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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.
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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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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: 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.
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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

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Intravenous regional anesthesia or the Bier block technique is used to anesthetize a specific limb or extremity. It uses exsanguinated or blood-drained vessels to transport local anesthetics or LAs to the peripheral nerve trunks. Lidocaine without vasoconstrictors like epinephrine is most commonly used for this technique. Other drugs used are prilocaine, ropivacaine, and chloroprocaine. Bupivacaine is not recommended for this technique due to its high cardiac toxicity.
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Social psychologists have documented that feeling good about ourselves and maintaining positive self-esteem is a powerful motivator of human behavior (Tavris & Aronson, 2008). In the United States, members of the predominant culture typically think very highly of themselves and view themselves as good people who are above average on many desirable traits (Ehrlinger, Gilovich, & Ross, 2005). Often, our behavior, attitudes, and beliefs are affected when we experience a threat to our...
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A Personalized 3D-Printed Model for Preoperative Evaluation in Thyroid Surgery
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Preoperative anesthesia evaluation.

Joseph D Tobias1

  • 1Department of Anesthesiology & Pain Medicine, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH, United States; The Ohio State University, Columbus 43205, OH, United States.

Seminars in Pediatric Surgery
|March 18, 2018
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Summary

The preoperative evaluation for pediatric patients has evolved, often occurring on the day of surgery via phone or online surveys. This process ensures safe anesthetic care by assessing patient status and planning interventions.

Keywords:
AnesthesiaBlood productPreoperative testing

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Area of Science:

  • Anesthesiology
  • Pediatric Surgery

Background:

  • The preoperative evaluation is critical for safe anesthetic care in pediatric patients.
  • Historically, patients were admitted the night before surgery, but now most arrive on the day of surgery, even for major procedures.

Purpose of the Study:

  • To review the essential components of the preoperative evaluation for pediatric patients.
  • To discuss the appropriate use of preoperative laboratory testing, investigative procedures, and radiologic imaging.
  • To highlight the importance of the airway examination in the preoperative assessment.

Main Methods:

  • The preoperative evaluation process has shifted towards remote assessments (phone, online surveys) to streamline care.
  • Information gathered includes current patient status, comorbid conditions, and the intended surgical procedure.
  • This evaluation identifies patients needing further testing or consultation with an anesthesiologist.

Main Results:

  • The preoperative evaluation facilitates identification of patients requiring additional testing or specialist consultation.
  • Decisions regarding necessary laboratory work-up and investigative procedures are made during this phase.
  • The process allows for discussion of anesthetic risks, the anesthetic plan, and postoperative analgesia options.

Conclusions:

  • The modern preoperative evaluation is adaptable, often conducted remotely, and essential for optimizing perioperative care.
  • It helps minimize surgical cancellations due to patient-related issues.
  • A thorough evaluation, including physical and airway examination, is key to safe pediatric anesthesia.