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Related Concept Videos

Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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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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Chemotherapy-Induced Nausea and Vomiting: Cannabinoids01:21

Chemotherapy-Induced Nausea and Vomiting: Cannabinoids

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Tetrahydrocannabinol (THC) is a phytocannabinoid that primarily interacts with the CB1 receptor, a type of G protein-coupled receptor (GPCR) predominantly in and around the chemoreceptor trigger zone (CTZ) and emetic center. THC also blocks the serotonin receptor activity in the dorsal vagal complex (DVC) by inhibiting serotonin release. THC exerts its anti-emetic effects through these interactions, which are beneficial for patients undergoing chemotherapy.
Two synthetic agonists of THC,...
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Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

637
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.
637
Local Anesthetics: Mechanism of Action01:23

Local Anesthetics: Mechanism of Action

3.3K
Local anesthetics (LAs) block sensory and motor impulses by inhibiting the sodium channels on the nerve cell membranes. This induces temporary loss of sensation, relieving pain in a specific body area.
Local anesthetics are amphiphilic molecules consisting of a hydrophobic aromatic part linked to a hydrophilic group by an ester or amide linkage. They are weak bases and are usually available as salts, which increases their solubility and stability. Once administered, LAs exist in the body either...
3.3K
Local Anesthetics: Adverse Effects01:12

Local Anesthetics: Adverse Effects

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While local anesthetics are generally safe and well-tolerated, they can occasionally cause adverse effects that vary in severity. Local anesthetics can induce toxicity at two distinct levels. They can either produce local effects through direct contact with the neural elements or be absorbed into the bloodstream from the injection site, leading to systemic effects.
Once absorbed into the systemic circulation, local anesthetics can affect the organs that depend on the functioning of sodium...
781

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Anesthetic implications in hyperthermic intraperitoneal chemotherapy.

Nishkarsh Gupta1, Vinod Kumar1, Rakesh Garg1

  • 1Department of Onco-Anesthesiology and Palliative Medicine, DR BRAIRCH, AIIMS, New Delhi, India.

Journal of Anaesthesiology, Clinical Pharmacology
|May 7, 2019
PubMed
Summary
This summary is machine-generated.

Hyperthermic intraperitoneal chemotherapy following cytoreductive surgery offers hope for peritoneal carcinomatosis patients. This approach requires careful perioperative management to address anesthetic challenges and potential complications.

Keywords:
Anesthesiafluid managementhyperthermic intraperitoneal chemotherapypostoperative care

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Area of Science:

  • Oncology
  • Surgical Oncology
  • Anesthesiology

Background:

  • Peritoneal carcinomatosis was historically considered incurable with poor survival rates.
  • The advent of hyperthermic intraperitoneal chemotherapy (HIPEC) after cytoreductive surgery (CRS) has improved outcomes.
  • Perioperative management for CRS + HIPEC is complex and critical for patient success.

Purpose of the Study:

  • To highlight the critical perioperative concerns in patients undergoing cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  • To discuss anesthetic challenges associated with this complex procedure.
  • To outline postoperative management strategies for patients with peritoneal carcinomatosis.

Main Methods:

  • Review of perioperative management strategies for cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
  • Identification of key anesthetic considerations including fluid management, hemodynamic stability, thermoregulation, and coagulation.
  • Discussion of chemotherapeutic drug toxicity, particularly renal toxicity, and postoperative care.

Main Results:

  • Anesthetic management requires meticulous attention to fluid balance, blood pressure, body temperature, and electrolyte levels.
  • Coagulation status must be closely monitored and managed.
  • Potential renal toxicity from chemotherapeutic agents necessitates vigilant postoperative monitoring and management.

Conclusions:

  • Optimal cytoreductive surgery followed by hyperthermic intraperitoneal chemotherapy offers a viable treatment for peritoneal carcinomatosis.
  • Comprehensive perioperative care, addressing anesthetic complexities and potential toxicities, is essential for successful outcomes.
  • Effective postoperative management is crucial for mitigating complications and supporting patient recovery.