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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.
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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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: 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.
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Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

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Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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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.
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Related Experiment Video

Updated: Dec 3, 2025

Novel Approach for Simultaneous Recording of Renal Sympathetic Nerve Activity and Blood Pressure with Intravenous Infusion in Conscious, Unrestrained Mice.
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Anesthetic consideration for patients with micra leadless pacemaker.

Sathappan Karuppiah1, Richard Prielipp1, Ratan K Banik1

  • 1Department of Anesthesiology, University of Minnesota, Minneapolis, MN, USA.

Annals of Cardiac Anaesthesia
|October 28, 2020
PubMed
Summary

The Micra pacemaker, a miniaturized leadless device, can present perioperative challenges due to its unique implantation and lack of external magnet response. Reprogramming is crucial for pacemaker-dependent patients undergoing surgery.

Keywords:
EMIMAGNETMICRA

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Area of Science:

  • Cardiology
  • Medical Devices
  • Electrophysiology

Background:

  • The Micra is a miniaturized, leadless, single-chamber pacemaker implanted directly into the right ventricular myocardium.
  • Transcatheter implantation offers a less invasive approach compared to traditional pacemakers.

Observation:

  • A 66-year-old pacemaker-dependent patient with a Micra device was scheduled for a kidney-pancreas transplant.
  • Preoperative cardiology consultation did not address pacemaker reprogramming needs.
  • The anesthesia team could not locate the pacemaker externally before surgery.

Findings:

  • The Micra pacemaker is embedded within the ventricular wall and is unresponsive to external magnets.
  • The surgical case was delayed to allow for reprogramming of the Micra pacemaker to VOO (fixed ventricular pacing) mode by the cardiac electrophysiology team.

Implications:

  • The novelty and lack of established guidelines for leadless pacemakers like Micra can lead to perioperative challenges.
  • Awareness and proactive management, including reprogramming, are essential for patients with Micra devices undergoing surgery.
  • Further research and clear guidelines are needed to ensure safe perioperative care for patients with novel cardiac implantable electronic devices.