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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.
84
General Anesthesia: Overview01:24

General Anesthesia: Overview

151
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...
151
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

553
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...
553
Stages of General Anesthesia01:22

Stages of General Anesthesia

298
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...
298
Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia01:16

Local Anesthetics: Clinical Application as Intravenous Regional Anesthesia

323
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...
323
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

396
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...
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Related Experiment Video

Updated: May 10, 2025

Author Spotlight: A Non-Intubated Video-Assisted Thoracoscopic Surgery with Multimodal Analgesia and Sevoflurane Inhalation Anesthesia
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Anesthesia management using ROP-1680 AsisTIVA : a case report.

Ryosuke Kawanishi1, Hiroki Yonezawa2, Takamune Minote3

  • 1Surgical Center, Tokushima University Hospital, Tokushima, Japan.

The Journal of Medical Investigation : JMI
|April 23, 2025
PubMed
Summary

AsisTIVA, an automated total intravenous anesthesia support software, successfully managed anesthesia at Tokushima University. This innovative system precisely controls anesthetic delivery, enhancing anesthesiologist focus and patient safety.

Keywords:
AsisTIVABispectral indexThe initial case in Tokushima University

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Area of Science:

  • Anesthesiology
  • Medical Informatics
  • Surgical Technology

Background:

  • Automated anesthesia delivery systems aim to improve patient safety and optimize anesthetic management.
  • Current anesthesia practices require significant anesthesiologist attention for drug titration and monitoring.

Purpose of the Study:

  • To evaluate the practical and commercial viability of AsisTIVA, an automated total intravenous anesthesia support software.
  • To assess the safety and efficacy of AsisTIVA in clinical anesthesia management.

Main Methods:

  • AsisTIVA software was used for total intravenous anesthesia at Tokushima University.
  • The system controlled propofol and remifentanil to maintain a Bispectral index of 45.
  • Rocuronium concentrations were adjusted to maintain a Train Of Four value of 1.

Main Results:

  • The initial clinical experience with AsisTIVA was successful, with no adverse effects reported.
  • AsisTIVA demonstrated practical and commercial viability as an automated anesthesia support system.
  • The software effectively managed anesthetic drug concentrations for targeted patient monitoring values.

Conclusions:

  • AsisTIVA is a viable automated system for total intravenous anesthesia.
  • The software enables anesthesiologists to redirect focus to other critical aspects of patient care.
  • Further expansion of AsisTIVA use is anticipated in clinical practice.