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Related Concept Videos

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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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
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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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Local Anesthetics: Chemistry and Structure-Activity Relationship01:30

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Local anesthetics (LAs) are drugs that induce a temporary loss of sensation in a limited body area, preventing pain. Cocaine was the first local anesthetic discovered in the late 19th century. Cocaine is a benzoic acid ester obtained from the leaves of coca shrubs and was often used for its psychotropic effects. Cocaine was first isolated in 1860 by Albert Niemann. Sigmund Freud studied the physiological actions of cocaine. Carl Koller later introduced it into clinical practice in 1884 as a...
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Suctioning the Nasopharyngeal Airway01:29

Suctioning the Nasopharyngeal Airway

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Nasopharyngeal suctioning is a procedure to remove secretions from the upper part of the respiratory tract that the patient cannot clear independently. It helps maintain airway patency and prevents complications such as aspiration pneumonia.
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Updated: Mar 9, 2026

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
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Anesthesia for functional endoscopic sinus surgery.

Daniel A Carlton1, Satish Govindaraj

  • 1Department of Otolaryngology - Head and Neck Surgery at Icahn School of Medicine at Mount Sinai, New York, New York, USA.

Current Opinion in Otolaryngology & Head and Neck Surgery
|December 23, 2016
PubMed
Summary
This summary is machine-generated.

Total intravenous anesthesia is favored for endoscopic sinus surgery to reduce bleeding and improve surgical field clarity. This technique, using propofol and remifentanil, offers hemodynamic stability and faster patient recovery.

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Area of Science:

  • Anesthesiology
  • Otolaryngology
  • Surgical Innovation

Background:

  • Functional endoscopic sinus surgery (FESS) requires optimal surgical conditions, including reduced bleeding and clear visualization.
  • Anesthetic management plays a critical role in achieving these conditions.

Purpose of the Study:

  • To review anesthetic techniques for FESS aimed at minimizing bleeding and enhancing the surgical field.
  • To discuss the physiological basis of these techniques, focusing on their impact on bleeding and surgical field quality.

Main Methods:

  • Review of existing literature on anesthetic strategies for FESS.
  • Discussion of deliberate hypotension, reverse Trendelenburg positioning, regional anesthesia, and cerebral monitoring.
  • Comparative analysis of inhalation anesthesia versus total intravenous anesthesia.

Main Results:

  • Literature review shows mixed results regarding inhalation vs. total intravenous anesthesia for surgical field quality and blood loss.
  • A trend favors total intravenous anesthesia (TIVA) in current literature.
  • Cerebral oximetry and transcranial Doppler ultrasound are emerging methods for monitoring cerebral perfusion during induced hypotension.

Conclusions:

  • Total intravenous anesthesia (TIVA) with propofol and remifentanil is the preferred method for deliberate hypotension in FESS.
  • This technique provides hemodynamic stability and facilitates rapid patient emergence.
  • TIVA contributes to improved surgical outcomes in endoscopic sinus surgery.