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Inhalant Anesthesia and Partial Intravenous Anesthesia
Published in Michele Barletta, Jane Quandt, Rachel Reed, Equine Anesthesia and Pain Management, 2023
Inhalant anesthetics are delivered via the lung to the target tissues of general anesthesia, namely the central nervous system, which includes the brain and spinal cord. A more detailed description of the fundamentals of inhalant anesthesia can be found in many comprehensive textbooks of anesthesiology. The intention of this chapter is to provide some practical information on the use of inhalant anesthetics in the horse.
Kindliness
Published in Robert S. Holzman, Anesthesia and the Classics, 2022
With an estimated 250 percent increase in the number of people with long-term conditions over the next 40 years as well as the increasingly large fraction of the population achieving elderly status, the next phase of anesthesia care will be to create transitions to continuity. These transitions are already present in many anesthesiology subspecialties like pain management and palliative care and nascent in other areas such as critical care, obstetric, pediatric and cardiac anesthesia, especially in tertiary care centers where patients often return for repeated procedures and are well known by their anesthesia caretakers.
What the Experts Have to Say
Published in Eve Shapiro, Joy in Medicine?, 2020
I became an anesthesiologist. Why anesthesiology? What I discovered I loved in medical school was physiology and pharmacology. And the beauty of anesthesia is that it’s applied physiology and applied pharmacology. And you have to be really good with your hands, which I am. I was a sculptor for many years. So, when you put it all together, I ended up in anesthesia because it is hands-on and you get to spend all this time thinking about cardiac, respiratory, and vascular physiology, and tinker with all these drugs. Oh, what fun.
Who can do this procedure? Using entrustable professional activities to determine curriculum and entrustment in anesthesiology – An international survey
Published in Medical Teacher, 2022
Christoph S. Burkhart, Salome Dell-Kuster, Claire Touchie
What about anesthesiology? In anesthesiology, many procedures and tasks are time-critical and may be life-saving if done correctly and in a timely fashion. However, in inexperienced hands, these procedures or skills may be immediately life-threatening. Sometimes, you do not have the time to hesitate and you absolutely have to know who can do what in order to provide timely and appropriate care to the patient. The question of who is allowed to do what procedure or task with how much supervision seems to be neatly addressed by EPAs. Examples of EPAs in anesthesiology include resuscitation of a trauma patient in the trauma bay, insertion of a central line, epidural analgesia for labor, handover of a patient to the postanesthesia care unit, and postoperative care or pain management after specific procedures (Wisman-Zwarter et al. 2016; Moll-Khosrawi et al. 2020).
Intraoperative hypotension and its organ-related consequences in hypertensive subjects undergoing abdominal surgery: a cohort study
Published in Blood Pressure, 2021
Szymon Czajka, Zbigniew Putowski, Łukasz J. Krzych
In this cohort study we screened 590 consecutive patients who underwent abdominal surgery between 1 October 2018 and 15 July 2019 in a university hospital. Organ retrieval surgery (n = 11), re-operations (n = 24), procedures performed under local anaesthesia and under monitored anaesthesia care (n = 33), and those classified as immediate according to the NCEPOD Classification of Intervention [10] (n = 14) were excluded. The flow chart describing study group selection is presented in Figure 1. Demographic and clinical data were recorded, including sex, age, weigh, height, comorbidities and their pharmacological treatment, according to the ICD 10 coding [11]. Body mass index (BMI) and Charlson Comorbidity Index (CCI) were subsequently calculated. The type and duration of anaesthesia as well as the type, duration and urgency of surgery were recorded [12]. Perioperative risk was assessed based on individual patient’s risk, according to the American Society of Anaesthesiology (ASA) physical status (PS) classification [13], and procedural risk, according to the European Society of Cardiology and European Society of Anaesthesiology recommendations [14]. Primary arterial hypertension was diagnosed based on medical records. The ongoing antihypertensive therapy was evaluated.
How Integrated Anesthesia Communication Leads to Dependable IONM Data
Published in The Neurodiagnostic Journal, 2021
Veronica O. Busso, John J. McAuliffe
The relationship between anesthesiologists and IONM personnel can be built by the inclusion of didactics and experience working with IONM physicians during residency and/or fellowship training. The written sections of the American Board of Anesthesiology exam have included questions about the effect of anesthetics on neurophysiological signals for a number of years. Advances in our understanding of anesthetic effects on electroencephalography (EEG) patterns have led to the identification of patterns specific to a surgical plane of hypnosis with propofol (Mahon et al. 2008b). Utilization of pharmacokinetic models for total intravenous anesthesia (TIVA) combinations combined with the use of EEG enables the IONM team and the anesthesia team to work together to assure adequate anesthetic depth while maximizing the chances for the preservation of neurophysiological signals.