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Related Concept Videos

Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

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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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Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

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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...
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General Anesthesia: Overview01:24

General Anesthesia: Overview

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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.
General anesthesia induces unconsciousness in the whole body, while the others target specific areas or sensations. It is administered to minimize adverse effects, maintain...
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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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Opioid Analgesics: Synthetic and Semisynthetic Opioids01:15

Opioid Analgesics: Synthetic and Semisynthetic Opioids

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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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Stages of General Anesthesia01:22

Stages of General Anesthesia

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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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Opioid-Free Anesthesia Versus Opioid-Balanced Anesthesia in Breast Surgeries: A Randomized Study.

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Opioid-free anesthesia (OFA) provides comparable recovery to opioid-balanced anesthesia (OBA) in breast surgery patients. OFA significantly reduced postoperative nausea and vomiting (PONV) incidence.

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Area of Science:

  • Anesthesiology
  • Surgical Recovery
  • Pain Management

Background:

  • Opioids are standard analgesics but cause side effects like postoperative nausea and vomiting (PONV).
  • Opioid-free anesthesia (OFA) protocols aim for effective pain relief with fewer adverse events than opioid-balanced anesthesia (OBA).

Purpose of the Study:

  • To compare the Quality of Recovery score (QoR-15) and intraoperative hemodynamics between OFA and OBA.
  • To assess postoperative pain (VAS scores), need for rescue analgesia, and adverse effects.

Main Methods:

  • Forty-eight breast surgery patients were randomized to OFA or OBA.
  • OFA involved thoracic paravertebral block with ropivacaine and general anesthesia without opioids.
  • OBA utilized a transdermal fentanyl patch prior to general anesthesia.

Main Results:

  • Overall QoR-15 scores at 24 and 48 hours were similar between groups (p > 0.05).
  • OFA showed significantly higher physical independence scores (p=0.016).
  • PONV incidence was significantly lower in the OFA group (p=0.037).

Conclusions:

  • OFA is a viable alternative to OBA, offering similar recovery quality and hemodynamic stability.
  • OFA demonstrates a reduced incidence of PONV compared to OBA.
  • Both OFA and OBA provide comparable postoperative analgesia.