Open AccessAnesthetic considerations for extracranial injuries in patients with associated brain trauma
Author(s) -
Ankur Khandelwal,
Parmod K. Bithal,
Girija Prasad Rath
Publication year - 2019
Publication title -
journal of anaesthesiology-clinical pharmacology/journal of anaesthesiology clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.466
H-Index - 32
eISSN - 2231-2730
pISSN - 0970-9185
DOI - 10.4103/joacp.joacp_278_18
Subject(s) - polytrauma , medicine , anesthetic , cerebral perfusion pressure , anesthesia , multimodal therapy , traumatic brain injury , intracranial pressure , hemodynamics , intensive care medicine , rehabilitation , surgery , physical therapy , cerebral blood flow , psychiatry
Patients with severe traumatic brain injury often presents with extracranial injuries, which may contribute to fatal outcome. Anesthetic management of such polytrauma patients is extremely challenging that includes prioritizing the organ system to be dealt first, reducing on-going injury, and preventing secondary injuries. Neuroprotective and neurorescue measures should be instituted simultaneously during extracranial surgeries. Selection of anesthetic drugs that minimally interferes with cerebral dynamics, maintenance of hemodynamics and cerebral perfusion pressure, optimal utilization of multimodal monitoring techniques, and aggressive rehabilitation approach are the key factors for improving overall patient outcome.