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Related Concept Videos

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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General Anesthesia: Overview01:24

General Anesthesia: Overview

526
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

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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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Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption01:23

Pharmacokinetics in Pediatric Patients: Overview and Drug Absorption

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Understanding the physiological differences in the pediatric population is crucial for effective pharmacotherapy. Neonates, infants, and children exhibit significant variations in gastric pH, gastric emptying time, intestinal transit time, and biliary function. These variations profoundly affect oral drug absorption, necessitating a nuanced approach to pediatric dosing.Neonates present with a unique physiological profile, having a gastric pH greater than 4 and faster and more irregular gastric...
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Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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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.
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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Drug Dosing: Infants and Children01:29

Drug Dosing: Infants and Children

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Pediatric patient dosages diverge from adults due to disparities in body surface area, total body water, and extracellular fluid per kilogram of body weight. The dosing regimen considers the variations in pharmacokinetics and pharmacology across distinct age groups, encompassing preterm newborns, infants, young children, older children, and adolescents. Calculation of pediatric patient doses is predicated on determining body surface area, which exhibits a superior correlation with the child's...
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Guidelines for Elective Pediatric Fiberoptic Intubation
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Experience with Combining Pediatric Procedures into a Single Anesthetic.

Renata M Miketic1, Joshua Uffman1, Dmitry Tumin1

  • 1Nationwide Children's Hospital, Columbus, Ohio.

Pediatric Quality & Safety
|November 21, 2019
PubMed
Summary

Combining multiple surgical procedures under one anesthetic is feasible for children, potentially reducing healthcare costs and parental burdens. This approach minimizes repeated anesthetic exposures for pediatric patients.

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Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Healthcare Management

Background:

  • Combining multiple surgical procedures during a single anesthetic session presents challenges for perioperative teams.
  • Factors to consider include coordinating specialties, parental time and travel, and minimizing anesthetic exposures for children.

Purpose of the Study:

  • To evaluate the feasibility and outcomes of combining multiple surgical procedures within a single anesthetic encounter in pediatric patients.

Main Methods:

  • A retrospective review of electronic medical records at Nationwide Children's Hospital was conducted.
  • Data were collected for patients undergoing two or more procedures involving two or more services during a single anesthetic encounter over one year (July 2015-June 2016).

Main Results:

  • 1,120 patients underwent multiple procedures in a single anesthetic session.
  • The average anesthesia time was 127 minutes, and PACU time was 64 minutes.
  • The unanticipated admission rate was 7.6% (85/1,120), with a higher proportion of patients with ASA status ≥3 in this group.

Conclusions:

  • Combining surgical procedures in a single anesthetic is feasible in pediatric patients.
  • This approach may lead to reduced healthcare costs.
  • It can also decrease parental financial and time obligations.