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Current Anesthesiology Reports
Erschienen in: Current Anesthesiology Reports 3/2014

01.09.2014 | Anesthesia for Trauma (J-F Pittet, Section Editor)

Choice of General Anesthetics for Trauma Patients

verfasst von: Robert A. Sikorski, A. Ken Koerner, L. Yvette Fouche-Weber, Samuel M. Galvagno Jr.

Erschienen in: Current Anesthesiology Reports | Ausgabe 3/2014

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Abstract

The trauma anesthesiologist has multiple competing concerns when supporting the patient with major trauma, but the priority must be focused on adequate resuscitation to facilitate surgical hemostasis. A broad, evidence-informed knowledge of airway management, resuscitation, physiology, pharmacology, and critical care is required to address the unique pathophysiological processes encountered in trauma. Judicious selection of anesthetic agents is crucial to ensure optimal outcomes. In this review, we describe approaches for the induction and maintenance of general anesthesia for the patient with major trauma. Considerations for ongoing resuscitation and hemodynamic instability will be explored and discussed with respect to the administration of anesthetic induction and maintenance agents. Practices at our institution are reviewed, including the administration of high-dose opioids as an integral part of both resuscitation and anesthesia for the patient with major trauma.
Literatur
1.
2.
• Stollings JL, Diedrich DA, Oyen LJ, Brown DR. Rapid-sequence intubation: a review of the process and considerations when choosing medications. Ann Pharmacol 2014;48:62–76. An excellent review describing the pharmacology of agents used for rapid sequence induction and intubation.
3.
• El-Orbany M, Connolly LA. Rapid sequence induction and intubation: current controversy. Anesth Analg 2010;110:1318–25. A thorough review on rapid sequence induction and intubation. Highlights all major current controversies reqarding this technique.
4.
Bassett MD, Smith CE. General anesthesia for trauma. In: Varon AJ, Smith CE, editors. Essentials of trauma anesthesia. New York: Cambridge University Press; 2012. p. 76–94.CrossRef
5.
Herbstritt A, Amarakone K. Towards evidence-based emergency medicine: best BETs from the Manchester Royal Infirmary. BET 3: is rocuronium as effective as succinylcholine at facilitating laryngoscopy during rapid sequence intubation. Emerg Med J. 2012;29:256–8.PubMedCrossRef
6.
Magorian T, Flannery KB, Miller RD. Comparison of rocuronium, succinylcholine, and vecuronium for rapid-sequence induction of anesthesia in adult patients. Anesthesiology. 1993;79:913–5.PubMedCrossRef
7.
Suzuki T, Aono M, Fukano N, Kobayashi M, Saeki S, Ogawa S. Effectiveness of the timing principle with high-dose rocuronium during rapid sequence induction with lidocaine, remifentanil and propofol. J Anesth. 2010;24:177–81.PubMedCrossRef
8.
Cheng WJ, Wong YL, Hui YL, Wu YW. Tan PP. Rapid sequence induction and tracheal intubation with vecuronium: with or without a priming dose. Ma Zui Xue Za Zhi. 1993;31:15–8.PubMed
9.
Doenicke AW, Czeslick E, Moss J, Hoernecke R. Onset time, endotracheal intubating conditions, and plasma histamine after cisatracurium and vecuronium administration. Anesth Analg. 1998;87:434–8.PubMed
10.
Deepika K, Bikhazi GB, Mikati HM, Namba M, Foldes FF. Facilitation of rapid-sequence intubation with large-dose vecuronium with or without priming. J Clin Anesth. 1992;4:106–10.PubMedCrossRef
11.
