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Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized.
Halothane, sold under the brand name Fluothane among others, is a general anaesthetic. It can be used to induce or maintain anaesthesia. One of its benefits is that it does not increase the production of saliva, which can be particularly useful in those who are difficult to intubate. It is given by inhalation.
Isoflurane, sold under the brand name Forane among others, is a general anesthetic. It can be used to start or maintain anesthesia; however, other medications are often used to start anesthesia, due to airway irritation with isoflurane. Isoflurane is given via inhalation.
General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications, which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient, or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients. Depending on the procedure, general anaesthesia may be optional or required. Regardless of whether a patient may prefer to be unconscious or not, certain pain stimuli could result in involuntary responses from the patient that may make an operation extremely difficult. Thus, for many procedures, general anaesthesia is required from a practical perspective.
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries, they refer to different positions and anesthetist is only used for non-physicians, such as nurse anesthetists.
Awareness under anesthesia, also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA), is a rare complication of general anesthesia where patients regain varying levels of consciousness during their surgical procedures. While anesthesia awareness is possible without resulting in any long-term memory of the experience, it is also possible for victims to have awareness with explicit recall, where they can remember the events related to their surgery.
Desflurane (1,2,2,2-tetrafluoroethyl difluoromethyl ether) is a highly fluorinated methyl ethyl ether used for maintenance of general anesthesia. Like halothane, enflurane, and isoflurane, it is a racemic mixture of (R) and (S) optical isomers (enantiomers). Together with sevoflurane, it is gradually replacing isoflurane for human use, except in economically undeveloped areas, where its high cost precludes its use. It has the most rapid onset and offset of the volatile anesthetic drugs used for general anesthesia due to its low solubility in blood.
Bispectral index (BIS) is one of several technologies used to monitor depth of anesthesia. BIS monitors are used to supplement Guedel's classification system for determining depth of anesthesia. Titrating anesthetic agents to a specific bispectral index during general anesthesia in adults allows the anesthetist to adjust the amount of anesthetic agent to the needs of the patient, possibly resulting in a more rapid emergence from anesthesia. Use of the BIS monitor could reduce the incidence of intraoperative awareness during anaesthesia. The exact details of the algorithm used to create the BIS index have not been disclosed by the company that developed it.
An inhalational anesthetic is a chemical compound possessing general anesthetic properties that is delivered via inhalation. They are administered through a face mask, laryngeal mask airway or tracheal tube connected to an anesthetic vaporiser and an anesthetic delivery system. Agents of significant contemporary clinical interest include volatile anesthetic agents such as isoflurane, sevoflurane and desflurane, as well as certain anesthetic gases such as nitrous oxide and xenon.
Minimum alveolar concentration or MAC is the concentration, often expressed as a percentage by volume, of a vapour in the alveoli of the lungs that is needed to prevent movement in 50% of subjects in response to surgical (pain) stimulus. MAC is used to compare the strengths, or potency, of anaesthetic vapours. The concept of MAC was first introduced in 1965.
Deep hypothermic circulatory arrest (DHCA) is a surgical technique in which the temperature of the body falls significantly and blood circulation is stopped for up to one hour. It is used when blood circulation to the brain must be stopped because of delicate surgery within the brain, or because of surgery on large blood vessels that lead to or from the brain. DHCA is used to provide a better visual field during surgery due to the cessation of blood flow. DHCA is a form of carefully managed clinical death in which heartbeat and all brain activity cease.
David L. Reich is an American academic anesthesiologist, who has been President & Chief Operating Officer of The Mount Sinai Hospital, and President of Mount Sinai Queens, since October 2013.
The International Anesthesia Research Society (IARS) is an international, professional medical society dedicated to improving clinical care, education and research in anesthesia, pain management, and perioperative medicine. It was founded in 1922 by Francis Hoeffer McMechan.
