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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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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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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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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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Fetal Circulation01:14

Fetal Circulation

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Fetal circulation is a unique system that facilitates the exchange of gases, nutrients, and waste products between the developing fetus and the mother. This intricate process takes place through a special organ called the placenta.
Two umbilical arteries transport blood from the fetus to the placenta. At the placenta, the blood absorbs oxygen and nutrients while simultaneously eliminating waste products. This oxygen-enriched and nutrient-rich blood then returns to the fetus through one...
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Instrumentation of Near-term Fetal Sheep for Multivariate Chronic Non-anesthetized Recordings
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New Trends in Fetal Anesthesia.

Kha M Tran1, Debnath Chatterjee2

  • 1University of Pennsylvania Perelman School of Medicine, Center for Fetal Diagnosis and Treatment, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.

Anesthesiology Clinics
|August 15, 2020
PubMed
Summary
This summary is machine-generated.

Fetal anesthesia requires understanding complex disease pathophysiology for diverse surgical interventions. Anesthetic plans must adapt to procedure type, gestational timing, and dual-patient monitoring needs.

Keywords:
EXITFetal anesthesiaFetal surgeryPRESTO

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Area of Science:

  • Anesthesiology
  • Maternal-Fetal Medicine
  • Fetal Surgery

Background:

  • Fetal surgical interventions are increasing, necessitating specialized anesthetic care.
  • Anesthetic management must consider the unique physiology of both the mother and the fetus.
  • Disease processes vary, requiring tailored treatment rationales.

Purpose of the Study:

  • To outline the critical considerations for anesthetic management in fetal surgery.
  • To emphasize the need for adaptable anesthetic plans based on procedural and gestational factors.
  • To highlight advanced anesthetic techniques for optimizing fetal outcomes.

Main Methods:

  • Review of current anesthetic practices for fetal interventions.
  • Analysis of disease pathophysiology and treatment strategies.
  • Description of anesthetic techniques, including moderate sedation to general anesthesia.
  • Discussion of advanced monitoring and pharmacological interventions.

Main Results:

  • Anesthetic plans must be individualized for minimally invasive procedures to major fetal surgery.
  • Gestational timing (early, mid-, late) significantly impacts anesthetic approach.
  • Comprehensive monitoring (dual-patient, invasive blood pressure) and advanced pharmacology are crucial.
  • Fluid restriction and vasopressor use are key components of management.

Conclusions:

  • Fetal anesthesia teams require deep understanding of disease pathophysiology and treatment.
  • Anesthetic plans must evolve with refined surgical techniques and patient needs.
  • Optimizing fetal cardiac function through advanced anesthetic choices is paramount for successful outcomes.