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The use of TIVA is advantageous in cases where volatile anesthesia is of high risk or is impossible, such as cases involving morbidly obese patients. [11] [12] TIVA has also been used for anesthetic delivery at sites of trauma such as serious accidents, disasters and wars. [1] The overall goals of TIVA include: [13] Smooth induction of anesthesia
Remifentanil can be administered as part of an anesthesia technique called TIVA (total intravenous anesthesia) using computer controlled infusion pumps in a process called TCI (target controlled infusion). A target plasma concentration is entered as ng/mL into the pump, which calculates its infusion rate according to patient factors like age ...
Inhaled anaesthetic agents are also frequently supplemented by intravenous analgesic agents, such as opioids (usually fentanyl or a fentanyl derivative) and sedatives (usually propofol or midazolam). Propofol can be used for total intravenous anaesthetia (TIVA), therefore supplementation by inhalation agents is not required. [45]
The quantity of a single anesthetic which is used for balanced techniques has similarity with that which is used for standing sedation. [9] However, compare to the doses used for TIVA (total intravenous anesthesia), which is always lower than using the single anesthetics. [ 9 ]
The Meyer-Overton correlation for anaesthetics. A nonspecific mechanism of general anaesthetic action was first proposed by Emil Harless and Ernst von Bibra in 1847. [9] They suggested that general anaesthetics may act by dissolving in the fatty fraction of brain cells and removing fatty constituents from them, thus changing activity of brain cells and inducing anaesthesia.
The best anesthetic, therefore, is the one with the lowest risk to the patient that still achieves the endpoints required to complete the procedure. The first stage in anesthesia is the pre-operative risk assessment consisting of the medical history, physical examination and lab tests. Diagnosing the patient's pre-operative physical status ...
Anesthetic risk factors include the use of volatile anesthetics, nitrous oxide (N 2 O), opioids, and longer duration of anesthesia. Patient factors that confer increased risk for PONV include female gender, obesity , age less than 16 years, past history of motion sickness or chemotherapy-induced nausea, high levels of preoperative anxiety , and ...
The FDA continued on in the communication to state that it was unlikely for a single, brief exposure to anesthesia to have negative learning or behavior effects, and recommended that health care professionals, patients, and caregivers weigh the benefits and risks of procedures requiring anesthetic exposures greater than three hours before ...