Neurosurgical anesthesiology, neuroanesthesiology, or neurological anesthesiology is a subspecialty of anesthesiology devoted to the total perioperative care of patients before, during, and after neurological surgeries, including surgeries of the central (CNS) and peripheral nervous systems (PNS). The field has undergone extensive development since the 1960s correlating with the ability to measure intracranial pressure (ICP), cerebral blood flow (CBF), and cerebral metabolic rate (CMR).
Throughout recorded history, attempts at producing a state of general anesthesia can be traced back to the writings of ancient Sumerians, Babylonians, Assyrians, Egyptians, Indians, and Chinese. Despite significant advances in anatomy and surgical technique during the Renaissance, surgery remained a last-resort treatment largely due to the pain associated with it. However, scientific discoveries in the late 18th and early 19th centuries paved the way for the development of modern anesthetic techniques.
The American Dental Society of Anesthesiology (ADSA) is an American professional association established in 1953 and based in Chicago.
Nicholas Peter Franks FRS FRSB has been Professor of Biophysics and Anaesthetics at Imperial College London since 1993. His research focuses on how general anaesthetics act at the cell and molecular levels as well as with neuronal networks. Franks holds patents on use of xenon gas as a neuroprotectant and has published research on the use of the anesthetic properties of xenon.
Obstetric anesthesia or obstetric anesthesiology, also known as ob-gyn anesthesia or ob-gyn anesthesiology, is a sub-specialty of anesthesiology that provides peripartum pain relief (analgesia) for labor and anesthesia for cesarean deliveries ('C-sections').
James Edward Cottrell is the Chair Emeritus, Department of Anesthesiology at SUNY Downstate Medical Center in New York City. He serves as a member of the New York State Board of Regents and is an avid collector of contemporary fine-art.
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, and the common anesthetic agent propofol was licensed in 1986. TIVA is currently employed in various procedures as an alternative technique of general anesthesia in order to improve post-operative recovery.
References
- ↑ Maze, Mervyn. "Anesthesiology". Professor of Anesthesiology. Retrieved June 16, 2016.
- ↑ "Imperial College". Imperial College, London. Retrieved June 18, 2016.
- ↑ Maze, Mervyn; Pirracchio, Romain (2016). "Will Xenon Be a Valuable Addition in Perioperative and Critical Care Settings?" (PDF). Anesthesia and Analgesia. 122 (3): 593–6. doi:10.1213/ANE.0000000000001156. PMID 26891385. S2CID 207126133.
- ↑ Laitio, Ruut; Hynninen, Marja; Arola, Olli; Virtanen, Sami; Parkkola, Riitta; Saunavaara, Jani; Roine, Risto O.; Grönlund, Juha; Ylikoski, Emmi; Wennervirta, Johanna; Bäcklund, Minna; Silvasti, Päivi; Nukarinen, Eija; Tiainen, Marjaana; Saraste, Antti; Pietilä, Mikko; Airaksinen, Juhani; Valanne, Leena; Martola, Juha; Silvennoinen, Heli; Scheinin, Harry; Harjola, Veli-Pekka; Niiranen, Jussi; Korpi, Kirsi; Varpula, Marjut; Inkinen, Outi; Olkkola, Klaus T.; Maze, Mervyn; Vahlberg, Tero; Laitio, Timo (2016). "Effect of Inhaled Xenon on Cerebral White Matter Damage in Comatose Survivors of Out-of-Hospital Cardiac Arrest" (PDF). JAMA. 315 (11): 1120–8. doi: 10.1001/jama.2016.1933 . PMID 26978207.
- ↑ "Mervyn Maze, MB, ChB | SmartTots". smarttots.org. Retrieved 2018-01-17.
- ↑ "About | SmartTots". smarttots.org. Retrieved 2018-01-17.
- ↑ Evers, Alex S. (2003). "Mervyn Maze, M.B., Ch.B., F.R.C.P." Anesthesiology. 99 (4): 777–778. doi: 10.1097/00000542-200310000-00006 . PMID 14508306.
- ↑ http://www.wfsahq.org/about-us/member-societies/129-israel-israel-society-of-anesthesiologists Anesthesiologists[ full citation needed ]
