Anesthetics
Anesthetics, Local
Anesthetics, Inhalation
Anesthetics, General
Anesthetics, Intravenous
Isoflurane
Halothane
Anesthetics, Combined
Enflurane
Lidocaine
Anesthesia
Anesthetics, Dissociative
Propofol
Anesthesia, Local
Methoxyflurane
Anesthesia, General
Anesthesia, Inhalation
Benzocaine
Ketamine
Nitrous Oxide
Nerve Block
Prilocaine
Thiopental
Etomidate
Procaine
Ether
Pentobarbital
Dibucaine
Mepivacaine
Anesthesia, Intravenous
Chloroform
Anesthesia, Conduction
Adjuvants, Anesthesia
Xylazine
Anesthesia Recovery Period
Anesthesia, Obstetrical
Hypnosis, Anesthetic
Fentanyl
Pregnanediones
Xenon
Dose-Response Relationship, Drug
Chlorofluorocarbons
Medetomidine
Monitoring, Intraoperative
Hypnotics and Sedatives
Anesthesia Department, Hospital
Ambulatory Surgical Procedures
Preanesthetic Medication
Amides
Receptors, GABA-A
Mandibular Nerve
Volatilization
Chloralose
Midazolam
Barbiturates
Pain Measurement
Urethane
Zolazepam
1-Octanol
Consciousness Monitors
Alfaxalone Alfadolone Mixture
Conscious Sedation
Intubation, Intratracheal
Malignant Hyperthermia
Drug Interactions
Brachial Plexus
Dental Pulp Test
Electroencephalography
Rats, Sprague-Dawley
Analgesia, Epidural
Analgesics, Opioid
Intraoperative Complications
Sufentanil
Sodium Channels
Hemodynamics
Sciatic Nerve
Double-Blind Method
Depression, Chemical
Dexmedetomidine
Felypressin
Analgesia, Obstetrical
Dogs
Epinephrine
Ligand-Gated Ion Channels
Xenopus laevis
Potassium Channels, Tandem Pore Domain
Propanidid
Alcohols
Injections, Epidural
Flurothyl
Maxillary Nerve
Apoferritins
Anesthesia, Closed-Circuit
Sodium Channel Blockers
Gas Scavengers
Electrophysiology
Receptors, Glycine
Ion Channel Gating
Alfentanil
Surgical Procedures, Operative
Pain
Droperidol
Aminobenzoates
Prospective Studies
Patch-Clamp Techniques
Unconsciousness
Membrane Potentials
Euthanasia, Animal
Reflex
Postoperative Complications
Brain
Thiamylal
Drug Hypersensitivity
Injections, Spinal
Diazepam
Ethyl Chloride
Laryngismus
Femoral Nerve
Butorphanol
Batrachotoxins
Surgical Procedures, Minor
Chlorofluorocarbons, Methane
Receptors, Nicotinic
Operating Room Technicians
Stereoisomerism
Postanesthesia Nursing
Carbon Dioxide
Benzyl Alcohol
Drug Combinations
Morphine
Potassium Channels
GABA Modulators
Oocytes
Binding Sites
Neurons
Pulmonary Alveoli
Rats, Wistar
Ischemic Preconditioning, Myocardial
Receptors, GABA
Intraoperative Awareness
Trichloroethanes
Subarachnoid Space
Administration, Topical
Synaptosomes
Neuromuscular Nondepolarizing Agents
Autonomic Nerve Block
Calcium
Pancuronium
Infusion Pumps
Meperidine
Analgesia, Patient-Controlled
Oxygen
Ion Channels
Binding of propofol to blood components: implications for pharmacokinetics and for pharmacodynamics. (1/1639)
AIMS: Propofol is a widely used i.v. anaesthetic agent. However, its binding properties to blood components have not been fully studied. METHODS: We studied the binding of propofol to erythrocytes, to human serum and to isolated serum proteins. Because propofol bound to ultrafiltration and equilibrium dialysis membranes, we used a co-binding technique with dextran coated charcoal and with erythrocytes. RESULTS: Propofol free fraction in blood was 1.2-1.7% at total concentrations ranging from 2.80 to 179 microM (0.5 to 32 microg ml(-1)). Fifty percent was bound to erythrocytes and 48% to serum proteins, almost exclusively to human serum albumin. In the clinical range of concentrations (0.5-16 microg ml(-1)) 40% of the molecules bound to erythrocytes are on the red blood cells membranes. No binding to lipoproteins occurred and binding to alpha1-acid glycoprotein was less than 1.5% CONCLUSIONS: We conclude that hypoalbuminaemia may increase propofol free fraction particularly during prolonged administration. Since propofol is non-restrictively cleared, no change in clearance is expected to occur, and the increase in free fraction will not be compensated by a parallel increase in clearance. It is also noted that many in vitro studies used concentrations 50 to 500 times the concentration expected to be encountered in the immediate cellular environment. (+info)Benzodiazepine premedication: can it improve outcome in patients undergoing breast biopsy procedures? (2/1639)
BACKGROUND: Women awaiting needle-guided breast biopsy procedures may experience high anxiety levels. A randomized, double-blind, placebo-controlled study was designed to evaluate the ability of midazolam and diazepam (in a lipid emulsion [Dizac]) to improve patient comfort during needle localization and breast biopsy procedures. METHODS: Ninety women received two consecutive doses of a study medication, one before the mammographic needle localization and a second before entering the operating room. Patients were assigned randomly to receive saline, 2.0 ml intravenously, at the two time points; midazolam, 1.0 mg intravenously and 2.0 mg intravenously; or diazepam emulsion, 2.0 mg intravenously and 5.0 mg intravenously, respectively. Patients assessed their anxiety levels before the needle localization, before entering the operating room, and on arrival in the operating room. Patients completed a questionnaire evaluating their perioperative experience at the time of discharge. RESULTS: Patient satisfaction during needle localization was significantly improved in both benzodiazepine treatment groups (vs. saline). The incidence of moderate-to-severe discomfort during needle localization was lower in the midazolam (20%) and diazepam emulsion (6%) groups compared with the saline group (70%) (P<0.05). The preoperative visual analogue scale anxiety scores were similar in all three groups. In the operating room, however, anxiety scores were 55% and 68% lower after midazolam (21+/-19) and diazepam emulsion (15+/-14) compared with saline (46+/-28). Finally, there was no difference in the time to achieve home-readiness or actual discharge time among the three groups. CONCLUSIONS: Premedication with midazolam or diazepam emulsion improved patients' comfort during needle localization procedures and significantly reduced intraoperative anxiety levels before breast biopsy procedures without prolonging discharge times. Use of diazepam emulsion may be an effective alternative to midazolam in this population. (+info)Postoperative behavioral outcomes in children: effects of sedative premedication. (3/1639)
