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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

677
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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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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

Local Anesthetics: Clinical Application as Epidural Anesthesia

753
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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Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

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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.
One of the advantages of...
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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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Pseudofracture: An Acute Peripheral Tissue Trauma Model
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Anesthesia for Trauma Patients.

Joshua M Tobin1, William P Barras1, Stephen Bree1

  • 1Joint Trauma System, 3698 Chambers Pass, Joint Base San Antonio, Fort Sam Houston, TX.

Military Medicine
|September 7, 2018
PubMed
Summary
This summary is machine-generated.

This clinical practice guideline offers a template for anesthetic management of trauma patients undergoing surgery. It integrates anesthesia induction and maintenance with ongoing resuscitation for critically injured patients.

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Area of Science:

  • Anesthesiology
  • Trauma Surgery
  • Critical Care Medicine

Background:

  • Understanding combat trauma pathophysiology has advanced, influencing anesthetic care for surgical trauma patients.
  • Anesthetic management for trauma patients requires pre-operative preparation, including OR warming and medication setup.
  • Hemodynamic instability and airway trauma are key considerations during anesthetic induction and intubation.

Purpose of the Study:

  • To provide a clinical practice guideline for anesthetic management of combat trauma patients.
  • To outline a template integrating anesthesia with resuscitation during surgery for trauma patients in extremis.
  • To improve the continuum of care for trauma patients from the operating room to the intensive care unit.

Main Methods:

  • Anesthesia induction accounting for potential hemodynamic instability and airway trauma.
  • Anesthesia maintenance using anesthetic gas, intravenous infusions, or a combination.
  • Simultaneous resuscitation, including blood product transfusion, antibiotics, and pharmacologic adjuncts like tranexamic acid and calcium.
  • Initiation of ventilatory strategies to mitigate lung injury in the operating room.
  • Transition of resuscitation to the intensive care setting post-operatively.

Main Results:

  • The guideline outlines a method for anesthetic care that incorporates induction and maintenance into ongoing resuscitation.
  • It emphasizes simultaneous management of anesthesia and resuscitation, including blood products and pharmacologic adjuncts.
  • Effective communication and transition of care are highlighted as vital for patient outcomes.

Conclusions:

  • The guideline provides a template for anesthetic management of trauma patients in extremis.
  • Integrating anesthesia with resuscitation is crucial for optimizing care during surgery.
  • Improved understanding of trauma pathophysiology guides contemporary anesthetic practices.