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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

273
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...
273
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

484
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...
484
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

188
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.
188
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

741
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...
741
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

532
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...
532
Stages of General Anesthesia01:22

Stages of General Anesthesia

602
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...
602

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Related Experiment Video

Updated: Aug 27, 2025

Assessing Changes in Volatile General Anesthetic Sensitivity of Mice after Local or Systemic Pharmacological Intervention
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General versus Regional Anesthesia and Neonatal Data: A Propensity-Score-Matched Study.

Liviu Cojocaru1, Cristiana Salvatori2, Amir Sharon2

  • 1Division of Maternal-Fetal Medicine, Department of Obstetrics, Gynecology and Reproductive Science, University of Maryland School of Medicine, Baltimore, Maryland.

American Journal of Perinatology
|October 1, 2022
PubMed
Summary

This study found no significant difference in neonatal outcomes between general anesthesia (GA) and regional anesthesia (RA) for prolonged cesarean delivery induction-to-delivery times (IADT). Both anesthesia types offer favorable outcomes, challenging older research.

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Area of Science:

  • Obstetrics and Gynecology
  • Anesthesiology
  • Neonatal Outcomes

Background:

  • Evaluating neonatal outcomes in cesarean deliveries with prolonged induction-to-delivery time (IADT) is crucial for improving surgical safety.
  • Previous studies suggested potential risks associated with prolonged IADT, necessitating updated research with modern anesthetic techniques.
  • This study specifically investigates the comparative safety of general anesthesia (GA) versus regional anesthesia (RA) in these prolonged cases.

Approach:

  • A retrospective case-control study analyzed singleton pregnancies with IADT ≥ 10 minutes between July 2014 and August 2020.
  • Propensity score matching was used to control for confounding maternal and pregnancy factors.
  • Exclusion criteria included urgent deliveries, conversion from RA to GA, and fetal anomalies.

Key Points:

  • Prolonged induction-to-delivery time (IADT) did not significantly impact neonatal outcomes between general anesthesia (GA) and regional anesthesia (RA) groups.
  • No significant differences were observed in cord arterial or venous pH, Apgar scores, NICU admission rates, or NICU length of stay.
  • Both GA and RA are associated with favorable neonatal outcomes in cases of prolonged IADT.

Conclusions:

  • Modern anesthetic practices ensure favorable neonatal outcomes for both general anesthesia (GA) and regional anesthesia (RA) even with prolonged induction-to-delivery times (IADT).
  • These findings contrast with historical data and highlight the importance of reappraising outcomes as medical advancements occur.
  • Improving cesarean delivery safety through careful anesthetic management remains a critical aspect of obstetric care.