BACKGROUND: Although multiple studies document the effect of sedative premedication on preoperative anxiety in children, there is a paucity of data regarding its effect on postoperative behavioral outcomes. METHODS: After screening for recent stressful life events, children undergoing anesthesia and surgery were assigned randomly to receive either 0.5 mg/kg midazolam in 15 mg/kg acetaminophen orally (n = 43) or 15 mg/kg acetaminophen orally (n = 43). Using validated measures of anxiety, children were evaluated before and after administration of the intervention and during induction of anesthesia. On postoperative days 1, 2, 3, 7, and 14, the behavioral recovery of the children was assessed using the Post Hospitalization Behavior Questionnaire. RESULTS: The intervention group demonstrated significantly lower anxiety levels compared with the placebo group on separation to the operating room and during induction of anesthesia (F[1,77] = 3.95, P = 0.041). Using a multivariate logistic regression model, the authors found that the presence or absence of postoperative behavioral changes was dependent on the group assignment (R = 0.18, P = 0.0001) and days after operation (R = -0.20, P = 0.0001). Post hoc analysis demonstrated that during postoperative days 1-7, a significantly smaller number of children in the midazolam group manifested negative behavioral changes. At week 2 postoperatively, however, there were no significant differences between the midazolam and placebo groups. CONCLUSIONS: Children who are premedicated with midazolam before surgery have fewer negative behavioral changes during the first postoperative week. (+info)Mechanisms of bronchoprotection by anesthetic induction agents: propofol versus ketamine. (4/1639)
BACKGROUND: Propofol and ketamine have been purported to decrease bronchoconstriction during induction of anesthesia and intubation. Whether they act on airway smooth muscle or through neural reflexes has not been determined. We compared propofol and ketamine to attenuate the direct activation of airway smooth muscle by methacholine and limit neurally mediated bronchoconstriction (vagal nerve stimulation). METHODS: After approval from the institutional review board, eight sheep were anesthetized with pentobarbital, paralyzed, and ventilated. After left thoracotomy, the bronchial artery was cannulated and perfused. In random order, 5 mg/ml concentrations of propofol, ketamine, and thiopental were infused into the bronchial artery at rates of 0.06, 0.20, and 0.60 ml/min. After 10 min, airway resistance was measured before and after vagal nerve stimulation and methacholine given via the bronchial artery. Data were expressed as a percent of baseline response before infusion of drug and analyzed by analysis of variance with significance set at P< or =0.05. RESULTS: Systemic blood pressure was not affected by any of the drugs (P>0.46). Baseline airway resistance was not different among the three agents (P = 0.56) or by dose (P = 0.96). Infusion of propofol and ketamine into the bronchial artery caused a dose-dependent attenuation of the vagal nerve stimulation-induced bronchoconstriction to 26+/-11% and 8+/-2% of maximum, respectively (P<0.0001). In addition, propofol caused a significant decrease in the methacholine-induced bronchoconstriction to 43+/-27% of maximum at the highest concentration (P = 0.05) CONCLUSIONS: The local bronchoprotective effects of ketamine and propofol on airways is through neurally mediated mechanisms. Although the direct effects on airway smooth muscle occur at high concentrations, these are unlikely to be of primary clinical relevance. (+info)Propofol concentrations in follicular fluid during general anaesthesia for transvaginal oocyte retrieval. (5/1639)
Propofol (Diprivan) is an i.v. anaesthetic used for general anaesthesia. The purpose of this study was to measure the propofol concentration in arterial blood and follicular fluid in patients during transvaginal oocyte retrieval. After approval by the University Ethics Committee, 30 women participated in this prospective study. Following induction of anaesthesia with 0.5 mg alfentanil and 2 mg.kg-1 propofol i.v., a continuous infusion of propofol at 10 mg.kg-1.h-1 was used for maintenance of anaesthesia. Follicular fluid and arterial blood samples were aspirated simultaneously at fixed intervals during the surgical procedure and propofol assayed by high pressure liquid chromatography (HPLC). The mean follicular fluid concentration of propofol increased linearly with time from 0.10 +/- 0.02 microgram.ml-1 to 0.57 +/- 0.06 microgram.ml-1 and was strongly related to the cumulative dose of propofol administered. The absorption of propofol was time-dependent. There was no correlation between the concentration of propofol in the follicular fluid and the arterial blood concentration of the drug. In conclusion, a propofol-based anaesthetic technique resulted in significant concentrations of this agent in follicular fluid, related to the dose administered and to the duration of propofol administration. (+info)Effects of inhaled oxygen concentration on fat metabolism during propofol infusion in rabbits. (6/1639)
We have investigated the effect of inhaled oxygen tension on lipid metabolism during propofol infusion. Propofol is supplied as a lipid emulsion containing 10% soybean oil, which is rich in triglycerides (TG). Infused TG are metabolized via three pathways in the liver cell; Krebs cycle, ketogenesis and release as very low density lipoproteins (VLDL) into the blood. For this reason, we measured TG and the products of the three pathways; carbon dioxide, ketone bodies and VLDL. Thirty-two rabbits were anaesthetized under four different conditions: propofol under hyperoxia, normoxia, hypoxia and isoflurane anaesthesia under hyperoxia. Our results indicated that hyperoxia produced more ketone bodies, normoxia more PaCO2 and hypoxia more free fatty acids (FFA) and TG compared with the other propofol infusion groups. We conclude that hyperoxia during propofol infusion facilitated fat metabolism through ketogenesis, while normoxia did so via the Krebs cycle. Also, hypoxia suppressed utilization of TG and VLDL production in the liver. (+info)Thiopental and propofol impair relaxation produced by ATP-sensitive potassium channel openers in the rat aorta. (7/1639)