• Fields AM, Rosbolt MB, Cohn SM. Induction agents for intubation of the trauma patient. J Trauma Acute Care Surg 2009;67:867–9. Another excellent review of induction agents for rapid sequence induction and intubation in trauma.
12.
13.
Agarwala A, Dershwitz M. Intravenous induction agents. In: Vacanti CA, Sikka PK, Urman RD, Dershwitz M, Segal BS, editors. Essential clinical anesthesia. New York: Cambridge University Press; 2011. p. 227–32.CrossRef
14.
Lipiner-Friedman D, Sprung CL, Laterre PF, et al. Adrenal function in sepsis: the retrospective CORTICUS cohort study. Crit Care Med. 2007;35:1012–8.PubMedCrossRef
15.
Chan CM, Mitchell AL, Shorr AF. Etomidate is associated with mortality and adrenal insufficiency in sepsis: a meta-analysis. Crit Care Med. 2012;40:2945–53.PubMedCrossRef
16.
Asehnoune K, Mahe PJ, Seguin P, et al. Etomidate increases susceptibility to pneumonia in trauma patients. Intensive Care Med. 2012;38:1673–82.PubMedCrossRef
17.
Himmelseher S, Durieux ME. Revising a dogma: ketamine for patients with neurological injury? Anesth Analg. 2005;101:524–34.PubMedCrossRef
18.
Sehdev RS, Symmons DA, Kindl K. Ketamine for rapid sequence induction in patients with head injury in the emergency department. Emerg Med Australas. 2006;18:37–44.PubMedCrossRef
19.
• Filanovsky Y, Miller P, Kao J. Myth: ketamine should not be used as an induction agent for intubation in patients with head injury. CJEM 2010;12:154–7. A well-written synopsis refuting claims about the harms of ketamine in patients with neurotrauma.
20.
Ballow SL, Kaups KL, Anderson S, Chang M. A standardized rapid sequence intubation protocol facilitates airway management in critically injured patients. J Trauma Acute Care Surg. 2012;73:1401–5.PubMedCrossRef
21.
Manley G, Knudson MM, Morabito D, Damron S, Erickson V, Pitts L. Hypotension, hypoxia, and head injury. Arch Surg. 2001;136:1118–23.PubMedCrossRef
22.
Schönenberg M, Reichwald U, Domes G, Badke A, Hautzinger M. Ketamine aggravates symptoms of acute stress disorder in a naturalistic sample of accident victims. Psychopharmacol. 2008;22:493–7.CrossRef
23.
Schönenberg M, Reichwald U, Domes G, Badke A, Hautzinger M. Effects of peritraumatic ketamine medication on early and sustained posttraumatic stress symptoms in moderately injured accident victims. Psychopharmacology. 2005;182:420–5.PubMedCrossRef
24.
Berman RM, Cappiello A, Anand A. Antidepressant effects of ketamine in depressed patients. Biol Psychiatry. 2000;47:351–4.PubMedCrossRef
25.
Zarate CA, Singh JB, Carlson PJ. A randomized trial of an N-methyl-D-aspartate antagonist in treatment-resistant major depression. Arch Gen Psychiatry. 2006;63:856–64.PubMedCrossRef
26.
Pinaud M, Lelausque JN, Chetanneau A, Fauchoux N, Menegalli D, Souron R. Effects of propofol on cerebral hemodynamics and metabolism in patients with brain trauma. Anesthesiol Clin. 1990;73:404–9.
27.
Smischney NJ, Beach ML, Loftus RW, Dodds TM, Koff MD. Ketamine/propofol admixture (ketofol) is associated with improved hemodynamics as an induction agent: a randomized, controlled trial. J Trauma Acute Care Surg. 2012;73:94–101.PubMedCrossRef
28.
Vaillaincourt C, Kapur AK. Opposition to the use of lidocaine in rapid sequence intubation. Ann Emerg Med. 2007;49:86–7.CrossRef
29.
Asfar SN, Abdulla WY. The effect of various administration routes of lidocaine on hemodynamics and ECG rhythm during endotracheal intubation. Acta Anaesthestiol Belg. 1990;41:17–24.
30.
