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Related Concept Videos

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

556
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.
One of the advantages of...
556
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

192
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.
192
General Anesthesia: Overview01:24

General Anesthesia: Overview

282
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...
282
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

493
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...
493
Stages of General Anesthesia01:22

Stages of General Anesthesia

668
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...
668
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

759
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...
759

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Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Expert Multinational Consensus Statement for Total Intravenous Anaesthesia (TIVA) Using the Delphi Method.

Giulia Uitenbosch1, Daniel Sng1, Hugo N Carvalho2

  • 1School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen AB25 2ZD, UK.

Journal of Clinical Medicine
|June 24, 2022
PubMed
Summary
This summary is machine-generated.

Total intravenous anaesthesia (TIVA) is favored by experts for its positive impact on patient experience, especially in pediatrics, and improved outcomes. Barriers like cost or training are not significant obstacles to TIVA adoption.

Keywords:
TIVAanaesthetic techniquesperi-operative anaesthesiatotal intravenous anaesthesiavolatile anaesthesia

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Area of Science:

  • Anesthesiology
  • Medical Practice

Background:

  • Total intravenous anaesthesia (TIVA) is an established technique, yet volatile agents remain common.
  • Significant variation exists in current anaesthetic practices globally.

Purpose of the Study:

  • To identify expert anaesthetists' motivations and barriers for using TIVA over volatile agents.
  • To analyze international opinions on TIVA adoption and practice.

Main Methods:

  • The Delphi method was employed with 29 international expert anaesthetists.
  • Three survey rounds were conducted, with data analyzed for consensus and prioritization.

Main Results:

  • Strong consensus was reached on TIVA's utility in pediatric anesthesia.
  • TIVA's benefits for reducing postoperative nausea and vomiting, environmental impact, and physiological control (airway, hemodynamics) were highlighted.

Conclusions:

  • Cost, training, and delayed emergence are not significant barriers to TIVA use.
  • Key drivers for TIVA adoption include patient experience (pediatrics) and procedure outcomes.
  • Further research is needed on geographical variations and monitoring equipment availability.