Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

343
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.
343
Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

536
Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
536
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

541
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...
541
General Anesthesia: Overview01:24

General Anesthesia: Overview

332
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...
332
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

909
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...
909
Stages of General Anesthesia01:22

Stages of General Anesthesia

954
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...
954

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

A Self-administered Preoperative Visual Paired Comparison Task Is Associated With Postanesthesia Care Unit Delirium.

Journal of neurosurgical anesthesiology·2026
Same author

Reframing Electroencephalography for Liver Transplantation: A Perioperative Perspective.

Anesthesia and analgesia·2026
Same author

Association of Postoperative Cumulative Fluid Balance and Outcomes Following Elective Cardiac Surgery.

Anesthesia and analgesia·2025
Same author

Jump On It! The Association of Physical Therapy Timing and Frequency With Functional Outcomes in Patients Supported With Extracorporeal Membrane Oxygenation: A Single-Center Retrospective Study.

Critical care explorations·2025
Same author

Venovenous Extracorporeal Membrane Oxygenation Cannulation by Intensivists and Surgeons: A Single-Center Retrospective Noninferiority Analysis of Complications and Outcomes From 2018 to 2023.

Critical care medicine·2025
Same author

The effects of physician stigma and hesitancy with opioids on patient pain care in the United States: A survey study.

Journal of opioid management·2025

Related Experiment Video

Updated: Oct 21, 2025

Chronic Cranial Window Technique for Repeated Cortical Recordings During Anesthesia in Pigs
07:12

Chronic Cranial Window Technique for Repeated Cortical Recordings During Anesthesia in Pigs

Published on: June 6, 2025

203

Opioid-Free Anesthesia for Craniotomy.

Ian L McCullough1, Jack W Shteamer1, Andrew M Erwood2

  • 1Departments of Anesthesiology.

Journal of Neurosurgical Anesthesiology
|September 1, 2021
PubMed
Summary

Opioid-free anesthesia (OFA) is feasible for craniotomy, showing noninferior opioid consumption and pain scores. Further trials are needed to confirm its effectiveness in reducing postoperative pain and improving emergence from anesthesia.

More Related Videos

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

1.9K
A Craniotomy Surgery Procedure for Chronic Brain Imaging
09:25

A Craniotomy Surgery Procedure for Chronic Brain Imaging

Published on: February 15, 2008

64.8K

Related Experiment Videos

Last Updated: Oct 21, 2025

Chronic Cranial Window Technique for Repeated Cortical Recordings During Anesthesia in Pigs
07:12

Chronic Cranial Window Technique for Repeated Cortical Recordings During Anesthesia in Pigs

Published on: June 6, 2025

203
Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
05:39

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia

Published on: May 26, 2023

1.9K
A Craniotomy Surgery Procedure for Chronic Brain Imaging
09:25

A Craniotomy Surgery Procedure for Chronic Brain Imaging

Published on: February 15, 2008

64.8K

Area of Science:

  • Neurosurgery
  • Anesthesiology
  • Pain Management

Background:

  • Perioperative opioids pose risks in craniotomy, potentially causing sedation and masking complications.
  • Multimodal anesthetic techniques offer opioid-free options but lack craniotomy-specific data.

Purpose of the Study:

  • To evaluate the feasibility and noninferiority of an opioid-free anesthetic (OFA) technique for supratentorial craniotomy.
  • To compare opioid consumption and pain scores between OFA and conventional opioid-based anesthesia.

Main Methods:

  • A pilot study involving six patients undergoing supratentorial craniotomy with a multimodal OFA technique (scalp block, dexmedetomidine, acetaminophen).
  • Matched comparison with 18 control patients receiving conventional opioid-based anesthesia.
  • Analysis of postoperative opioid consumption, pain scores, and PACU stay for noninferiority.

Main Results:

  • The OFA technique demonstrated noninferiority in opioid consumption and average postoperative pain scores (0-24 hours).
  • Noninferiority was also observed for postanesthesia care unit (PACU) length of stay.
  • Noninferiority was not met for time to first rescue opioid, 12-24 hour pain scores, or time to emergence.

Conclusions:

  • This pilot study supports the feasibility of an opioid-free anesthetic technique for craniotomy.
  • Larger randomized controlled trials are warranted to further investigate multimodal anesthetic techniques for craniotomy.