ATP-sensitive potassium channel openers are used as vasodilators in the treatment of cardiovascular disorders. The effects of i.v. anaesthetics on arterial relaxation induced by ATP-sensitive potassium channel openers have not been studied. Therefore, in this study, we have examined if thiopental (thiopentone) and propofol affect the vascular response to the ATP-sensitive potassium channel openers, cromakalim and pinacidil, in the isolated rat aorta. Rings of rat thoracic aortas without endothelium were suspended for isometric force recording. Concentration-response curves were obtained in a cumulative manner. During submaximal contractions with phenylephrine 0.3 mumol litre-1, relaxation after cromakalim 0.1-30 mumol litre-1, pinacidil 0.1-30 mumol litre-1 and papaverine 0.1-300 mumol litre-1 was demonstrated. Thiopental 30-300 mumol litre-1, propofol 10-100 mumol litre-1, 10% Intralipid 45 microliters or glibenclamide 5 mumol litre-1 were applied 15 min before addition of phenylephrine. During contractions with phenylephrine, cromakalim and pinacidil induced concentration-dependent relaxation. A selective ATP-sensitive potassium channel antagonist, glibenclamide 5 mumol litre-1, abolished this relaxation, whereas it did not affect relaxation produced by papaverine. Thiopental concentrations > 30 mumol litre-1 significantly impaired relaxation produced by cromakalim or pinacidil. Propofol concentrations > 10 mumol litre-1 also significantly reduced relaxation produced by cromakalim or pinacidil, whereas Intralipid was ineffective. Thiopental 300 mumol litre-1 and propofol 100 mumol litre-1 did not alter relaxation produced by papaverine. These results suggest that the i.v. anaesthetics, thiopental and propofol, impaired vasodilatation mediated by ATP-sensitive potassium channels in vascular smooth muscle cells. (+info)Effect of remifentanil on the auditory evoked response and haemodynamic changes after intubation and surgical incision. (8/1639)
We have observed the effect of intubation and incision, as measured by the auditory evoked response (AER) and haemodynamic variables, in 12 patients undergoing hernia repair or varicose vein surgery who received remifentanil as part of either an inhaled anaesthetic technique using isoflurane or as part of a total i.v. technique using propofol. Anaesthesia was induced with remifentanil 1 microgram kg-1 and propofol, neuromuscular block was achieved with atracurium 0.6 mg kg-1 before intubation, and anaesthesia was maintained with a continuous infusion of remifentanil in combination with either a continuous infusion of propofol or inhaled isoflurane. The AER and haemodynamic variables were measured before and after intubation and incision. The effects of intubation and incision on the AER and haemodynamic variables were not significantly different between the remifentanil-propofol and remifentanil-isoflurane groups. However, the study had a low power for this comparison. When the data for the two anaesthetic combinations were pooled, the only significant effects were increases in diastolic arterial pressure and heart rate immediately after intubation; these were not seen 5 min after intubation. There were no cardiovascular responses to incision. There were no significant changes in the AER after intubation or incision. (+info)Postoperative pain is typically managed with pain medication, which may include opioids, nonsteroidal anti-inflammatory drugs (NSAIDs), or other types of medications. The goal of managing postoperative pain is to provide effective pain relief while minimizing the risk of complications such as addiction, constipation, or nausea and vomiting.
In addition to medication, other techniques for managing postoperative pain may include breathing exercises, relaxation techniques, and alternative therapies such as acupuncture or massage. It is important for patients to communicate with their healthcare provider about the severity of their pain and any side effects they experience from medication, in order to provide effective pain management and minimize complications.
Postoperative pain can be categorized into several different types, including:
* Acute pain: This type of pain is intense but short-lived, typically lasting for a few days or weeks after surgery.
* Chronic pain: This type of pain persists for longer than 3 months after surgery and can be more challenging to manage.
* Neuropathic pain: This type of pain is caused by damage to nerves and can be characterized by burning, shooting, or stabbing sensations.
* Visceral pain: This type of pain originates in the internal organs and can be referred to other areas of the body, such as the back or abdomen.
The exact cause of malignant hyperthermia is not fully understood, but it is believed to be related to a genetic predisposition and exposure to certain anesthetic agents. The condition can be triggered by a variety of factors, including the use of certain anesthetics, stimulation of the sympathetic nervous system, and changes in blood sugar levels.
Symptoms of malignant hyperthermia can include:
* Elevated body temperature (usually above 104°F/40°C)
* Muscle rigidity and stiffness
* Heart arrhythmias and palpitations
* Shivering or tremors
* Confusion, agitation, or other neurological symptoms
* Shortness of breath or respiratory failure
If left untreated, malignant hyperthermia can lead to serious complications such as seizures, brain damage, and even death. Treatment typically involves the immediate discontinuation of any triggering anesthetic agents, cooling measures such as ice packs or cold compresses, and medications to help regulate body temperature and reduce muscle rigidity. In severe cases, mechanical ventilation may be necessary to support breathing.
Overall, malignant hyperthermia is a rare but potentially life-threatening condition that requires prompt recognition and treatment to prevent serious complications and improve outcomes.
Some common examples of intraoperative complications include:
1. Bleeding: Excessive bleeding during surgery can lead to hypovolemia (low blood volume), anemia (low red blood cell count), and even death.
2. Infection: Surgical wounds can become infected, leading to sepsis or bacteremia (bacterial infection of the bloodstream).
3. Nerve damage: Surgery can sometimes result in nerve damage, leading to numbness, weakness, or paralysis.
4. Organ injury: Injury to organs such as the liver, lung, or bowel can occur during surgery, leading to complications such as bleeding, infection, or organ failure.
5. Anesthesia-related complications: Problems with anesthesia can include respiratory or cardiac depression, allergic reactions, or awareness during anesthesia (a rare but potentially devastating complication).
6. Hypotension: Low blood pressure during surgery can lead to inadequate perfusion of vital organs and tissues, resulting in organ damage or death.
7. Thromboembolism: Blood clots can form during surgery and travel to other parts of the body, causing complications such as stroke, pulmonary embolism, or deep vein thrombosis.
8. Postoperative respiratory failure: Respiratory complications can occur after surgery, leading to respiratory failure, pneumonia, or acute respiratory distress syndrome (ARDS).
9. Wound dehiscence: The incision site can separate or come open after surgery, leading to infection, fluid accumulation, or hernia.
10. Seroma: A collection of serous fluid that can develop at the surgical site, which can become infected and cause complications.
