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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.
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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Stages of General Anesthesia01:22

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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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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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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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Local Anesthetics: Pharmacokinetics01:13

Local Anesthetics: Pharmacokinetics

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The potency and duration of action of local anesthetics (LAs) are determined by their pharmacokinetics. Pharmacokinetics describes how LAs are absorbed, distributed, metabolized, and eliminated from the body. When administered to the vascular tissues, LAs are quickly absorbed and enter the systemic circulation, reducing their localized effects. Adding vasoconstrictors such as epinephrine to LAs reduces their absorption into the systemic circulation, making them clinically effective. The...
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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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Factors Contributing to General Anesthesia Appointment Failure.

Kaziwa Ibrahim1, Travis Nelson2, Ana Lucia Seminario3

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Summary

Many pediatric dental patients miss general anesthesia (GA) appointments due to illness or fasting issues. Factors like age, insurance, early check-in, and proximity to the clinic also impact attendance for dental surgery.

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Area of Science:

  • Pediatric Dentistry
  • Dental Anesthesia
  • Healthcare Management

Background:

  • Dental care under general anesthesia (GA) is crucial for pediatric patients with extensive needs.
  • Appointment no-shows and cancellations pose significant challenges to clinic efficiency and patient access.

Purpose of the Study:

  • To identify factors associated with appointment attendance for pediatric dental patients receiving general anesthesia.
  • To understand reasons for cancellations and no-shows in a pediatric dentistry residency program.

Main Methods:

  • Cross-sectional study of patients scheduled for GA dental care over 12 months.
  • Data collected from electronic health records, analyzing demographics, appointment details, and reasons for absence.
  • Statistical analysis to determine associations between patient characteristics and attendance.

Main Results:

  • Out of 543 GA cases, 105 cancelled with short notice and 74 failed to attend.
  • Younger patients (6-11 years), those with Medicaid, early check-in times, and shorter travel distances were less likely to attend.
  • Illness (53%) and fasting violations (4.4%) were primary reasons for cancellations/no-shows.

Conclusions:

  • A significant percentage of pediatric dental patients miss GA appointments, primarily due to illness and fasting non-compliance.
  • Logistical factors like transportation and insurance also contribute to appointment failures.
  • Strategies to mitigate these barriers are needed to improve access to essential dental care.