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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

434
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...
434
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

128
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.
128
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

635
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...
635
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

294
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...
294
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

422
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...
422
Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

760
The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
760

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Pediatric Anesthesia in the Community.

Richard P Dutton1, Robert B Bryskin2, Marion 'Red' Starks3

  • 1Department of Anesthesiology, Texas A&M College of Medicine, Baylor University Medical Center, Dallas, TX, USA.

Advances in Anesthesia
|January 22, 2024
PubMed
Summary

This study reviews US pediatric anesthesia demographics over seven years, highlighting practice variations between specialized children's hospitals and community settings. Findings offer insights into the national landscape of pediatric anesthesia providers and case distribution.

Keywords:
DemographicsOutcomesPatient experiencePediatric anesthesiaSpecialization

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Area of Science:

  • Anesthesiology
  • Pediatrics
  • Health Services Research

Background:

  • Pediatric anesthesia is a specialized field with diverse practice settings nationwide.
  • High-risk pediatric cases are often concentrated in dedicated children's hospitals.
  • Most pediatric anesthesia practitioners and cases occur in community hospitals and ambulatory centers.

Purpose of the Study:

  • To analyze demographic trends in pediatric anesthesia across the United States.
  • To compare practice characteristics in different healthcare facility types.
  • To provide a comprehensive overview of the national pediatric anesthesia landscape.

Main Methods:

  • Retrospective analysis of seven years of data.
  • Data sourced from US Anesthesia Partners, a national anesthesia practice.
  • Inclusion of data from various hospital types and outpatient facilities.

Main Results:

  • The majority of pediatric anesthesia cases and practitioners are based in community settings, not just children's hospitals.
  • Demographic data reveals the distribution of pediatric anesthesia services across diverse healthcare facilities.
  • Analysis covers a seven-year period, providing a temporal perspective on practice patterns.

Conclusions:

  • Pediatric anesthesia practice is predominantly community-based.
  • Understanding these demographics is crucial for resource allocation and training.
  • The findings underscore the significant role of non-specialized children's hospitals in pediatric anesthesia care.