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Related Concept Videos

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.
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Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
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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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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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Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
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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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Orthognathic Surgery: Anesthetic Considerations and Perioperative Management.

Bernice Z Yu1, Jacquelyn M Roth1, Ethan Fung1

  • 1Division of Plastic and Maxillofacial Surgery, Icahn School of Medicine at Mount Sinai.

The Journal of Craniofacial Surgery
|July 30, 2025
PubMed
Summary

Orthognathic surgery requires careful anesthetic management to control blood loss and pain. Strategies include hypotensive anesthesia, hemostatic agents, and nerve blocks to improve patient outcomes and minimize complications.

Keywords:
Anesthesiaorthognathic surgeryperioperative treatment

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Area of Science:

  • Plastic Surgery
  • Anesthesiology
  • Oral and Maxillofacial Surgery

Background:

  • Orthognathic surgery involves significant blood loss due to facial vascularity and dissection.
  • Postoperative complications like shivering, nausea, vomiting, and agitation require specific management.
  • Effective perioperative care is crucial for successful orthognathic surgery outcomes.

Purpose of the Study:

  • To review evidence-based perioperative anesthetic practices for orthognathic surgery.
  • To focus on key areas: hypotensive anesthesia, hemostasis, nerve blocks, and postoperative complication management.

Main Methods:

  • Comprehensive review of existing literature on perioperative anesthetic management in orthognathic surgery.
  • Analysis of strategies for blood loss prevention and pain control.
  • Evaluation of methods for managing common postoperative complications.

Main Results:

  • Judicial hypotensive anesthesia and hemostatic agents are primary strategies for blood loss control.
  • Preoperative nerve blocks enhance hemodynamic stability and reduce postoperative opioid requirements.
  • Specific considerations are needed for nausea, vomiting, and emergence agitation due to maxillomandibular fixation.

Conclusions:

  • Optimized perioperative anesthetic management is essential for orthognathic surgery.
  • Multimodal approaches to hemostasis, pain control, and complication management improve patient safety and recovery.
  • Evidence-based practices in anesthesia are critical for addressing the unique challenges of orthognathic procedures.