11. Nerve damage: Injury to nerves during surgery can result in numbness, weakness, or paralysis, sometimes permanently.
12. Urinary retention or incontinence: Surgery can damage the bladder or urinary sphincter, leading to urinary retention or incontinence.
13. Hematoma: A collection of blood that can develop at the surgical site, which can become infected and cause complications.
14. Pneumonia: Inflammation of the lungs after surgery can be caused by bacteria, viruses, or fungi and can lead to serious complications.
15. Sepsis: A systemic inflammatory response to infection that can occur after surgery, leading to organ dysfunction and death if not treated promptly.
It is important to note that these are potential complications, and not all patients will experience them. Additionally, many of these complications are rare, and the vast majority of surgeries are successful with minimal or no complications. However, it is important for patients to be aware of the potential risks before undergoing surgery so they can make an informed decision about their care.
There are several different types of pain, including:
1. Acute pain: This type of pain is sudden and severe, and it usually lasts for a short period of time. It can be caused by injuries, surgery, or other forms of tissue damage.
2. Chronic pain: This type of pain persists over a long period of time, often lasting more than 3 months. It can be caused by conditions such as arthritis, fibromyalgia, or nerve damage.
3. Neuropathic pain: This type of pain results from damage to the nervous system, and it can be characterized by burning, shooting, or stabbing sensations.
4. Visceral pain: This type of pain originates in the internal organs, and it can be difficult to localize.
5. Psychogenic pain: This type of pain is caused by psychological factors such as stress, anxiety, or depression.
The medical field uses a range of methods to assess and manage pain, including:
1. Pain rating scales: These are numerical scales that patients use to rate the intensity of their pain.
2. Pain diaries: These are records that patients keep to track their pain over time.
3. Clinical interviews: Healthcare providers use these to gather information about the patient's pain experience and other relevant symptoms.
4. Physical examination: This can help healthcare providers identify any underlying causes of pain, such as injuries or inflammation.
5. Imaging studies: These can be used to visualize the body and identify any structural abnormalities that may be contributing to the patient's pain.
6. Medications: There are a wide range of medications available to treat pain, including analgesics, nonsteroidal anti-inflammatory drugs (NSAIDs), and muscle relaxants.
7. Alternative therapies: These can include acupuncture, massage, and physical therapy.
8. Interventional procedures: These are minimally invasive procedures that can be used to treat pain, such as nerve blocks and spinal cord stimulation.
It is important for healthcare providers to approach pain management with a multi-modal approach, using a combination of these methods to address the physical, emotional, and social aspects of pain. By doing so, they can help improve the patient's quality of life and reduce their suffering.
There are several different types of unconsciousness, including:
1. Concussion: A mild form of traumatic brain injury that can cause temporary unconsciousness, confusion, and amnesia.
2. Coma: A more severe form of unconsciousness that can be caused by a head injury, stroke, or other medical condition. Comas can last for days, weeks, or even months.
3. Vegetative state: A condition in which a person is unaware and unresponsive, but still has some reflexes. This can be caused by a traumatic brain injury, stroke, or other medical condition.
4. Persistent vegetative state (PVS): A long-term version of the vegetative state that can last for months or years.
5. Brain death: A permanent form of unconsciousness that is caused by severe damage to the brain.
Unconsciousness can be diagnosed through a variety of medical tests, including:
1. Neurological exam: A doctor will check the patient's reflexes, muscle strength, and sensation to determine the extent of any brain damage.
2. Imaging tests: CT or MRI scans can help doctors identify any structural abnormalities in the brain that may be causing unconsciousness.
3. Electroencephalogram (EEG): A test that measures electrical activity in the brain to determine if there is any abnormal brain wave activity.
4. Blood tests: To rule out other medical conditions that may be causing unconsciousness, such as infections or poisoning.
Treatment for unconsciousness depends on the underlying cause and can range from simple observation to complex surgical procedures. Some common treatments include:
1. Medications: To control seizures, reduce inflammation, or regulate brain activity.
2. Surgery: To relieve pressure on the brain, repair damaged blood vessels, or remove tumors.
3. Rehabilitation: To help the patient regain lost cognitive and motor function.
4. Supportive care: To address any other medical conditions that may be contributing to the unconsciousness, such as infections or respiratory failure.
PONV can be caused by various factors, including:
1. Anesthesia-related factors: The type and dose of anesthesia used, as well as the duration of anesthesia exposure, can contribute to PONV.
2. Surgical factors: The type and duration of surgery, as well as any complications during the procedure, can increase the risk of PONV.
3. Patient-related factors: Factors such as age, gender, body mass index (BMI), smoking status, and medical history can influence the likelihood of PONV.
4. Medication-related factors: Certain medications used during or after surgery, such as opioids and benzodiazepines, can increase the risk of PONV.
PONV can lead to a range of complications, including dehydration, electrolyte imbalances, and aspiration pneumonia. It can also cause significant discomfort, pain, and distress for patients, leading to delayed recovery and increased healthcare costs.
There are several strategies to prevent or manage PONV, including:
1. Anti-nausea medications: Prophylactic medications such as ondansetron, dolasetron, and granisetron can be given before or after surgery to reduce the risk of PONV.
2. Anesthesia techniques: Techniques such as avoiding general anesthesia, using regional anesthesia, and maintaining a stable body temperature can help reduce the risk of PONV.
3. Patient positioning: Positioning patients in a way that minimizes pressure on the stomach and diaphragm can help reduce the risk of PONV.
4. Fluid management: Encouraging patients to drink fluids before and after surgery can help prevent dehydration and electrolyte imbalances.
5. Deep breathing exercises: Encouraging patients to perform deep breathing exercises during the recovery period can help reduce nausea and vomiting.
6. Aromatherapy: Using aromatherapy with essential oils such as lavender and peppermint can help reduce nausea and vomiting.
7. Ginger: Ginger has anti-inflammatory properties and has been shown to reduce nausea and vomiting in some studies.
8. Vitamin B6: Some studies have suggested that taking vitamin B6 before surgery may reduce the risk of PONV.
9. Acupuncture: Acupuncture has been shown to reduce PONV in some studies.
10. Herbal remedies: Some herbal remedies such as peppermint, ginger, and chamomile have anti-nausea properties and may help reduce PONV.
It is important for patients to discuss their individual risk factors with their anesthesiologist before undergoing surgery and to follow any instructions provided by their healthcare provider regarding prevention and management of PONV.
