In the s, physicians started to augment inhaled general anesthetics with intravenous general anesthetics.
Literature regarding the use of porcine and bovine-derived medications and medical devices for patients who practice Judaism, Islam, and Hinduism is limited.
Consideration and knowledge of these issues is necessary to facilitate successful communication with a diverse patient population and respect her religious convictions. We present a report of a year-old patient of the Islamic faith who required anticoagulation following a lower extremity orthopedic procedure.
The family and patient requested no porcine-derived medications, thereby precluding the use of subcutaneous low molecular weight heparin. Issues surrounding religious concerns regarding animal-derived medications and healthcare products are reviewed and options for effective care in such circumstances outlined.
Religious-related concerns and animal-derived medications during anesthetic care. Many such products may not even be considered and known to be animal-derived during their use. For example, gelatin capsules, surfactants, and surgical implants may be derived from porcine or bovine material.
We present a case report of a year-old patient of the Islamic faith, who required anticoagulation following a lower extremity orthopedic procedure. The family and the patient requested not to use porcine-derived medications, thereby precluding the use of subcutaneous low molecular weight heparin.
Her past medical history was positive for osteoporosis, allergic rhinitis, gastroesophageal reflux disease GERDasthma, and kidney stones. Past surgical history was negative, but she had previously sustained multiple fractures that were treated conservatively. Prior to surgery, she had severe bowing deformities of both of her femurs, and had to use a wheelchair for mobilization.
Two days earlier, she sustained fracture of her left femur and was admitted to the inpatient ward through the emergency department. She was placed on aspirin mg daily for deep vein thrombosis DVT prophylaxis and the femur was placed in traction while waiting for the surgical equipment to arrive.
She was expected to require fixation of the right femur as well, depending on the success of fixation of the left femur.
She was on several medications for the treatment of GERD, osteoporosis, and asthma including cephalexin mg by mouth twice a dayfluticasone 1 spray in each nostril dailycetirizine 10 mg by mouth once a dayondansetron 4 mg by mouth every 8 h as neededfamotidine 20 mg by mouth twice a daypotassium citrate 10 mEq by mouth twice a daycalcium carbonate mg by mouth three times a dayalbuterol meter dosed inhaler 2 puffs every 4 h as neededbeclomethasone 2 puffs twice a daycholecalciferol 4, unit by mouth once a dayomeprazole 20 mg by mouth once a dayand amitriptyline 10 mg by mouth once a day.
The latter was related to religious concerns and not a true allergy. Physical examination revealed a patient in no acute distress in a motorized wheelchair.
She was noted to have bowing deformities of the femurs bilaterally and brittle discolored teeth. Her vital signs were within normal limits. Airway examination revealed a Mallampati grade II.
Her cardiovascular and pulmonary examinations were unremarkable. Preoperative laboratory parameters included hemoglobin Electrolytes and renal function were normal. Anesthesia was induced while the patient was still in her hospital bed because of severe pain with motion.
She was then transferred to the operating table. An epidural catheter was placed at the L interspace. To facilitate intraoperative monitoring, an arterial cannula was placed.
Maintenance anesthesia included sevoflurane, fentanyl, and ongoing neuromuscular blockade with intermittent rocuronium. The procedure lasted approximately 6 h. She was transferred to the post-anesthesia care unit PACU in stable condition and then to the Intensive Care Unit for ongoing blood pressure monitoring.
Due to the need for postoperative immobilization, the primary orthopedic service requested DVT prophylaxis.Practice Advisory on Anesthetic Care for Magnetic Resonance Imaging: A Report by the American Society of Anesthesiologists Task Force on Anesthetic Care for Magnetic Resonance Imaging* You will receive an email whenever this article is corrected, updated, or cited in the literature.
Monitored anesthesia care (MAC) has been described as a specific anesthesia service for diagnostic or therapeutic procedures performed under local anesthesia along with sedation and analgesia, titrated to a level that preserves spontaneous breathing and airway reflexes, according to the latest.
The likelihood that a specific complication will arise for a given patient is determined by the nature of the procedure, the anesthetic techniques used, the patient's comorbidities, and preoperative medical assessment and optimization.
Is this newer anesthetic injection technique better for patients? Taking a look at the Anterior Middle Superior Alveolar injection and the impact it has on patient care. A patient who receives general anesthesia is usually under the care of an anesthesiologist, a medical doctor who has completed three years of specialized training in anesthesia beyond medical school.
A nurse anesthetist is a specially trained nurse who may also administer general anesthesia, usually under the direct supervision of the.
Anesthesia or anaesthesia (from Greek "without sensation") is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes. It may include analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), or unconsciousness.A patient under the effects of anesthetic drugs is referred to as being anesthetized.