Samaha T, Ravussin P, Clauquin C. Prevention of increase of blood pressure and intracranial pressure during endotracheal intubation in neurosurgery: esmolol versus lidocaine. Ann Fr Anesth Reanim. 1996;15:36–40.PubMedCrossRef
31.
• Curry N, Davis PW. What’s new in resuscitation strategies for the patient with multiple trauma? Injury 2012;43:1021–8. A succinct review of damage control resuscitation and damage control surgery.
32.
Morrison CA, Carrick MM, Norman MA, et al. Hypotensive resuscitation strategy reduces transfusion requirements and severe postoperative coagulopathy in trauma patients with hemorrhagic shock: preliminary results of a randomized controlled trial. J Trauma Acute Care Surg. 2011;70:652–63.CrossRef
33.
Domino KB, Posner KL, Caplan RA, Cheney FW. Awareness during anesthesia: a closed claims analysis. Anesthesiology. 1999;90:1053–61.PubMedCrossRef
34.
Schneider G. Intraoperative awareness. Anasthesiol Intensivemed Notfallmed Schmerzther. 2003;38:75–84.CrossRef
35.
Radovanovic D, Radovanovic Z. Awareness during general anaesthesia: implications of explicit intraoperative recall. Eur Rev Med Pharmacol Sci. 2011;15:1085–9.PubMed
36.
Borzova V, Smith C. Monitoring and prevention of awareness in trauma anesthesia. Internet J Anesthesiol 2009;23.
37.
American Society of Anesthesiologists Task Force on Intraoperative Awareness. Practice advisory for intraoperative awareness and brain function monitoring. Anesthesiology. 2006;104:847–64.CrossRef
38.
Hofstetter C, Boost A, Flondor M, et al. Anti-inflammatory effects of sevoflurane and mild hypothermia in endotoxemic rats. Acta Anaesthesiol Scand. 2007;51:893–9.PubMedCrossRef
39.
Lee JJ, Li L, Jung HH, Zuo Z. Postconditioning with isoflurane reduced ischemia-induced brain injury in rats. Anesthesiology. 2008;108:1055–62.PubMedCentralPubMedCrossRef
40.
Lee HT, Emala CW, Joo JD, Kim M. Isoflurane improves survival and protects against renal and hepatic injury in murine septic peritonitis. Shock. 2007;27:373–9.PubMedCrossRef
41.
Reutershan J, Chang D, Hayes JK, Ley K. Protective effects of isoflurane pretreatment in endotoxin-induced lung injury. Anesthesiology. 2006;104:511–7.PubMedCrossRef
42.
Head BP, Patel P. Anesthetics and brain protection. Cur Opin Anaesthesiol. 2007;20:395–9.CrossRef
43.
Beck-Schimmer B, Breitsenstein S, Urech S, et al. A randomized controlled trial on pharmacological preconditioning in liver surgery using a volatile anesthetic. Ann Surg. 2008;248:909–18.PubMedCrossRef
44.
Julier K, da Silva R, Garcia C, et al. Preconditioning by sevoflurane decreases biochemical markers for myocardial and renal dysfunction in coronary artery bypass surgery: a double-blinded, placebo-controlled, multicenter study. Anesthesiology. 2003;98:1315–27.PubMedCrossRef
45.
DeHert SG, Turani F, Mathur S, Stowe DF. Cardioprotection with volatile anesthetics: mechanisms and clinical implications. Anesth Analg. 2005;100:1584–93.CrossRef
46.
deVasconcellos K, Sneyd JR. Nitrous oxide: are we still in equipoise? A qualitative review of current controversies. Br J Anaesth. 2013;111:877–85.CrossRef
47.
Enlund M, Endmark L, Revenas B. Is nitrous oxide a real gentlemen? Acta Anesthesiol Scand. 2001;944:922–3.CrossRef
48.
Myles PS, Leslie K, Chan MT, et al. Avoidance of nitrous oxide for patients undergoing major surgery: a randomized controlled trial. Anesthesiology. 2007;107:221–31.PubMedCrossRef
49.
Reitsma S, Slaaf DW, Vink H, van Zandvoort MA, Oude Egbrink MG. The endothelial glycocalyx: composition, functions, and visualization. Pflugers Arch. 2007;454:345–59.PubMedCentralPubMedCrossRef
