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To induce general anesthesia, propofol is the drug used almost exclusively, having largely replaced sodium thiopental. [13]It is often administered as part of an anesthesia maintenance technique called total intravenous anesthesia, using either manually programmed infusion pumps or computer-controlled infusion pumps in a process called target controlled infusion (TCI).
Propofol [6] is a non-barbiturate derivative that is thought to act by stimulating inhibitory GABA receptors and blocking excitatory NMDA receptors. It takes 40 seconds for the effects of propofol to kick in, and effects last six minutes. [3] Propofol has both sedative and amnestic effects, but provides no analgesia.
Total intravenous anesthesia (TIVA) refers to the intravenous administration of anesthetic agents to induce a temporary loss of sensation or awareness. The first study of TIVA was done in 1872 using chloral hydrate , [ 1 ] and the common anesthetic agent propofol was licensed in 1986.
SponTaneous Respiration using IntraVEnous anaesthesia and High-flow nasal oxygen (STRIVE Hi) is an open airway technique that uses an upwards titration of propofol which maintains ventilation at deep levels of anaesthesia. It has been used in airway surgery as an alternative to tracheal intubation. [99]
The BIS is an electroencephalogram-derived multivariant scale that, when a drug such a propofol is used, correlates with the metabolic rate of glucose. [15] Both loss of consciousness and awakening from anesthesia are correlated with this scale. [16] The efficacy of BIS index monitoring is not without controversy. [17]
POEM is a form of natural orifice translumenal endoscopic surgery, or NOTES. Like the traditional surgical myotomy, the procedure is performed under general endotracheal anesthesia. The remainder of the procedure is performed using a flexible endoscope inserted through the mouth, and no cuts are made on the chest or abdomen.
The TESSYS method (transforaminal endoscopic surgical system) is a minimally-invasive, endoscopic spinal procedure for the treatment of a herniated disc.It was a further development of the YESS method by the Dutch Dr Thomas Hoogland in the Alpha Klinik in Munich in 1989 and was first called THESSYS (Thomas Hoogland EndoScopic SYStem).
[1] [7] One survey of anesthesiologists who practice intravenous regional anesthesia found that 98% used adjuvant benzodiazepines and/or opioids, with benzodiazepines always being given systemically (to the whole body and brain), whereas opioids can be given either systemically or locally (only into the limb being anesthetized). Most providers ...