1. Infection: Bacterial or viral infections can develop after surgery, potentially leading to sepsis or organ failure.
2. Adhesions: Scar tissue can form during the healing process, which can cause bowel obstruction, chronic pain, or other complications.
3. Wound complications: Incisional hernias, wound dehiscence (separation of the wound edges), and wound infections can occur.
4. Respiratory problems: Pneumonia, respiratory failure, and atelectasis (collapsed lung) can develop after surgery, particularly in older adults or those with pre-existing respiratory conditions.
5. Cardiovascular complications: Myocardial infarction (heart attack), cardiac arrhythmias, and cardiac failure can occur after surgery, especially in high-risk patients.
6. Renal (kidney) problems: Acute kidney injury or chronic kidney disease can develop postoperatively, particularly in patients with pre-existing renal impairment.
7. Neurological complications: Stroke, seizures, and neuropraxia (nerve damage) can occur after surgery, especially in patients with pre-existing neurological conditions.
8. Pulmonary embolism: Blood clots can form in the legs or lungs after surgery, potentially causing pulmonary embolism.
9. Anesthesia-related complications: Respiratory and cardiac complications can occur during anesthesia, including respiratory and cardiac arrest.
10. delayed healing: Wound healing may be delayed or impaired after surgery, particularly in patients with pre-existing medical conditions.
It is important for patients to be aware of these potential complications and to discuss any concerns with their surgeon and healthcare team before undergoing surgery.
There are several different types of drug hypersensitivity reactions, including:
1. Maculopapular exanthema (MPE): This is a type of allergic reaction that causes a red, itchy rash to appear on the skin. It can be caused by a variety of medications, including antibiotics and nonsteroidal anti-inflammatory drugs (NSAIDs).
2. Exfoliative dermatitis: This is a more severe form of MPE that can cause widespread scaling and peeling of the skin. It is often associated with reactions to antibiotics and other medications.
3. Stevens-Johnson syndrome (SJS): This is a rare but potentially life-threatening condition that can be caused by certain medications, including antibiotics and NSAIDs. SJS can cause blisters to form on the skin and mucous membranes, as well as fever and fatigue.
4. Toxic epidermal necrolysis (TEN): This is a severe and potentially life-threatening condition that can be caused by certain medications, including antibiotics and NSAIDs. TEN can cause widespread peeling of the skin, as well as fever and fatigue.
5. Anaphylaxis: This is a severe allergic reaction that can be caused by a variety of medications, including antibiotics and NSAIDs. It can cause symptoms such as hives, itching, swelling, and difficulty breathing.
Drug hypersensitivity reactions can be diagnosed through a combination of physical examination, medical history, and laboratory tests. Treatment typically involves discontinuing the medication that is causing the reaction, as well as providing supportive care to manage symptoms such as fever, itching, and pain. In severe cases, hospitalization may be necessary to monitor and treat the reaction.
Prevention of drug hypersensitivity reactions can be challenging, but there are several strategies that can help reduce the risk. These include:
1. Gradual dose escalation: When starting a new medication, it is important to gradually increase the dose over time to allow the body to adjust.
2. Monitoring for signs of a reaction: Patients should be monitored closely for signs of a reaction, such as hives, itching, or difficulty breathing.
3. Avoiding certain medications: In some cases, it may be necessary to avoid certain medications that are known to cause hypersensitivity reactions.
4. Skin testing: Skin testing can be used to determine whether a patient is allergic to a particular medication before starting treatment.
5. Desensitization: In some cases, desensitization therapy may be used to gradually expose the patient to the medication that is causing the reaction, with the goal of reducing the risk of an adverse event.
Word origin: [O. Eng. larynx + Gr. , voice.]
Synonyms:
1. Stuttering.
2. Hysterical stammering.
3. Spasmodic dysartria.
Note under Dysarthria: Laryngismus is a form of spasmodic dysarthria, the spasms being more sudden and violent than in the ordinary type.
Source: Stedman's Medical Dictionary (28th ed.) via MedicineNet.com
Terms popularity compared to other word forms of 'laryngismus':
Laryngismus has been less popular than other word forms such as 'laryngitis'.
Reference link: medicine.net/ned/2013/laryngismus-stuttering.htm
Hypothermia can be mild, moderate, or severe. Mild hypothermia is characterized by shivering and a body temperature of 95 to 97 degrees Fahrenheit (32 to 36.1 degrees Celsius). Moderate hypothermia has a body temperature of 82 to 94 degrees Fahrenheit (28 to 34 degrees Celsius), and the person may appear lethargic, drowsy, or confused. Severe hypothermia is characterized by a body temperature below 82 degrees Fahrenheit (28 degrees Celsius) and can lead to coma and even death if not treated promptly.
Treatment for hypothermia typically involves warming the person up slowly, using blankets or heating pads, and providing warm fluids to drink. In severe cases, medical professionals may use a specialized warm water bath or apply warm packs to specific areas of the body.
Preventing hypothermia is important, especially in cold weather conditions. This can be done by dressing appropriately for the weather, staying dry and avoiding wet clothing, eating regularly to maintain energy levels, and seeking shelter if you become stranded or lost. It's also essential to recognize the signs of hypothermia early on so that treatment can begin promptly.
Intraoperative awareness is a serious issue because it can lead to memory recall of the surgical procedure, which can be distressing for the patient. In some cases, patients may also experience pain or discomfort during the procedure, which can result in long-term psychological and emotional sequelae.
The exact incidence of intraoperative awareness is not well established, but it is estimated to occur in 1-2% of all surgical procedures. However, the phenomenon is likely underreported due to the difficulty of detecting and documenting consciousness during anesthesia.
The causes of intraoperative awareness are multifactorial and may include:
* Inadequate dosing or timing of anesthetic medications
* Drug interactions or allergies
* Technical difficulties with the anesthesia equipment
* Patient factors such as obesity, sleep apnea, or psychiatric disorders
To minimize the risk of intraoperative awareness, anesthesiologists use a variety of techniques to ensure adequate anesthesia and avoid any potential complications. These may include:
* Using multiple anesthetic drugs and monitoring devices to maintain appropriate depth of anesthesia
* Administering additional doses of anesthetics as needed during the procedure
* Regularly checking the patient's vital signs and level of consciousness during the procedure
* Providing adequate pain management during the recovery period
Overall, intraoperative awareness is a rare but potentially distressing complication of anesthesia that can have long-term psychological and emotional consequences. Anesthesiologists must be vigilant in monitoring their patients' consciousness levels throughout the surgical procedure to minimize the risk of this phenomenon.
