Inadequate and incomplete pain assessment methods contribute to inadequate pain management. Thus, to gather all the information about pain is very important. There are multiple methods available depending on: A. Subjective description B. Objective description C. Characteristic of pain D. Description of pain There are many components mentioned for “Ideal pain Assessment” like patient quotes, […]
Flumazenil is the first specific benzodiazepine antagonist, used as a specific antidote in known or suspected benzodiazepine overdose treatment . In addition, flumazenil could be employed to reverse sedation produced by benzodiazepines during general anesthesia and prolonged sedation in intensive care units. Flumazenil is a specific and competitive antagonist at the central benzodiazepine receptor, reversing
Midazolam effects cerebral metabolic oxygen requirement (CMRO2) by decreasing it and cerebral blood flow, analogous to barbiturates and propofol. It causes dose-related changes in regional cerebral blood flow in brain regions associated with the normal functioning of arousal, attention, and memory. Patients with decreased intracranial compliance show little or no change in intra-cranial pressure when
This butorphanol drug class was introduced about 25-30 years back. That was the era of morphine, pethidine, so it did not gain much acceptance. But now re-introduced, has become a major “find”. It is a classical example of “resurrection”. Butorphanol is a morphinan derivative with spectrum of activity almost like pentazocine, only that it is 20
The Phenobarbital schedule is listed here. The long-term administration of high doses of thiopental is associated with an increased incidence of nosocomial infections and associated mortality. Barbiturate coma may cause reversible leucopenia and an increased infection rate. Long-term administration of thiopental may also promote reversible antibiotic-induced bone marrow suppression. Thiopentone depresses T-lymphocyte function. Loop et
A special mention must be made here about the novel ways of using neuraxial regional anesthesia anticoagulation . The use started in 1979. Gradually they have become very popular and almost all the clinically available opioids have been tried by this route. Nowadays the flexibility of neuraxial regional anesthesia anticoagulation is available to be given
Propofol and egg allergy are quietly related as one of the side effects. Allergic reactions to propofol on first exposure are usually because of the isopropyl groups that may act as epitopes and that are present in various medications andcosmetics. Allergic reactions to propofol upon re-exposure are usually because of the phenol molecule. Propofol and
Etomidate mechanism of action is shown here. The GABAA receptor plays a central role in the etomidate mechanism of action Etomidate exerts its effects on the receptor by binding directly to a specific site or sites on the protein and allosterically enhancing the apparent affinity of GABA for its receptor. At much higher concentrations etomidate
Etomidate induces loss of consciousness rapidly (5—15 seconds) and recovery occurs in 5 to 15 minutes. The elimination Etomidate half life is 4.6 +1- 2.6 hours and total apparent volume of distribution, 4.5 +/- 2.2 L/kg. The volume of distribution of etomidate half life is large, suggesting considerable tissue uptake. The plasma clearance is 879
Ketamine produces effective sedation, hence also known as Ketamine sedation . In pediatric patients for short surgical procedures or for putting intravenous catheters before IV induction ketamine has shown effective for producing sedation. It is highly effective with a wide margin of safety, and uniquely preserves protective airway reflexes and also does not require intravenous
