Anesthesia and surgery

Uhing MR, Beno DW, Jiyamapa-Serna VA, Chen Y, Galinsky RE, Hall SD and Kimura RE (2004) The Effect of Anesthesia and Surgery on CYP3A Activity in Rats. Drug Metab Dispos 32 pp 1325-1330. 

In situ intestinal mechanisms (e.g., polarity in transport) Evaluation of absorption enhancing strategies on a mechanistic basis Well-defined absorptive area Good oxygenation Closest model to in vivo Implies anesthesia and surgery... 

Promethazine Promethazine also is indicated for preoperative, postoperative, or obstetric sedation prevention and control of nausea and vomiting associated with certain types of anesthesia and surgery an adjunct to analgesics for control of postoperative pain sedation and relief of apprehension, and to produce light sleep antiemetic effect in postoperative patients active and prophylactic treatment of motion sickness (oral and rectal only). 

When used for nausea or vomiting associated with anesthesia and surgery, administer by deep IM injection at, or shortly before, termination of anesthesia. 

Scopolamine inhibits excessive motility and hypertonus of the Gl tract in irritable colon syndrome, mild dysentery, diverticulitis, pylorospasm, and cardiospasm. Transdermal patch Prevention of nausea and vomiting associated with motion sickness and recovery from anesthesia and surgery in adults. 

Hydroxyzine hydrochloride Atarax, Vistarit) is the antihistamine with the greatest use in the treatment of anxiety. It is often used to reduce the anxiety that is associated with anesthesia and surgery. It also produces sedation, dries mucous membranes (via an anticholinergic mechanism), and has antiemetic activity. A more extensive discussion of the pharmacology of the Hj-receptor antagonists is found in Chapter 38. 

During the 16th century, European explorers found that natives in the Amazon Basin of South America were using curare, an arrow poison that produced skeletal muscle paralysis, to kill animals. The active compound, d-tubocurarine, and its modern synthetic derivatives, have had a major influence on the practice of anesthesia and surgery and have proved useful in understanding the basic mechanisms involved in neuromuscular transmission. 

Fentanyl, sufentanil, and alfentanil are frequently used before anesthesia and surgery as a sedative and analgesic, as well as a continuous infusion for primary anesthesia. Because opioids rarely affect the cardiovascular system, they are particularly useful for cardiac surgery and other high-risk cases. Opioids act directly on spinal cord receptors, and are frequently used in epidurals for spinal anesthesia. Side effects may include nausea and vomiting, itching, and respiratory depression. 

Glycopyrrolate (Robinul, others) is employed orally to inhibit GI motility and also is used parenteraUy to block the effects of vagal stimulation during anesthesia and surgery. 

Promethazine (25 mg 1 hour before travel) is indicated for acute and prophylactic treatment of motion sickness, and for prevention and control of nausea and vomiting associated with anesthesia and surgery. 

Tait A R, Voepel-Lewis T, Mallviya S (2003). Do they understand Part I parental consent for children participating in clinical anesthesia and surgery research. 

Hulbert JC, Grossman JE, Cummings KB. Risk fectors of anesthesia and surgery in bleomy-cin-tieated patients. J Urol (Baltimore) (1983) 130,163-4. 

Smessaert AA, Hicks RG. Problems caused by rauwolfia drugs during anesthesia and surgery. NY State JMed 96 ) 61,2399-2403. 

Wandelt, M.A. Definitions of words germane to evaluation of healthcare. NLNPub 1976(15-1611) 57-58,1976. Warner, M.A. (eds.). Positioning in Anesthesia and Surgery. Philadelphia, PA WB. 

Post Anesthesia Care Unit (PACU) Area where patients go to recover from the immediate effects of anesthesia and surgery. 

Drugs and Other Agents Used in Anesthesia and Surgery... 

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