Trauma to the face or mouth
Gingivitis (inflammation of the gums)
Periodontal disease (gum disease)
Viral infections such as herpes simplex
Bacterial infections such as strep throat
Canker sores (ulcers on the lining of the mouth)
Leukoplakia (abnormal growth of cells on the lining of the mouth)
Oral cancer
Symptoms of an oral hemorrhage can include:
Blood in the saliva
Blood on the teeth, gums, or tongue
Pain or discomfort in the mouth
Difficulty swallowing
Bad breath (halitosis)
Treatment for an oral hemorrhage will depend on the underlying cause, but may include:
Antibiotics to treat bacterial infections
Pain relief medication
Topical anesthetics to numb the affected area
Cold compresses to reduce swelling
In severe cases, surgery may be necessary to stop the bleeding or remove any damaged tissue.
It is important to seek medical attention if you experience an oral hemorrhage, as it can be a sign of a more serious underlying condition. A healthcare professional can diagnose the cause of the bleeding and provide appropriate treatment.
Synonyms: Bronchial Constriction, Airway Spasm, Reversible Airway Obstruction.
Antonyms: Bronchodilation, Relaxation of Bronchial Muscles.
Example Sentences:
1. The patient experienced bronchial spasms during the asthma attack and was treated with an inhaler.
2. The bronchial spasm caused by the allergic reaction was relieved by administering epinephrine.
3. The doctor prescribed corticosteroids to reduce inflammation and prevent future bronchial spasms.
* Definition: A hernia that occurs when a part of the intestine bulges through a weakened area in the abdominal wall, typically near the inguinal region.
* Also known as: Direct or indirect inguinal hernia
* Prevalence: Common, affecting approximately 2% of adult males and 1% of adult females.
* Causes: Weakened abdominal muscles, age-related degeneration, previous surgery, or injury.
Slide 2: Types of Inguinal Hernia
* Indirect inguinal hernia: Occurs when a part of the intestine descends into the inguinal canal and protrudes through a weakened area in the abdominal wall.
* Direct inguinal hernia: Occurs when a part of the intestine protrudes directly through a weakened area in the abdominal wall, without passing through the inguinal canal.
* Recurrent inguinal hernia: Occurs when a previous hernia recurs after previous surgical repair.
Slide 3: Symptoms of Inguinal Hernia
* Bulge or lump in the groin area, often more prominent when coughing or straining.
* Pain or discomfort in the groin area, which may be exacerbated by straining or heavy lifting.
* Burning sensation or weakness in the groin area.
* Abdominal pain or nausea.
Slide 4: Diagnosis of Inguinal Hernia
* Physical examination to detect the presence of a bulge or lump in the groin area.
* Imaging tests such as ultrasound, CT scan, or MRI may be ordered to confirm the diagnosis and rule out other conditions.
Slide 5: Treatment of Inguinal Hernia
* Surgery is the primary treatment for inguinal hernia, which involves repairing the weakened area in the abdominal wall and returning the protruded intestine to its proper position.
* Open hernia repair: A surgical incision is made in the groin area to access the hernia sac and repair it with synthetic mesh or other materials.
* Laparoscopic hernia repair: A minimally invasive procedure in which a small camera and specialized instruments are inserted through small incisions to repair the hernia sac.
Slide 6: Prevention of Inguinal Hernia
* Maintaining a healthy weight to reduce strain on the abdominal wall.
* Avoiding heavy lifting or strenuous activities that can put additional pressure on the abdominal wall.
* Keeping the abdominal wall muscles strong through exercises such as crunches and planks.
* Avoiding smoking and other unhealthy habits that can weaken the abdominal wall.
Slide 7: Complications of Inguinal Hernia
* Strangulation: When the hernia sac becomes trapped and its blood supply is cut off, it can lead to tissue death and potentially life-threatening complications.
* Obstruction: The hernia can cause a blockage in the intestine, leading to abdominal pain, vomiting, and constipation.
* Recurrence: In some cases, the hernia may recur after initial repair.
Slide 8: Treatment of Complications
* Strangulation: Emergency surgery is necessary to release the trapped tissue and restore blood flow.
* Obstruction: Surgical intervention may be required to remove the blockage and restore intestinal function.
* Recurrence: Repeat hernia repair surgery may be necessary to prevent recurrence.
Slide 9: Prognosis and Quality of Life
* With prompt and proper treatment, the prognosis for inguinal hernia is generally good, and most people can expect a full recovery.
* In some cases, complications such as strangulation or obstruction may result in long-term health problems or impaired quality of life.
* However, with appropriate management and follow-up care, many people with inguinal hernia can lead active and healthy lives.
Slide 10: Conclusion
* Inguinal hernia is a common condition that can cause significant discomfort and complications if left untreated.
* Prompt diagnosis and appropriate treatment are essential to prevent complications and improve outcomes.
* With proper management, most people with inguinal hernia can expect a full recovery and improved quality of life.
The term "decerebrate" comes from the Latin word "cerebrum," which means brain. In this context, the term refers to a state where the brain is significantly damaged or absent, leading to a loss of consciousness and other cognitive functions.
Some common symptoms of the decerebrate state include:
* Loss of consciousness
* Flaccid paralysis (loss of muscle tone)
* Dilated pupils
* Lack of responsiveness to stimuli
* Poor or absent reflexes
* Inability to speak or communicate
The decerebrate state can be caused by a variety of factors, including:
* Severe head injury
* Stroke or cerebral vasculature disorders
* Brain tumors or cysts
* Infections such as meningitis or encephalitis
* Traumatic brain injury
Treatment for the decerebrate state is typically focused on addressing the underlying cause of the condition. This may involve medications to control seizures, antibiotics for infections, or surgery to relieve pressure on the brain. In some cases, the decerebrate state may be a permanent condition, and individuals may require long-term care and support.
