Presentation
This article presents an in-depth discussion of a case involving a nearly 10-year-old boy with a history of an unspecified form of MD, who presented for endodontic treatment of tooth No. 30 under deep sedation. [ncbi.nlm.nih.gov]
Entire Body System
- Pain
The patients answered a questionnaire, administered by phone during the postoperative period, regarding measurement of pain intensity, using the visual analog scale (VAS), and the time of onset of pain. [ncbi.nlm.nih.gov]
- Unconsciousness
Local anesthetics[edit] Local anesthetic agents prevent transmission of nerve impulses without causing unconsciousness. [en.wikipedia.org]
The four phases of unconsciousness Stage 1 is known as induction, the period between the administration of anesthetic and loss of consciousness. [theconversation.com]
Propofol is used sometimes in patients in intensive care units in hospitals to cause unconsciousness. [mayoclinic.org]
Published on Feb 5, 2018 General anesthetics are a group of drugs commonly used in major surgery to produce unconsciousness, analgesia, and depression of reflexes. [youtube.com]
These findings support the hypothesis that unconsciousness occurs in the unstimulated subject during fentanyl-induced apnea and rigidity. [doi.org]
- Surgical Procedure
Abstract Local anesthetics are commonly used in the perioperative environment to facilitate surgical procedures or to provide postoperative pain management for patients. [ncbi.nlm.nih.gov]
Regional anesthesia techniques provide important advantages compared with general anesthesia in some surgical procedures [1, 3]. Regional anesthesia is not only performed for adequate anesthesia in the surgical procedures. [hindawi.com]
- Hypothermia
Chills and shivering (hypothermia) – This occurs in up to half of patients as they regain consciousness after surgery, and it might be related to body temperature. [asahq.org]
Severe hypothermia may result in coagulopathy, delayed awakening, or arrhythmia. [emedicine.medscape.com]
More likely is the occurrence of intraoperative hypothermia due to a combination of four types of heat loss: conductive, convective, evaporative and radiant. [tsaco.bmj.com]
- Severe Pain
BACKGROUND: Major abdominal surgeries are associated with severe pain, which can affect respiratory and cardiac functions if insufficiently treated; this increases postoperative morbidity. [ncbi.nlm.nih.gov]
Narcotic analgesics, such as opioids, act on the central nervous system to relieve pain. They are used for more severe pain. [mouthhealthy.org]
There is a wide range of pain medication available to help a person cope, including: nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or acetaminophen for mild to moderate pain opioids, such as morphine, for moderate or severe pain For [medicalnewstoday.com]
Patients in severe pain prior to surgery may be given morphine or fentanyl. [encyclopedia.com]
Respiratoric
- Dyspnea
A 44-year-old man with a past surgical history of pancreaticoduodenectomy presented fluctuating fever, jaundice, dyspnea and yellowish sputum. [ncbi.nlm.nih.gov]
Gastrointestinal
- Nausea
Rate/drug effects Humans Hypotension/chemically induced Hypotension/drug therapy Injections, Epidural/adverse effects Lidocaine/administration & dosage Lidocaine/adverse effects* Lumbosacral Plexus/drug effects* Middle Aged Monitoring, Intraoperative Nausea [ncbi.nlm.nih.gov]
While side effects differ based on the substance (e.g., halothane can cause hepatotoxicity), the most common side effect is nausea. [amboss.com]
Warriner’s research is focused on the use of blood substitutes in surgical patients, the value of preoperative beta blockers, the reversal of muscle relaxants and the prevention of postoperative nausea and vomiting. ► LECTURIO is your single-point resource [youtube.com]
Patients given monitored anesthesia rather than general anesthesia experience fewer incidences of nausea and vomiting and typically can be discharged home safely and quickly. The image below depicts intraoral approach for an infraorbital block. [emedicine.medscape.com]
Side effects Nausea is a common side effect of general anesthesia. There are a number of potential side effects of anesthesia. Some individuals may experience none, others a few. [medicalnewstoday.com]
- Abdominal Pain
Pain control and advice An anesthesiologist who specializes in pain medicine may assist patients who have pain due to a range of causes, including headaches, burns, diabetes and herpes, or where they are experiencing chest pain, abdominal, pain pelvic [medicalnewstoday.com]
Celiac Plexus Block : A celiac plexus block is generally performed to relieve pain in patients with cancer of the pancreas or other chronic abdominal pains. [asra.com]
Cardiovascular
- Heart Block
Unintentional intravascular injection of bupivacaine during regional anesthesia may produce severe cardiovascular toxicity, including left ventricular depression, atrioventricular heart block, and life-threatening arrhythmias such as ventricular tachycardia [accessmedicine.mhmedical.com]
