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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-based TIVA significantly improves post-operative recovery profile and comfort, minimizes nausea and vomiting, facilitates rapid recovery, greater hemodynamic stability, preservation of hypoxic pulmonary vasoconstriction, reduction in intracerebral pressure, and reduces the risk of organ toxicity. [14]
Called target controlled infusion (TCI), it involves using a computer-controlled syringe driver (pump) to infuse propofol throughout the duration of surgery, removing the need for a volatile anaesthetic and allowing pharmacologic principles to more precisely guide the amount of the drug used by setting the desired drug concentration.
The bag valve mask concept was developed in 1956 by the German engineer Holger Hesse and his partner, Danish anaesthetist Henning Ruben, following their initial work on a suction pump. [3] Hesse's company was later renamed Ambu A/S, which has manufactured and marketed the device since 1956. An Ambu bag is a self-inflating bag resuscitator from ...
After the anesthetist sets the desired parameters in a computer and presses the start button, the system controls the infusion pump, while being monitored by the anesthetist. [1] TCI is as safe and effective as manually controlled infusion. [2] [3] TCI can be sub-classified according to the target.
The following are the major indications for the use of central venous catheters: [3] Difficult peripheral venous access – central venous catheters may be placed when it is difficult to gain or maintain venous access peripherally (e.g. obesity, scarred veins from prior cannulations, agitated patient).
The user interface of pumps usually requests details on the type of infusion from the technician or nurse that sets them up: . Continuous infusion usually consists of small pulses of infusion, usually between 500 nanoliters and 10 milliliters, depending on the pump's design, with the rate of these pulses depending on the programmed infusion speed.
Patient-controlled epidural analgesia (PCEA) is a related term describing the patient-controlled administration of analgesic medicine in the epidural space, by way of intermittent boluses or infusion pumps. This can be used by women in labour, terminally ill cancer patients or to manage post-operative pain.