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Related Concept Videos

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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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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Sedatives and Hypnotics Drugs: Miscellaneous Agents

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Sedatives and hypnotics encompass a wide range of substances, each with its unique mechanism of action, uses, and potential adverse effects.
Melatonin congeners like ramelteon (Rozerem) and tasimelteon (Hetlioz) selectively bind to melatonin receptors (MT1 and MT2) and thus mimic the actions of melatonin, a hormone that regulates sleep-wake cycles. Tasimelteon is primarily used for non-24-hour sleep-wake disorder, common in blind patients. They are also used to treat conditions like insomnia...
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Inhalational Anesthetics: Overview01:20

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Inhalation anesthetics are drugs that induce general anesthesia upon inhalation. They work by increasing the sensitivity of GABAA receptors or inhibiting NMDA receptors, leading to a decrease in central nervous system activity. The depth of anesthesia can be rapidly adjusted by changing the concentration of the inhaled gas. Some common examples of inhalational anesthetics include volatile liquids like isoflurane, desflurane, sevoflurane and gases like xenon and nitrous oxide. Isoflurane, a...
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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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Skeletal muscle relaxants are used to relax muscle tone and alleviate painful muscle contractions. However, the choice of skeletal muscle relaxants depends on the duration of the surgical procedure in order to minimize potential side effects. Skeletal muscle relaxants like neuromuscular blocking agents [NMBAs] are commonly employed as adjuvants alongside general anesthetics in clinical settings. NMBAs are also used to maintain controlled ventilation during surgery of the larynx or pharynx...
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Updated: Jul 29, 2025

Intra-Operative Neural Monitoring of Thyroid Surgery in a Porcine Model
08:16

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Remimazolam Anesthesia for Thyroid Surgery.

Sae Nakagawa1, Tomoharu Shakuo1, Sakurako Matsudo1

  • 1Department of Anesthesiology, Showa University Northern Yokohama Hospital, 35-1, Chigasaki-Chuo, Tsuzuki-Ku, Yokohama-Shi, Kanagawa-Ken 224-8503, Japan.

Case Reports in Anesthesiology
|May 24, 2023
PubMed
Summary

This case study demonstrates the safe anesthesia management of thyroid surgery using remimazolam and flumazenil. Combining these agents effectively managed potential complications and ensured patient comfort during and after the procedure.

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Area of Science:

  • Anesthesiology
  • Surgical Complications
  • Pharmacology

Background:

  • Thyroid surgery poses risks like airway obstruction and nerve damage.
  • Remimazolam is a potential anesthetic to mitigate these risks.
  • The combined efficacy of remimazolam and flumazenil in thyroid surgery is not well-documented.

Observation:

  • A 72-year-old patient underwent partial thyroidectomy under general anesthesia.
  • Remimazolam was used for induction and maintenance, with neuromonitoring.
  • Flumazenil was administered post-extubation to assess for complications.

Findings:

  • The patient experienced active postoperative hemorrhage requiring reoperation.
  • Remimazolam facilitated neurostimulator use with minimal muscle relaxation.
  • Flumazenil aided in confirming no recurrent laryngeal nerve palsy but revealed hemorrhage.

Implications:

  • Remimazolam and flumazenil offer a safe anesthesia approach for thyroid surgery.
  • Sedated extubation with remimazolam may reduce hemodynamic instability.
  • The anterograde amnesic effect of remimazolam may improve psychological outcomes after reoperation.