Etomidate
Sepsis
Talmage Egan
Propofol
Local anesthetic
Fentanyl
Photic sneeze reflex
Steven Shafer
Anesthesia
Methyl fluoroacetate
Etoxadrol
Diazirine
Nicotinic acetylcholine receptor
Transvaginal oocyte retrieval
Neosaxitoxin
Anesthetic
Ketamine
Methitural
History of general anesthesia
Medetomidine
Benzyl alcohol
Theories of general anaesthetic action
Ernest H. Volwiler
General anaesthetic
Animal euthanasia
Local anesthetic nerve block
Stevens-Johnson syndrome
Balanced anesthesia
Halogenated ether
Dental anesthesia
Childbirth
Self-hypnosis
Doxepin
Flumazenil
Pheochromocytoma
1934 in science
Hydroxyzine
Prilocaine
Behavioral neuroscience
Intraperitoneal injection
Midazolam
Flurothyl
History of electroconvulsive therapy in the United States
Brit milah
Inhalant
JM-1232
List of skin conditions
Anti-NMDA receptor encephalitis
Antiemetic
Coinduction (anesthetics)
Carbetocin
Total intravenous anaesthesia
Surgical stress
Ketamine in society and culture
Biological half-life
Effects of early-life exposures to anesthesia on the brain
List of MeSH codes (D27)
Oral sedation dentistry
Postsurgical Infections Associated with an Extrinsically
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Illinois,...
Remimazolam - current knowledge on a new intravenous benzodiazepine anesthetic agent - PubMed
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DailyMed - SEVOFLURANE liquid
Subjects: Anesthetics, Intravenous -- adverse effects - Digital Collections - National Library of Medicine Search Results
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Anticholinergic syndrome after anesthesia: a case report and review
Current version of study NCT04330183 on ClinicalTrials.gov
Pilot Study of Ketamine in Adults With Obsessive-Compulsive Disorder (OCD) - Full Text View - ClinicalTrials.gov
Local Anesthetic Toxicity: Practice Essentials, Background, Pathophysiology
ICD-10-CM/PCS MS-DRG v37.0 Definitions Manual
Conscious sedation for surgical procedures: MedlinePlus Medical Encyclopedia
Sufentanil - Drugs and Lactation Database (LactMed®) - NCBI Bookshelf
Events
Rehabilitation and Fibromyalgia: Practice Essentials, Overview, Multidisciplinary Rehabilitation
Anesthetic gas | Practice Greenhealth
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Thiopental : Wheeless' Textbook of Orthopaedics
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DailyMed - PROPOFOL injection, emulsion
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IndexCat
Propofol5
- An epidemiologic investigation identified use of an intravenous anesthetic, propofol (DiprivanPr*), delivered by an infusion pump and attendance by one anesthesiologist as risk factors. (cdc.gov)
- Propofol is a rapid-onset, short-acting intravenous anesthetic agent. (nih.gov)
- Administration of propofol, the most frequently used intravenous anesthetic worldwide, has been associated with several iatrogenic infections despite its relative safety. (cdc.gov)
- Globally, propofol is the most frequently used intravenous (IV) anesthetic for the induction and maintenance of general anesthesia ( 1 ). (cdc.gov)
- Intravenous anesthetic propofol binds to 5-lipoxygenase and attenuates leukotriene B4 production. (harvard.edu)
Anesthesia7
- A review of anesthesia practices revealed numerous breaks in aseptic technique during preparation of the anesthetic. (cdc.gov)
- Still, many prescription and over the counter medications as well as many anesthetic agents possess anticholinergic activity, and this diagnosis should be considered in patients with altered mental status following general anesthesia. (nih.gov)
- See also Local Anesthetic Systemic Toxicity (LAST) Under Anesthesia . (medscape.com)
- Large doses of lidocaine (up to 55 mg/kg, versus the conventional maximum of 4.5 mg/kg) are used for tumescent anesthesia, in which a dilute local anesthetic solution is injected into subcutaneous tissue until it becomes firm and tense. (medscape.com)
- With the leadership and engagement of an anesthesia clinical champion, it is possible to reduce the impacts of anesthetic gas in the operating room. (practicegreenhealth.org)
- The American Society of Anesthesiologists offers guidance on environmental sustainability, including anesthetic choice and management, and the reduction, capture, and reuse of waste anesthesia gases. (practicegreenhealth.org)
- To produce anesthesia, doctors use drugs called anesthetics . (nih.gov)
Analgesia4
- 13. Anesthetic frequently used for analgesia during surgery. (pharmacologycorner.com)
- Purpose: Postoperative analgesia following minimally invasive video assisted thoracoscopic surgery (VATS) in pediatric patients may involve intravenous opioid analgesics and continuous local anesthetic infusions via an epidural infusion catheter. (elsevier.com)
- Finding non-opioid alternatives for intravenous analgesia is problematic based on the limited availability this class of drugs. (clinicaltrials.gov)
- Finding non-opioid alternatives for intravenous analgesia is problematic based on limited availability and poor side-effect profile. (clinicaltrials.gov)
Medication4
- 4 - 6 ] When a combination of anesthetic agents is used for a procedure, follow the recommendations for the most problematic medication used during the procedure. (nih.gov)
- An intravenous (IV) is inserted to provide anesthetic medication. (healthyplace.com)
- People with treatment-resistant bipolar disorder were relieved from the symptoms of depression in as little as 40 minutes after an intravenous dose of the anesthetic medication ketamine. (nih.gov)
- The anesthetic medication ketamine is known to block NMDA receptors, an important class of receptor for glutamate. (nih.gov)
Systemic5
- 8. The halogenated anesthetic which is advantageous in patients with cardiovascular disease because it maintains cardiac output, produces systemic and coronary vasodilation, and catecholamine dependent arrhythmias are uncommon. (pharmacologycorner.com)
- The use of epidural catheters may avoid systemic side effects of intravenous opioids in this vulnerable population. (elsevier.com)
- Both groups received intravenous systemic opioids. (elsevier.com)
- The toxicity of local and infiltration anesthetics can be local or systemic. (medscape.com)
- Systemic toxicity of anesthetics most often involves the central nervous system (CNS) or the cardiovascular system. (medscape.com)
California2
- Anesthetic induction of California sea lions ( Zalophus californianus ) (n=9) with alfaxalone (1.07-2.02 mg/kg) and midazolam (0.196-0.312 mg/kg) administered intramuscularly was performed opportunistically during assessments at a rehabilitation center. (vin.com)
- Alfaxalone with midazolam appears to be a safe and reliable combination for anesthetic induction in California sea lions and warrants further investigation. (vin.com)
