Anesthesia

Remimazolam

Recent Advances in Anesthesia /

Remimazolam  Introduction Ultra-short-acting intravenous benzodiazepine Structurally related to midazolam Rapid, predictable metabolism resembles the pharmacokinetic concept of remifentanil Available as remimazolam besylate Water-soluble formulation Trade name: Byfavo Chemistry Imidazobenzodiazepine containing a metabolically labile carboxylic ester linkage Molecular formula: C₂₁H₁₉BrN₄O₂ Molecular weight: approximately 439.3 Da The ester linkage permits rapid hydrolysis to an inactive metabolite Mechanism […]

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Apnoeic Oxygenation

Recent Advances in Anesthesia /

Apnoeic Oxygenation Definition Apnoeic oxygenation is the continuous delivery of oxygen to the airway during apnoea, allowing ongoing alveolar oxygen uptake without spontaneous breathing or positive-pressure ventilation. It delays desaturation and prolongs safe apnoea time during airway management. Important: It maintains oxygenation but does not provide adequate ventilation. Mechanism O₂ continues to diffuse from alveoli

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Neuropathic Pain 

Pain and Palliative Care Anesthesia /

NEUROPATHIC PAIN  BRIEFThis guide translates Neuropatic pain: Fundamental neurophysiology and pharmacology into structured bedside diagnostic and therapeutic pathways. DEFINITION AND ETIOLOGY Neuropathic pain: Defined by the International Association for the Study of Pain (IASP) as pain caused by a lesion or disease of the somatosensory nervous system .  It is critical to recognize that neuropathic

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Pediatric airway anatomy and assessment

Pediatric Anesthesia /

Paediatric Airway Anatomy and Assessment Introduction Paediatric airway management differs significantly from adult airway management because of unique anatomical and physiological characteristics. A relatively large tongue, cephalad larynx, compliant airway structures, and limited oxygen reserves predispose children to airway obstruction and rapid desaturation. Understanding these differences and performing a systematic airway assessment are essential for

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Nociceptors and Pain Fiber Classification

Pain and Palliative Care Anesthesia /

Nociceptor Classification and Molecular Transduction Clinical Pearls & Key Takeaways •  Temporal Distinction: The dichotomy between ‘first’ and ‘second’ pain is purely a function of conduction velocities between fast myelinated Aδ and slow unmyelinated C fibres. •  Molecular Transduction: TRPV1 acts as a non-selective gating channel responsive to heat and local acidosis, whereas mechanical noxious

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Pre anesthetic Check up

Must Know Anesthesia Topics /

Pre-Anaesthetic Check-up (PAC) Objectives of PAC The Pre-Anaesthetic Check-up (PAC) is a systematic evaluation performed before anaesthesia to assess the patient’s current health status, identify potential preoperative risks, optimise the patient, and formulate an individualised anaesthetic plan. The main objectives are: Assess the patient’s current health status Identify existing medical conditions and their severity. Assess

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Fetal Circulation

Cardiac Anesthesia /

1. Introduction The circulation of blood from the placenta to and through the fetus and back to the placenta is known as fetal circulation. It is a parallel circuit, unlike adult circulation, which is a serial circuit. Both the right and left ventricles pump blood in parallel to the systemic and placental circuits, rather than

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Neurotransmitters in Pain

Pain and Palliative Care Anesthesia /

Neurotransmitters in Pain Neurotransmitter Role in Pain Modulation Mechanism of Action Glutamate Primary excitatory neurotransmitter; mediates nociceptive signal transmission in the spinal cord and brain. Activates NMDA and AMPA receptors, facilitating excitatory neurotransmission and central sensitization. Substance P Facilitates pain transmission and inflammation by promoting neurogenic inflammation and sensitization. Binds to neurokinin-1 (NK1) receptors; increases

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Pain Assessment

Pain and Palliative Care Anesthesia /

Pain Assessment Tools & Scales 1. Core Principles of Pain Assessment Pain is inherently subjective, making self-reporting the gold standard of pain assessment whenever possible. However, the inability to communicate verbally does not negate the possibility that a patient is experiencing pain. Modern clinical guidelines (such as the PADIS guidelines) emphasize a hierarchical approach to

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Referred Pain

Pain and Palliative Care Anesthesia /

Referred Pain and Dermatomes  Referred Pain: Pathophysiology & Mechanisms Referred pain is a phenomenon where pain is perceived in an area remote from the site of the actual nociceptive stimulus. This is a highly tested concept across critical care and anaesthesia boards, heavily relying on neuroanatomical principles. The definitive, evidence-based explanation for referred pain is

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