oxygen delivery, immune function, cognition, and potential cardiovascular or respiratory issues.
  • High concentrations of nitrous oxide are often required, potentially limiting oxygen supply.

Purpose of the Study:

  • To compare outcomes between nitrous oxide-based anesthesia and nitrous oxide-free anesthesia in adult surgical patients.
  • To evaluate the impact of nitrous oxide on in-hospital mortality, complications, and length of stay.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials (RCTs) were conducted.
  • Searches included major databases (Cochrane CENTRAL, MEDLINE, EMBASE, Web of Science) and trial registries.
  • Data from 24 trials involving 13,872 participants were synthesized, with primary outcome being in-hospital case fatality rate.

Main Results:

  • Nitrous oxide-based anesthesia was associated with an increased incidence of pulmonary atelectasis (OR 1.57, 95% CI 1.18-2.10).
  • No significant differences were found in in-hospital mortality, pneumonia, myocardial infarction, stroke, nausea/vomiting, or length of hospital stay.
  • Quality of evidence ranged from high (pulmonary atelectasis, myocardial infarction) to low (pneumonia, nausea/vomiting, wound infection).

Conclusions:

  • Avoidance of nitrous oxide may be prudent for patients with pre-existing pulmonary dysfunction or those at high risk for postoperative nausea and vomiting.
  • Potential selection bias exists due to eight studies awaiting classification.