Procedure5
- Design: Our primary aim was to compare total morphine equivalents (MEQ) required, and pain scores between local anesthetic epidural infusion catheters combined with intravenous opioids, versus intravenous opioids alone in pediatric patients following VATS procedure. (elsevier.com)
- Conscious sedation is a combination of medicines to help you relax (a sedative) and to block pain (an anesthetic) during a medical or dental procedure. (medlineplus.gov)
- The procedure is done using local anesthetic. (nih.gov)
- The anesthetic numbs your throat and helps prevent gagging during the procedure. (nih.gov)
- General anesthetics make patients unconscious during the procedure while local and regional anesthetics just numb part of the body and allow patients to remain awake. (nih.gov)
Inhalation1
- Sevoflurane, volatile liquid for inhalation, a nonflammable and nonexplosive liquid administered by vaporization, is a halogenated general inhalation anesthetic drug. (nih.gov)
Ketamine1
- In the first phase of the study, the participants were randomly assigned to receive a single dose of either intravenous ketamine or placebo (saline). (nih.gov)
Cardiovascular1
- 10. The intravenous anesthetic with excitatory effects on the central nervous system but produces the least cardiovascular disturbance among intravenous anesthetics. (pharmacologycorner.com)
Clinical2
- The evaluation of patients with possible toxicity from a local anesthetic should be guided by the clinical presentation. (medscape.com)
- 7. Muir W, Lerche P, Wiese A, Nelson L, Pasloske K, Whittem T. The cardiorespiratory and anesthetic effects of clinical and supraclinical doses of alfaxalone in cats. (vin.com)
Local6
- While generally safe, local anesthetic agents can be toxic if administered inappropriately, and in some cases may cause unintended reactions even when properly administered. (medscape.com)
- Manifestations of local anesthetic toxicity typically appear 1 to 5 minutes after the injection, but onset may range from 30 seconds to as long as 60 minutes. (medscape.com)
- Adding epinephrine to local anesthetics can make them last longer. (healthline.com)
- These drugs include general, regional, and local anesthetics. (nih.gov)
- Doctors use local and regional anesthetics to block pain in a part of the body. (nih.gov)
- Local anesthetics affect a small part of the body, such as a single tooth. (nih.gov)
Dose1
- 1 ] Two expert panels advocates waiting for at least 4 hours after a single intravenous dose of midazolam (e.g., for endoscopy) before resuming nursing. (nih.gov)
Agent3
- 12. In contrast to most anesthetics, this agent produces cardiac stimulation, resulting in increased blood pressure, heart rate and cardiac output. (pharmacologycorner.com)
- Reducing or eliminating the use of desflurane, the most expensive anesthetic agent with the highest global warming potential (GWP). (practicegreenhealth.org)
- The advantages of sodium evipal as an anesthetic agent. (nih.gov)
Seizure1
- 7. The anesthetic which should be avoided in patients with a seizure disorder because tonic-clonic seizures are associated with its use. (pharmacologycorner.com)
Correlate1
- Blood levels of the anesthetic may be measured, although blood levels may not correlate with toxicity or may not be obtained at a clinically useful time. (medscape.com)
Receptors2
- Here we present cryo-electron microscopy structures of GABA A receptors bound to intravenous anaesthetics, benzodiazepines and inhibitory modulators. (nature.com)
- Forman, S. A. & Miller, K. W. Mapping general anesthetic sites in heteromeric γ-aminobutyric acid type A receptors reveals a potential for targeting receptor subtypes. (nature.com)
General5
- Emerging molecular mechanisms of general anesthetic action. (nature.com)
- Evipan as a general anesthetic. (nih.gov)
- General anesthetics cause changes in brain waves. (nih.gov)
- Doctors provide general anesthetics either directly into the bloodstream (intravenously) or as an inhaled gas. (nih.gov)
- General anesthetics typically are very safe. (nih.gov)
Vein2
- You may receive the medicine through an intravenous line (IV, in a vein) or a shot into a muscle. (medlineplus.gov)
- Placement of central line, if needed: An intravenous line (tube) is placed into a major vein in the chest. (nih.gov)
Effects3
- Both berberine and hydrastine produced parasympatholytic and anesthetic effects when applied to the eyes. (nih.gov)
- Scientists have developed a collection of anesthetic drugs with different effects. (nih.gov)
- Because inhaled anesthetics have different effects than intravenous ones, scientists suspect that the two types of drugs target different sets of proteins. (nih.gov)
Spray1
- A health care professional will give you a liquid anesthetic to gargle or will spray anesthetic on the back of your throat. (nih.gov)
Unconscious1
- To minimize these risks, specialized doctors called anesthesiologists carefully monitor unconscious patients and can adjust the amount of anesthetic they receive. (nih.gov)
Patients3
- 3. The minimum alveolar concentration (MAC) is the concentration of anesthetic at 1 atmosphere of pressure that produces immobility in 50% of patients exposed to a noxious stimulus. (pharmacologycorner.com)
- Both drugs are commonly used as anesthetic in patients undergoing open-heart surgery. (nih.gov)
- With these anesthetics, patients stay conscious and comfortable. (nih.gov)
Line1
- If you have a severe infection and aren't producing enough catecholamines, you may need to be given epinephrine through an intravenous line (IV). (healthline.com)
Provide1
- An intravenous (IV) needle will be placed in your arm to provide a sedative. (nih.gov)
Patient2
- 5. The anesthetic that may be most safely used in a patient with a history of malignant hyperthermia? (pharmacologycorner.com)
- Waste anesthetic gases - unused gas exhaled by the patient - are considered Scope 1 greenhouse gases and may make up 5 percent or more of a hospital's entire carbon footprint. (practicegreenhealth.org)
Plasma1
- Plasma pharmacokinetics of alfaxalone in dogs after an intravenous bolus of Alfaxan-CD RTU. (vin.com)
Action1
- Which anesthetic has the fastest onset of action? (pharmacologycorner.com)
Longer1
- Inhaled anesthetics may take longer to wear off. (nih.gov)
Highest1
- 6. Anesthetic associated with the highest incidence of hepatitis. (pharmacologycorner.com)
Potential1
- 9. This anesthetic has become obsolete due to its potential for causing nephrotoxicity. (pharmacologycorner.com)
Blood1
- 2. The blood:gas partition coefficient is the ratio of anesthetic concentration in blood compared to gas phase. (pharmacologycorner.com)