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Related Concept Videos

Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

122
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.
122
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

432
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...
432
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

289
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...
289
General Anesthesia: Overview01:24

General Anesthesia: Overview

218
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...
218
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

627
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...
627
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

413
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...
413

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Pediatric anesthesia in North America.

Ilavajady Srinivasan1, Simon Whyte2, Katherine Bailey2

  • 1Department of Anesthesia and Pain Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada.

Paediatric Anaesthesia
|March 11, 2024
PubMed
Summary

Pediatric anesthesia training and care delivery vary significantly across North America and the Caribbean. Key challenges include workforce shortages and infrastructure limitations, impacting patient care quality.

Keywords:
anesthesia care deliverydeveloping worldeducationquality improvement

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Area of Science:

  • Medical Education
  • Anesthesiology
  • Pediatric Care

Background:

  • This review examines pediatric anesthesia training, care delivery, and challenges in Canada, Barbados, and the United States.
  • Pediatric anesthesia is a critical sub-specialty impacting millions of children annually.

Purpose of the Study:

  • To provide an overview of the current state of pediatric anesthesia.
  • To identify and compare challenges in training and care delivery across diverse healthcare systems.

Main Methods:

  • Educational review of existing literature and practices.
  • Comparative analysis of pediatric anesthesia landscapes in three distinct regions.

Main Results:

  • Canada focuses on national accreditation and faces workforce shortages, especially in remote areas.
  • Barbados, lacking dedicated pediatric facilities, relies on trained anesthetists and faces infrastructure/workforce challenges.
  • The United States grapples with recruitment, supply chain issues, and site proliferation impacting care quality.

Conclusions:

  • Addressing workforce shortages and improving infrastructure are crucial for enhancing pediatric anesthesia care globally.
  • Collaborative national and organizational efforts are vital for advancing pediatric anesthesia quality and safety.