50.
Sisak K, Soeyland K, McLeod M, et al. Massive transfusion in trauma: blood product ratios should be measured at 6 hours. ANZ J Surg. 2012;82:161–7.PubMedCrossRef
51.
Forsythe SM, Schmidt GA. Sodium bicarbonate for the treatment of lactic acidosis. Chest. 2000;117:260–7.PubMedCrossRef
52.
• Dutton RP. Resuscitative strategies to maintain homeostasis during damage control surgery. Br J Surg. 2011;99:21–8. A thorough review discussing the concept of damage control resuscitation.
53.
Johansson PI, Stensballe J, Rasmussen LS, Ostrowski SR. A high admission syndecan-1 level, a marker of endothelial glycocalyx degradation, is associated with inflammation, protein C depletion, fibrinolysis, and increased mortality in trauma patients. Ann Surg. 2011;254:194–200.PubMedCrossRef
54.
Johansson PI, Stensballe J, Rasmussen LS, Ostrowski SR. High circulating adrenaline levels at admission predict increased mortality after trauma. J Trauma Acute Care Surg. 2012;72(2):428–36.PubMed
55.
Ostrowski SR, Sorensen AM, Larsen CF, Johansson PI. Thrombelastography and biomarker profiles in acute coagulopathy of trauma: a prospective study. Scand J Trauma Resusc Emerg Med. 2011;19:64.PubMedCentralPubMedCrossRef
56.
Johansson PI, Ostrowski SR. Acute coagulopathy of trauma: balancing progressive catecholamine induced endothelial activation and damage by fluid phase anticoagulation. Med Hypotheses. 2010;75:564–7.PubMedCrossRef
57.
• Holcomb JB. A novel and potentially unifying mechanism for shock induced early coagulopathy. Ann Surg 2011;254:201–2. Excellent paper describing the pathophysiology of shock and coagulopathy.
58.
DeBlasi RA, Palmisani S, Boezi M, et al. Effects of remifentanil-based general anesthesia with propofol or sevoflurane on muscle microcirculation as assessed by near-infrared spectroscopy. Br J Anaesth. 2008;101:171–7.CrossRef
59.
Brookes ZLS, Brown NJ, Reilly CS. The dose-dependent effects of fentanyl on rat skeletal muscle microcirculation in vivo. Anesth Analg. 2003;96:456–62.PubMed
60.
61.
Lin JY, Hung LM, Lai LY, Wei FC. Kappa-opioid receptor agonist protects the microcirculation of skeletal muscle from ischemia reperfusion injury. Ann Plast Surg. 2008;61:330–6.PubMedCrossRef
62.
Puana R, McAllister RK, Hunter FA, Warden J, Childs EW. Morphine attenuates microvascular hyperpermeability via a protein kinase A-dependent pathway. Anesth Analg. 2008;106:480–5.PubMedCrossRef
63.
Holcomb JB, Pati S. Optimal trauma resuscitation with plasma as the primary resuscitative fluid: the surgeon’s perspective. Hematology Am Soc Hematol Educ Progr. 2013;2013:656–9.CrossRef
64.
• Tobin JM, Grabinsky A, McCunn M, et al. A checklist for trauma and emergency anesthesia. Anesth Analg 2013;117:1178–84. Describes the use of a checklist to prepare for and administer trauma anesthesia.
65.
• Shere-Wolfe RF, Galvagno SM, Grissom TE. Critical care considerations in the management of the trauma patient following initial resuscitation. Scand J Trauma Resusc Emerg Med 2012;20:1–15. An excellent overview of post-resuscitation critical care.
Metadaten
Titel
Choice of General Anesthetics for Trauma Patients
verfasst von
Robert A. Sikorski
A. Ken Koerner
L. Yvette Fouche-Weber
Samuel M. Galvagno Jr.
Publikationsdatum
01.09.2014
Verlag
Springer US
Erschienen in
Current Anesthesiology Reports / Ausgabe 3/2014
Elektronische ISSN: 2167-6275
DOI
https://doi.org/10.1007/s40140-014-0066-5

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