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Analgesia and Pain Management01:25

Analgesia and Pain Management

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Pain is critical to various clinical pathologies, provoking an urgent need for effective management. Pain, whether acute or chronic, is a complex neurochemical process. Its alleviation depends on the type, with nonopioid analgesics effective for mild to moderate pain, such as musculoskeletal or inflammatory pain, while neuropathic pain responds best to anticonvulsants, tricyclic antidepressants, or serotonin/norepinephrine reuptake inhibitors. For severe acute or chronic pain, opioids may be...
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Parenteral Anesthetics: Overview01:24

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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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Opioid Analgesics: Morphine and Other Natural Cogeners01:20

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Opioids are a class of drugs that mimic endogenous opioid peptides and act on opioid receptors, and help in pain relief. These compounds are classified as natural, synthetic, or semi-synthetic. Natural opioids, like morphine, codeine, and thebaine, are derived from the opium poppy plant (Papaver somniferum or Papaver album) and are termed opiates. Synthetic opioids are artificial, while semi-synthetic opioids combine natural and synthetic compounds. Morphine, a prototypical opioid, possesses a...
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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

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Synthetic and semisynthetic opioids are pivotal in pain management and tackling opioid addiction. Semisynthetic opioids, including morphinans (morphine derivatives), oxycodone, oxymorphone, hydrocodone, and hydromorphone, have improved pharmacokinetic profiles compared to morphine. Additionally, heroin and 6-MAM (6-Monoacetylmorphine) show better CNS penetration than morphine due to heightened lipid solubility. Hydromorphone, a potent opioid, undergoes hepatic metabolism to form the active...
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Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

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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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Related Experiment Video

Updated: Jul 1, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Opioid-free anesthesia: a practical guide for teaching and implementation.

Katherine A Blum1, Li-Yen Liew2, Amy R Dutia2

  • 1School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK - katherine.blum@nhs.scot.

Minerva Anestesiologica
|March 14, 2024
PubMed
Summary
This summary is machine-generated.

Opioid-free anesthesia (OFA) offers a safer approach to surgery by minimizing opioid risks and improving recovery. This guide provides practical strategies for teaching and implementing OFA, enhancing patient-centered care.

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Area of Science:

  • Anesthesiology
  • Pain Management
  • Patient Safety

Background:

  • Opioid use in anesthesia carries significant risks, including side effects and addiction.
  • Multimodal analgesia has reduced opioid dosages, but opioid-free anesthesia (OFA) is gaining traction.
  • OFA is associated with reduced nausea and vomiting, contributing to better patient outcomes.

Framework:

  • OFA implementation requires a structured approach encompassing education, leadership, and guidelines.
  • Key components include patient preparation, judicious selection of OFA agents, and tailored postoperative care.
  • A proposed framework offers practical options for successful OFA integration.

Implementation:

  • Educational strategies and training are crucial for widespread OFA adoption.
  • Overcoming challenges in less experienced settings requires adaptable implementation models.
  • Local guidance and leadership support facilitate the transition to OFA.

Implications:

  • OFA represents a shift towards more patient-centered perioperative care.
  • Evidence supports opioid-sparing techniques and OFA for improved surgical recovery.
  • Personalized approaches to pain management are essential, with OFA as a valuable option.