Psychiatrical
- Withdrawn
Withdrawal symptoms last from approximately 6 to a peak of 24 to 72 hours after the drug has been withdrawn. [asra.com]
Neurologic
- Confusion
Postoperative delirium – Confusion when regaining consciousness after surgery is common, but for some people — particularly older patients — the confusion can come and go for about a week. [asahq.org]
Other common side effects from the medicine are: Nausea and vomiting Dry mouth Sore throat Hoarse voice Sleepiness Shivering Muscle aches Itching Confusion -- especially in older people Rarely, people can be very confused for a few days after their surgery [webmd.com]
It can induce a condition known as postoperative delirium, a state of serious confusion and memory loss. [io9.gizmodo.com]
- Amnesia
Under general anesthesia, the patient is unable to feel pain and may also have amnesia. [medicalnewstoday.com]
While under general anesthesia, a patient is unable to feel pain and will likely wake with some short-term amnesia (memory loss). Experts are unsure exactly how general anesthetics work. [drugs.com]
The authors sought to determine whether unconsciousness and amnesia occur when humans develop rigidity and apnea after intravenous fentanyl (without other concomitant anesthetics). [doi.org]
Since then, doctors have gotten much better at putting us out with drug combinations that ease pain, relax muscles and, in some cases, put us in a deep state of hypnosis that gives us temporary amnesia. [livescience.com]
- Agitation
Eighty-one percent of the events experienced were attributable to agitation or prolonged recovery. [jamanetwork.com]
Some may become agitated, inconsolable or restless. Others may be sleepy and unsteady on their feet for the rest of the day. Most pediatric patients are able to resume their normal activity within six to eight hours. [radiologyinfo.org]
Because of those findings, surveillance tools for detecting opiate-related somnolence include nursing scales such as the Richmond Agitation and Sedation Scale (RASS) and the Pasero Opioid-Induced Sedation Scale (POSS).29 Beyond mere surveillance however [tsaco.bmj.com]
- Temporary Amnesia
Since then, doctors have gotten much better at putting us out with drug combinations that ease pain, relax muscles and, in some cases, put us in a deep state of hypnosis that gives us temporary amnesia. [livescience.com]
- Stupor
Opium was praised by the Persian philosopher and physician Avicenna in the eleventh century as the most powerful of stupor-producing substances. [encyclopedia.com]
Treatment
We describe the perioperative management of a complex pediatric patient undergoing a posterior tracheopexy which is a relatively new surgical treatment, with a novel surgical approach-thoracoscopy. [ncbi.nlm.nih.gov]
Prognosis
The resulting prognosis can be excellent after the rapid removal of inciting agents and the application of appropriate treatments. [ncbi.nlm.nih.gov]
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. [healdove.com]
Etiology
[…] poisoning* Antidotes/administration & dosage* Cesarean Section Fat Emulsions, Intravenous/administration & dosage* Female Humans Infusions, Spinal Lidocaine/administration & dosage Lidocaine/poisoning* Poisoning/diagnosis Poisoning/drug therapy* Poisoning/etiology [ncbi.nlm.nih.gov]
Epidemiology
The results of single-center and multicenter registries and epidemiologic studies complement this information. Between March 2014 and November 2016, 47 separate cases of LAST were described in 35 peer-reviewed articles. [ncbi.nlm.nih.gov]
In humans, recent preliminary findings from epidemiological studies suggest an association between surgery and anesthesia early in life and subsequent learning abnormalities. [doi.org]
This may have been a chance finding, as analyses did not adjust for multiple endpoints.43 The PANDA study addressed many of the limitations of the previous epidemiologic studies. [fda.gov]
Pathophysiology
Obstetric and anesthetic management are particularly challenging, and treatment requires knowledge of pathophysiologic mechanisms in order to provide safe care to this group of patients. [ncbi.nlm.nih.gov]
[…] hypertension Desflurane: sympatho-adrenergic reaction → ↑ blood pressure and ↑ heart rate Sevoflurane: interacts with soda lime → nephrotoxic breakdown products (known as compounds A–E) Enflurane: proconvulsive Halothane: hepatotoxic → halothane hepatitis [5] Pathophysiology [amboss.com]
Pathophysiological effects during laparoscopic cholecystectomy 2.1. [intechopen.com]
Prevention
Spontaneous spinal epidural hematoma during pregnancy is a quite rare event requiring emergent decompressive surgery in the majority of cases to prevent permanent neurological damage. [ncbi.nlm.nih.gov]
The scavenging system should be kept in good repair to prevent leaks using a maintenance and inspection program as listed below. [ccohs.ca]