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Related Concept Videos

General Anesthesia: Overview01:24

General Anesthesia: Overview

556
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...
556
Inhalational Anesthetics: Overview01:20

Inhalational Anesthetics: Overview

970
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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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...
1.4K
Local Anesthetics: Clinical Application as Epidural Anesthesia01:29

Local Anesthetics: Clinical Application as Epidural Anesthesia

682
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...
682
Parenteral Anesthetics: Overview01:24

Parenteral Anesthetics: Overview

566
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.
566
Local Anesthetics: Clinical Application as Spinal Anesthesia01:11

Local Anesthetics: Clinical Application as Spinal Anesthesia

1.3K
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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Anesthesia in Austere Environments: A Narrative Review.

Hebah M Ismail1

  • 1Department of Clinical Anesthesiology, Weill Cornell Medicine, Cornell University, 525 E. 68th Street, New York, NY 10065, USA.

The Surgical Clinics of North America
|October 30, 2025
PubMed
Summary

Millions die yearly from lack of surgical and anesthetic care, especially in austere settings. Improving access requires capacity building, aid, and innovative technologies like telemedicine for essential anesthesia services.

Keywords:
Anesthesia limited resourcesAustere environmentsCombat anesthesiaDisaster anesthesiaGlobal anesthesiaLow-income and middle-income countries

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Area of Science:

  • Medical Science
  • Public Health
  • Global Health

Background:

  • Over one million preventable deaths occur annually due to inadequate access to emergency and essential surgical and anesthetic care.
  • Austere environments, including low- and middle-income countries, isolated regions, disaster zones, and combat areas, pose unique challenges to healthcare delivery.
  • Limited infrastructure, resources, and harsh environmental conditions exacerbate the difficulties in providing safe anesthesia in these settings.

Purpose of the Study:

  • To review strategies for enhancing safe anesthetic care in resource-limited and challenging environments.
  • To identify current and emerging approaches to overcome barriers in delivering anesthesia in austere settings.
  • To highlight the role of technology in expanding access to surgical and anesthetic services globally.

Main Methods:

  • Literature review of existing strategies and interventions for anesthesia in austere environments.
  • Analysis of approaches including humanitarian aid, local capacity building, and technological solutions.
  • Examination of case studies and reports on telemedicine and mHealth applications in anesthesia delivery.

Main Results:

  • Strategies such as medical missions, training local healthcare providers, and equipment improvisation are crucial.
  • Telemedicine, mobile health (mHealth) applications, and other innovative technologies show promise in increasing anesthesia access.
  • Capacity building and technological integration are key to sustainable improvements in anesthetic care in underserved regions.

Conclusions:

  • Improving access to safe anesthetic care in austere environments necessitates a multi-faceted approach.
  • Investment in local training, resources, and the adoption of novel technologies is vital to reduce preventable deaths.
  • Global health initiatives must prioritize strengthening anesthesia services in resource-limited settings to achieve better surgical outcomes.