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Related Concept Videos

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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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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Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy01:26

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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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General Anesthesia: Overview01:24

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

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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.
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Parenteral Anesthetics: Overview01:24

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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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Updated: Nov 16, 2025

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Procedural episode-based cost measures: anesthesia matters.

Alice A Tolbert Coombs1

  • 1Department of Anesthesiology and Critical Care Medicine, Associate Professor, Virginia Commonwealth University, Medical College of Virginia, Richmond, Virginia, USA.

Current Opinion in Anaesthesiology
|February 19, 2021
PubMed
Summary
This summary is machine-generated.

Episode-based cost measures (EBCM) are increasingly used by CMS for physician payments. Anesthesiologists must understand EBCM to manage costs, improve quality, and ensure practice viability.

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Area of Science:

  • Healthcare economics
  • Anesthesiology practice management

Background:

  • Episode-based cost measures (EBCM) bundle all healthcare services for a specific condition or procedure.
  • Procedural EBCM is a significant factor in healthcare payment models and quality assessment.

Purpose of the Study:

  • To inform anesthesiologists about the impact of EBCM on their clinical practice.
  • To highlight the importance of understanding cost attribution in anesthetic management.

Main Methods:

  • Review of Centers for Medicare and Medicaid Services (CMS) payment methodologies.
  • Analysis of the role of EBCM in current healthcare spending.

Main Results:

  • EBCM represents 4.5% of Medicare Part A and B spending, with increasing adoption.
  • Cost attribution under EBCM identifies all services and complications related to anesthetic management.

Conclusions:

  • EBCM directly influences anesthesiologists' quality performance, efficiency metrics, and reimbursement.
  • Understanding EBCM is crucial for anesthesiologists to maintain practice viability and adapt to evolving payment structures.